The vicious cycle of physical inactivity, fatigue and kinesiophobia in patients with fibromyalgia syndrome.

This study aims to determine the association between fatigue, kinesiophobia, disease severity, and physical inactivity by comparing fibromyalgia syndrome (FMS) patients with healthy controls. Pain and fatigue are significant barriers to the participation in functional activities. Inactivity is a result of fatigue, but exercise is the foundation of FMS treatment. This case-control study included a total of 203 participants (107 patients with FMS and 96 healthy volunteers). The fibromyalgia impact questionnaire, the fatigue severity scale, the international physical activity questionnaire, and the Tampa scale for kinesiophobia were assessed. The FMS group scored significantly higher on the fatigue severity scale and kinesiophobia than the control group (p<0.001). Significantly lower metabolic task equivalent (MET) scale values were observed in the FMS group compared to the control group (p<0.001). The severity of fatigue and kinesiophobia correlated positively with the FMS impact questionnaire (p=0.001, r=0.621) and negatively with the MET scale (p=0.009, r= -0.287). Patients with FMS experience greater fatigue, kinesiophobia, and inactivity. As the severity of FMS worsens, so do disability, kinesiophobia, and fatigue. This study highlights the importance of breaking the cycle of fatigue and inactivity in the treatment of FMS.

Cribriform Morphology in Gleason Score 3+4 Moderate-Risk Prostate Cancer: Is it Risk Factor for Biochemical Recurrence?

Objective: Studies have reported that the cribriform morphology observed in prostate biopsy is associated with increased up-staging, upgrading, positive surgical margins and aggressive prognosis after radical prostatectomy. In our study, we aimed to evaluate the relationship between cribriform morphology and biochemical recurrence in patients with moderate-risk localized PCa with a Gleason score of 3+4 (ISUP grade 2) after radical prostatectomy. Methods: Datas of 177 patients in the moderate-risk group who were evaluated as ISUP grade 2 after radical prostatectomy were retrospectively evaluated. Patients were divided into 2 groups as without (Group 1) and with biochemical recurrence (Group 2). Age, preoperative PSA level, T stage, follow-up time and presence of cribriform morphology in both groups were evaluated and compared. Results: The mean preoperative serum total PSA level (group 1: 8.2 ± 3.9 and group 2: 11.9 ± 4.7) and presence of cribriform morphology (group 1: 25 (16%) and group 2: 9 (42%)) was significantly higher in group 2 (p = 0.001 and p = 0.007, respectively). According to the results of univariate and multivariate logistic regression analysis, preoperative serum total PSA level and pres-ence of cribriform morphology were found to be independent risk factors for biochemical recurrence (OR: 4,4; %95 Cl: 1,6-11,7; p=0.003 and OR: 4,7; %95 Cl: 1,7-13,1; p=0,003, respectively). Conclusion: Cribriform morphology of PCa is a risk factor for biochemical recurrence in patients with moderate risk and GS 3+4. In this respect, individualizing PCa cases accompanied by cribriform morphology from other Gleason Score 3+4 cases seems to be an appropriate approach (AU)

DO ANDROGENS PREDICT CARDIOVASCULAR RISK INCLUDING CARDIOTROPHIN-1 LEVELS in PATIENTS WITH OBESE and LEAN POLYCYSTIC OVARY SYNDROME.

Introduction: We aimed to investigate Cardiotrophin-1 (CT-1) levels along with other markers of cardiovascular disease and the association of androgen levels with these parameters in both lean and overweight or obese PCOS patients. Material and Methods: The study included 90 overweight or obese PCOS patients with metabolic syndrome (MS) and 80 lean PCOS patients without MS. The control group consisted of 140 healthy females. Anthropometric measurements, plasma glucose, insulin, lipid and hormone profile, homocysteine, hs-CRP, CT-1 levels and carotid-IMT were evaluated in all study subjects. Results: Fasting insulin, HOMA values were significantly higher in obese PCOS patients. Total testosteron levels were higher in both PCOS groups with respect to both controls. Serum homocysteine, hs-CRP, CT-1 and carotid-IMT values were significantly higher in both PCOS groups compared to controls (p=0.001, pCIMT: 0.005). CT-1 was positively correlated with insulin, HOMA, total testosterone, homocysteine, hs-CRP and carotid IMT. After multiple regression analysis, CT-1 was significantly positively correlated with total testosterone, hs-CRP and carotid IMT. Conclusions: CT-1 was associated with other cardiovascular risk markers and its use as a cardiovascular risk marker might be suggested. Cardiovascular risk was increased even in lean PCOS patients without MS and it might be associated with elevated androgen levels.

Propofol Compared to Midazolam Sedation and to General Anesthesia for Percutaneous Microwave Ablation in Patients with Hepatic Malignancies: A Single-Center Comparative Analysis of Three Historical Cohorts.

PURPOSE: In percutaneous ablation procedures, periprocedural pain, unrest and respiratory concerns can be detrimental to achieve a safe and efficacious ablation and impair treatment outcome. This study aimed to compare the association between anesthetic technique and local disease control in patients undergoing percutaneous microwave ablation (MWA) of colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC). MATERIALS AND METHODS: This IRB-exempted single-center comparative, retrospective analysis of three cohorts analyzed 90 patients treated for hepatic malignancies from January 2013 until September 2018. The local tumor progression-free survival (LTPFS), safety and periprocedural pain perception were assessed using univariate and multivariate Cox proportional hazard regression analyses to correct for potential confounders. RESULTS: In 114 procedures (22 general anesthesia; 32 midazolam; 60 propofol), 171 liver tumors (136 CRLM; 35 HCC) were treated with percutaneous MWA. Propofol and general anesthesia were superior to midazolam/fentanyl sedation regarding LTPFS (4/94 [4.3%] vs. 19/42 [45.2%] vs. 2/35 [5.7%]; P < 0.001, respectively). Local tumor progression rate was 14.6% (25/171). Eighteen tumors (72.0%) were retreated by ablation. Of them, 14 (78%) were previously treated with midazolam. Propofol versus midazolam (P < 0.001), general anesthesia versus midazolam (P = 0.016), direct postprocedural visual analog pain score above 5 (P = 0.050) and more than one tumor per procedure (P = 0.045) were predictors for LTPFS. Multivariate analysis revealed that propofol versus midazolam (HR 7.94 [95% CI 0.04-0.39; P < 0.001]) and general anesthesia versus midazolam (HR 6.33 [95% CI 0.04-0.69; P = 0.014]) were associated with LTPFS. Pain during and directly after treatment was significantly worse in patients who received midazolam sedation (P < 0.001). CONCLUSIONS: Compared to propofol and general anesthesia, midazolam/fentanyl sedation was associated with an increased periprocedural perception of pain and lower local tumor progression-free survival. To reduce the number of repeat procedures required to eradicate hepatic malignancies, general anesthesia and propofol sedation should be favored over midazolam.

Clinical Success of Fiber-reinforced Composite Resin as a Space Maintainer.

INTRODUCTION: The early loss of deciduous molars is a frequently encountered problem in dentistry. Various space maintainer designs were developed to prevent the loss of the space. The aim of this study was to evaluate long-term clinical performance and survival rates of fiber-reinforced composite resin (FRCR) as a space maintainer clinically. MATERIALS AND METHODS: This study was designed on 44 children who had early missed deciduous molars. Space maintainers were prepared on plaster models of patients and fixed directly to the adjacent teeth. Survival rate and whether it causes any damage to adjacent teeth were examined clinically and radio-graphically for 24 months or until failure. Kaplan-Meier survival analysis was used for the statistical analyses. RESULTS: Overall, 16.2% of space maintainers were dislodged and accepted to be failed at the end of 12 months. At the 24-month control, 52.2% success was stated with the FRCR space maintainer and because of permanent tooth eruption, 31.8% of space maintainer were taken out. The mean duration of space maintainers was measured to be 14.8 ± 3.48 months. There was no statistical significance between survival time and gender, tooth number, localization, and measured space (p > 0.05). CONCLUSION: After all 24 months follow-up, as well as esthetic properties of FRCR space maintainer, their applicability in a single seance and strength against the forces are determined as the advantages of the technique. CLINICAL SIGNIFICANCE: The FRCR space maintainers can be thought of as alternatives to metal space maintainers.

Polymorphisms of eNOS, catalase, and myeloperoxidase genes in prostate cancer in Turkish men: preliminary results.

Prostate cancer (PCa) is the most common type of neoplasm in European males. Genetic and epigenetic factors contribute to PCa development and progression. In this study, we aimed to assess the relationship between PCa and polymorphisms in the genes encoding endothelial nitric oxide synthase (eNOS), catalase (CAT), and myeloperoxidase (MPO). In total, 193 patients were included in the study. Patients were divided into three groups: PCa (78), benign prostate hyperplasia (40), and control males (75). The parameters assessed included body mass index (BMI), smoking habits, presence of prostatism, prostate-specific antigen (PSA) levels, Gleason scores of prostate specimens, as well as polymorphisms in eNOS-G894T, CAT- 262T, and MPO G-463T genes. BMI and smoking status of controls and patient groups showed no significant difference. CAT-262T gene polymorphism was found to be homozygous in 35.4% of PCa patients, which was 4.02-fold that in the controls (P = 0.006). There was no statistically significant difference in eNOS-G894T and MPO G-463T gene polymorphisms between any of the groups. In conclusion, we found catalase levels to be associated with PCa diagnosis and PSA value. We did not find any significant differences between groups for other polymorphisms, but we believe that further studies with a large sample size may be needed before drawing definite conclusions.

Prognostic factors effective on survival of patients with glioblastoma: Anadolu Medical Center experience.

AIM: The aim of this study is to offer survival following radiation therapy using intensity-modulated radiotherapy or volumetric arc therapy with temozolomide in patients with glioblastoma. MATERIALS AND METHODS: Ninety-two previously treated patients with high-grade glioma (World Health Organization [WHO] grade IV) were studied in Anadolu Medical Center, Department of Radiation Oncology, between January 2006 and July 2015. The diagnosis was established by pathology in all cases. The median age was 59 years (range, 19-86 years). The median tumor diameter was 45 mm, and the rate of the multicentric tumors was 16.3%. The location of the tumor was temporal in 33.7%, parietal in 14.1%, frontal in 23.9%, occipital in 9.8%, and others in 18.5%. The gross total and subtotal resection were performed in 60.9% of the patients, partial resection in 26.1%, and only stereotactic biopsy in 13.0% of the patients. RESULTS: The median overall survival (OS) was 33.01 ± 4.76 months (95% confidence interval 25.64-40.38 months). 1, 2, and 5 years OS was 74.3%, 44.3%, and 31.8%, respectively. The median progression-free survival (PFS) was 27.36 ± 3.87 months (95% confidence interval 19.82-34.89 months). 1, 2, and 5 years PFS was 62.7%, 32.6%, and 27.2%, respectively. On univariate analysis, gender, extent of surgery, tumor size, Karnofsky performance status, and tumor suppressor gene (P53) were significant predictors of OS and PFS. On multivariate analysis, gender (PFS: P = 0.006, OS: P = 0.003), extent of surgery (PFS: P = 0.004, OS: P = 0.012), P53 (PFS: P = 0.003, OS: P = 0.021), and size of tumor (PFS: P = 0.005, OS: 0.012) remained significantly associated with PFS and OS. There is no statistically significant in OS and PFS between female and male (OS: log-rank: 0.79 P = 0.375, PFS: log-rank: 0.54 P = 0.465). PSF and OS were not significantly significant with total/near total resection compared with partial resection (PSF: P = 0.46 log-rank = 0.54, OS: P = 0.340 log-rank = 0.91). Patients with P53 <50% value and patients with P53 >50% value were compared and results were not found statistically significant (PSF: P = 0.917 log-rank = 0.01, OS: P = 0.892 log-rank = 0.02). For patients with tumor size <0 mm, small tumor size did not improve the PSF and OS (PSF: P = 0.291 log-rank = 1.11, OS: P = 0.288 log-rank = 1.13). CONCLUSION: Ninety-two previously treated patients with high-grade glioma (WHO Grade IV) were evaluated with multivariate analysis. Gender, extent of surgery, P53, and tumor size were found as prognostic factors affecting on survival.

Relationship of Interleukin-10 and Transforming Growth Factor-ß Levels With Short-Term Graft Function After Kidney Transplantation.

INTRODUCTION: We evaluated the relationship of interleukin-10 (IL-10) and transforming growth factor-ß (TGF-ß) levels with graft function in kidney transplantation patients receiving tacrolimus-based immunosuppression during the early post-transplantation period. MATERIAL AND METHODS: There were 112 patients who underwent kidney transplantation from live donors between May 2011 and May 2013. Eight patients had at least 1 of the exclusion criteria, and the remaining 104 patients were included in the study. The recipients underwent evaluation for biochemical markers, complete blood count, and creatinine and cytokine (IL-10, TGF-ß) levels during the pretransplantation and post-transplantation 6 months. RESULTS: The creatinine level was negatively correlated with IL-10 and positively correlated with TGF-ß levels in both the pretransplantation and early post-transplantation period. CONCLUSION: Low serum TGF-ß and high IL-10 levels at post-transplantation month 6 might have a positive effect on graft survival in living donor kidney recipients on tacrolimus-based immunosuppressive treatment.

Assessment of body image perception in patients undergoing laparoscopic nephrectomy.

AIM: Aim of the study was to evaluate body image perception (BIP) in patients undergoing laparoscopic nephrectomy (LN), comparing with open nephrectomy (ON). METHODS: LN had been performed on 36 (51%) patients, ON had been applied to 34(49%). At the preoperative and postoperative 3rd month, body dysmorphic disorder scale (BDDS) has been applied to patients in order to measure body image change. BDDS has been filled by posing questions to patient. RESULTS: The BDDS score in the postoperative period in patients in whom LN was performed has been higher in proportion to the preoperative period, and BIP has been bad (BDDS score=19.66 ± 6.08 and 15.22 ± 4.78, P=0.00, respectively). The mean BDDS points of patients in the group of ON at the preoperative and postoperative 3rd month have been 16.50 ± 7.04 and 24.23 ± 7.32, respectively. In the group of ON, BIP has been impairing in the post-operative period (P=0.000). There has been no statistically significant difference between LN and ON groups in terms of the pre-operative mean BDDS score (P=0.78). However, the mean BDDS score has been significantly lower in LN group at the postoperative 3rd month, and BIP has been better (P=0.01). A significant negative correlation has been detected between age and body image (P=0.001, r=-0.388). CONCLUSION: Although incisions in LN are smaller, BIP is impairing in the post-operative period. However, when compared to open surgery, BIP has been determined to be better. A significant correlation has been present between age and body image. LN is a more trustworthy surgical method particularly in young patients in terms of BIP too.

The effect of Glutathione-S-transferases in the susceptibility to bladder cancer.

BACKGROUND: Urinary bladder cancer is a quite common cancer type in men and women all over the world. Genetic polymorphisms of xenobiotic-metabolizing enzymes could increase individual susceptibility to various cancer types. AIMS: The aim of our study is to evaluate the rate of these polymorphisms in a group of patients from Central Anatolia. METHODS: Our study subjects consist of 65 men with histopathologically confirmed bladder TCC and 70 cancer-free control subjects. Restriction fragment length polymorphism (RFLP) method was used for the detection of polymorphisms of GSTT1 and GSTM1. RESULTS: There was no association between bladder cancer and GSTM1 polymorphism (ORs = 0.64, 95% CI = 0.32-1.29), but the probability of bladder cancer in patients with GSTT1 null genotype (67.9%), was significantly higher from the probability of bladder cancer with GSTT1 normal genotype (43.0%) statistically (ORs = 2.8, 95% CI = 1.16-6.75). CONCLUSION: Polymorphisms of these genes have been assessed to evaluate the relative risk of various cancers. Our intention is to continue this study with larger series of bladder cancer patients in a group of Turkish population from Central Anatolia.

The role of National Institutes of Health category IV prostatitis in accurately staging the newly diagnosed prostate cancer.

BACKGROUND: It has been known that the National Institutes of Health category IV (NIH-IV) prostatitis increases the serum total prostate-specific antigen (tPSA) in patients with benign prostatic hyperplasia. However, the effect of NIH-IV prostatitis on tPSA levels, which are used for staging prostate cancer (PCa) in patients with PCa, has not been previously investigated. AIM: To evaluate the effect of NIH-IV prostatitis on the tPSA which is used for staging PCa in patients with newly diagnosed PCa. METHOD: A total of 198 patients in whom PCa was detected were included in the study. Group 1 included patients with only PCa, while Group 2 included patients with prostatitis and PCa. The tPSA levels of patients in Groups 1 and 2 were compared. RESULTS: A total of 120 (61%) PCa (Group 1) and 78 (39%) PCa+NIH-IV prostatitis (Group 2) patients were identified. The tPSA levels of 70 (58%) patients in Group 1 and 22 (28%) patients in Group 2 were at the interval of <20 ng/ml (the mean levels of tPSA: 11.8±4.5 and 14.1±3.3, respectively). The tPSA levels of 50 (42%) patients in Group 1 and 56 (72%) patients in Group 2 were within the range of ≥20 ng/ml (the mean levels of tPSA: 39.9±31.0 and 47.0±29.2, respectively). Within both the <20 ng/ml range and ≥20 ng/ml range, the mean tPSA value in Group 2 was found to be significantly higher than that of Group 1 (p=0.03 and 0.01, respectively). CONCLUSION: The existence of NIH-IV prostatitis together with cancer in patients with PCa significantly increases the tPSA level which is used in staging the PCa.

Frequency of alterations in the MEFV gene and clinical signs in familial Mediterranean fever in Central Anatolia, Turkey.

Familial Mediterranean fever is a recessive autoinflammatory disease that is frequent in Armenians, Jews, Arabs, and Turks. The MEFV gene is responsible for this disease. We looked for MEFV gene variations (polymorphism and mutations) in a population that resides in Central Anatolia, Turkey. DNA was extracted from peripheral blood leukocytes of 802 familial Mediterranean fever patients. The DNA sequence data were examined for approximately 150 different mutations and polymorphisms, including single nucleotide polymorphisms in different exons of the MEFV gene. The male:female ratio of these patients was 1.44:1. Mutations were detected in 48.1% of the patients; 7.5% were homozygous, 11.1% were compound heterozygous and 31.5% had only one identifiable mutant allele. No mutations were detected in 51.9% of the patients. The main clinical characteristics of the patients were: abdominal pain in 20.6%, arthritis in 22.9% and amyloidosis in 4.6%. Sixty-six percent of patients had a family history of familial Mediterranean fever; 19.4% of the patients were found to have parental consanguinity. We conclude that the genetics of familial Mediterranean fever is more complex than has previously been reported; heterozygous patients presenting a severe phenotype should be further analyzed for less common secondary MEFV mutations, using gene sequencing.

Immunohistochemical characterization of perineal melanoma in Kilis goats.

We describe the clinical, histopathological and immunohistochemical features of the malignant melanomas in the perineal regions of Kilis goats from Sanliurfa province in Turkey. We studied 13 female Kilis goats between 3 and 8 years old that were brought to Harran University Veterinary School, Department of Surgery, between 2002 and 2010. By macroscopic examination, the masses were determined to have elastic consistency, dark brown-black color, necrotic surfaces and ulceration. Microscopically, pleomorphic cells were observed under the basal layer and these advanced toward the dermis. These cells were polyhedral, round or spindle-shaped, anaplastic, and their cytoplasm contained varying amounts of dark brown-black pigments. Immunohistochemical staining was obtained with anti-melan A, vimentin and S100 antibodies.

The azoospermia factor locus-c region was found to be related to Klinefelter syndrome in Turkish patients.

We looked for a possible association between Klinefelter syndrome (KFS) and microdeletions in the Y chromosome in Turkish KFS patients. We examined the frequency of KFS in male patients with proven non-obstructive azoospermia and the types of Y chromosome microdeletions in these KFS patients. Fifty azoospermic patients and 50 fertile men were included in this study. KFS was found in 14 azoospermic patients. Y chromosome microdeletions were found in eight KFS patients. Azoospermia factor locus c (AZFc) was the most commonly deleted interval in KFS patients. All KFS patients had elevated plasma follicle-stimulating hormone and luteinizing hormone concentrations, but they had normal plasma testosterone concentrations. Testis biopsy of five samples with Y microdeletions revealed Sertoli cell-only syndrome. No Y microdeletions were found in the fertile group. We concluded that there could be an association between the AZFc region and KFS. Screening for this should be part of diagnostic work-up, particularly in those considering assisted reproduction.

Genetic anomalies in patients with severe oligozoospermia and azoospermia in eastern Turkey: a prospective study.

Infertility is defined as the inability to conceive a child after one year of regular unprotected intercourse; it is a major health problem affecting about 10-15% of all couples. Infertility is due to a male factor in approximately 50% of cases. The human Y chromosome contains genes necessary for gonadal differentiation into a testis and genes for complete spermatogenesis. We examined the frequency and type of both chromosomal abnormalities and Y chromosome microdeletions in 90 patients with severe male factor infertility and 75 fertile control men. Thirty of the infertile patients had nonobstructive azoospermia, 30 had oligozoospermia and 30 had normozoospermia. Five of 30 were azoospermic, four of 30 were oligozoospermic and two of 30 were normozoospermic with Y chromosome microdeletions. The AZFc locus was the most frequently deleted region (64%). Ten cases with azoospermia, four cases with oligozoospermia and four cases with normozoospermia had chromosomal abnormalities. The 75 men with proven fertility were genetically normal. We conclude that various chromosomal abnormalities and deletions of the Y chromosome can cause infertility; therefore, genetic screening is indicated for infertile patients.

Evaluation of reticulocyte parameters in iron deficiency, vitamin B(12) deficiency and beta-thalassemia minor patients.

The aim of this study was to test the clinical utility of reticulocyte parameters in differential diagnosis in iron deficiency anemia (IDA), vitamin B(12) deficiency (B12) and beta-thalassemia minor (TM). We analyzed the percentage of reticulocyte, absolute reticulocyte count, mean content hemoglobin of reticulocyte (CHr), mean corpuscular volume of reticulocyte (MCVr), corpuscular hemoglobin concentration mean of reticulocyte (CHCMr), MCVr/MCV ratio, CHr/CH ratio and CHCMr/CHCM ratio in healthy donors (n = 34), iron deficiency (IDA) (n = 41), vitamin B(12) deficiency (B12) (n = 22), and TM (n = 34). This study demonstrates that the cutoff value of CHr was 25.7 as indicative of IDA (85.4% sensitivity, 97.1% specificity). CHr and MCVr may be useful for TM (cutoff value < or = 24.8 for CHr) and B12 (>102.1, cutoff value for MCVr), respectively. Sensitivity and specificity of these parameters were 90.9, 86.4% and 97.1, 82.4%, respectively. CHCMr is useful to differentiate IDA and TM from B12. While CHr was low value in microcytic groups (mean 21.8 +/- 3.3 for IDA, 21.0 +/- 2.9 for TM), it was high in B12 (mean 32.1 +/- 5.7). However, that of CHr/CH ratio was only significantly in IDA group compared with the control (P < 0.05, mean 0.98). Therefore, there are limitations regarding CHr and CHr/CH ratio differential diagnosis in microcytic and macrocytic groups. CHr, MCVr, and CHCMr are not sufficiently sensitive and specific to differentiate TM from IDA. We conclude that measurement of reticulocyte count and parameters may be a very useful implement in the diagnosis of IDA and TM.

Two cases of acneiform eruption induced by inhibitor of epidermal growth factor receptor.

BACKGROUND: Cetuximab is a member of a new family of antineoplastic agents that inhibit the epidermal growth factor receptor (EGF-R), and which are increasingly being used in the treatment of solid tumors. METHODS: We have observed new secondary side effects. We present here 2 patients with acneiform eruption secondary to the administration of cetuximab (IMC-C225, Erbitux). The diagnoses of these patients were adenocarcinoma. RESULTS: Histologically, a superficial purulent folliculitis and disordered differentiation with focal parakeratosis were observed. The follicular eruption responded favorably to treatment with 5% benzoyl peroxide and 4% erythromycin gel. These lesions healed within a few days after treatment. CONCLUSION: The cutaneous adverse effects of cetuximab are similar to other EGF-R-targeted agents and result from direct interference with the functions of EGF-R signaling in the skin.

Effects of tiletamine-zolazepam anaesthesia on plasma antioxidative status and some haematological parameters in sheep.

It is not clear whether the anaesthetic agents tiletamine and zolazepam have antioxidant or pro-oxidant effects. Therefore, this study was carried out to investigate the effects of tiletamine-zolazepam anaesthesia on oxidant/antioxidant status in blood plasma and on haematological parameters in 10 healthy Awassi ewes. The tiletamine-zolazepam combination was administrated in a dose of 7.5 mg/kg intramuscularly. The animals were spontaneously breathing air during the procedure. Blood samples were collected by jugular venipuncture before induction and at 30, 60, 120 min, 24 h and 3 days after anaesthesia. Malondialdehyde concentration, an index of lipid peroxidation, was higher at 30, 60, 120 min and 24 h (P < 0.05) than the baseline value in the plasma. The level of glutathione decreased (P < 0.05) at 30, 60 and 120 min, then returned to the baseline level. Beta-carotene concentration was lower (P < 0.05) than the baseline value during anaesthesia with the exception of its level at 120 min. Glutathione peroxidase and catalase activities decreased (P < 0.05) at the onset of anaesthesia, then returned to baseline values. There was no significant change in vitamin A level. Red blood cell count, haematocrit and haemoglobin concentration significantly decreased (P < 0.05) only at 30 min and thereafter they gradually returned to the baseline values. Based on the results tiletamine-zolazepam anaesthesia seems to accelerate lipid peroxidation and to impair the enzymatic antioxidant defence in the blood plasma.

Assessment of rigid multi-modality image registration consistency using the multiple sub-volume registration (MSR) method.

Registration of different imaging modalities such as CT, MRI, functional MRI (fMRI), positron (PET) and single photon (SPECT) emission tomography is used in many clinical applications. Determining the quality of any automatic registration procedure has been a challenging part because no gold standard is available to evaluate the registration. In this note we present a method, called the 'multiple sub-volume registration' (MSR) method, for assessing the consistency of a rigid registration. This is done by registering sub-images of one data set on the other data set, performing a crude non-rigid registration. By analysing the deviations (local deformations) of the sub-volume registrations from the full registration we get a measure of the consistency of the rigid registration. Registration of 15 data sets which include CT, MR and PET images for brain, head and neck, cervix, prostate and lung was performed utilizing a rigid body registration with normalized mutual information as the similarity measure. The resulting registrations were classified as good or bad by visual inspection. The resulting registrations were also classified using our MSR method. The results of our MSR method agree with the classification obtained from visual inspection for all cases (p < 0.02 based on ANOVA of the good and bad groups). The proposed method is independent of the registration algorithm and similarity measure. It can be used for multi-modality image data sets and different anatomic sites of the patient.