Cognitive Disengagement Syndrome in Mothers of Children With Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: To examine the cognitive disengagement syndrome (CDS) symptoms of mothers of children with attention-deficit/hyperactivity disorder (ADHD). METHOD: The participants consisted of 223 mothers of children with ADHD, and data were collected using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5-CV), the Stroop Test (ST), the Barkley Adult SCT Scale (CDS), and the Adult ADHD Self-Report Scale (ASRS). RESULTS: The participants were divided into four groups based on psychopathology: the group without any psychiatric disorder, the group with only ADHD, the group with a psychiatric disorder other than ADHD, and the group with another psychiatric disorder along with ADHD. The group with any psychiatric disorder along with ADHD had the highest CDS scores, while the group without any psychopathology had the lowest CDS scores. CONCLUSION: CDS seems to be a construct associated with both ADHD and other internalizing disorders. Further studies are needed to shed more light on these relationships.

The Role of Childhood Trauma on Prenatal Attachment: A Cross-Sectional Study.

ABSTRACT: Although the quality of prenatal attachment is a strong predictor of the quality of postnatal mother-infant attachment and mother-child interaction, little is known about the specific impacts of maternal exposure to childhood traumas, and it deserves more attention. This study was conducted to determine whether there is a relationship between childhood traumas and pren1atal attachment levels. Prenatal attachment and childhood trauma were evaluated in 104 pregnant women using the Prenatal Attachment Scale and Childhood Trauma Questionnaire. Our results showed that all kinds of childhood traumatic experiences were associated with lower prenatal attachment scores. Also, more severe childhood traumas were strongly associated with weaker prenatal attachment. This study contributes to the very limited literature on the prenatal attachment of expectant mothers with childhood traumas by emphasizing the importance of pregnant women's exposure to childhood traumas as a risk factor for low prenatal attachment.

Executive Functions, Intellectual Capacity, and Psychiatric Disorders in Adults with Type 1 Chiari Malformation.

OBJECTIVE: Contrary to popular belief, the cerebellum is involved not only in motor planning, balance, and coordination but also in cognitive processes. The present study aimed to investigate executive functions (EFs), intellectual capacity, and psychiatric disorders in adults with type 1 Chiari malformation, which is defined as a hindbrain anomaly that involves the cerebellum. METHODS: The study included 62 adults, with 29 in the CM group and 33 in the control group. EFs were evaluated using the Stroop test, number sequence learning test, and standardized mini-mental state examination (SMMSE). The intelligence quotient (IQ) was measured using the Kent EGY and Porteus maze tests, and psychiatric disorders were evaluated using the Structured Clinical Interview for DSM-5, Clinician Version (DSM-5-CV). RESULTS: The CM group took longer than the control to complete the Stroop test for each section (P < 0.005). Although the mean IQ scores of both groups were within the normal range, the CM group had a lower mean IQ score than the control group (P < 0.005). Although the mean SMMSE scores of both groups were within the normal range, the CM group had a lower mean SMMSE score than the control group (P < 0.005). The CM group had a higher rate of psychiatric comorbidities than the control group (P < 0.005). CONCLUSIONS: The study found that subjects with type 1 Chiari malformation performed worse in EFs than healthy controls and had a higher prevalence of psychiatric disorders.

The relationship between chronotype, night eating behavior and fear of COVID-19 in academics.

Academics are an occupational group that works at an intense pace. The number of studies on chronotype and night eating behavior in academics is limited, and there is insufficient data on whether fear of COVID-19 is also a risk for developing eating disorders. This study aimed to investigate the relationship between chronotype and night eating syndrome (NES) and examine the influence of fear of COVID-19 on night eating behavior in academics. The study data were collected using the personal information form, "Morningness-Eveningness Questionnaire, The Night Eating Questionnaire (NEQ), and the Fear of COVID-19 Scale." According to the chronotypes of the academicians, it was determined that the score compatible with NES and the scores of the Fear of COVID-19 Scale differed statistically significantly, and the score compatible with NES and Fear of COVID-19 Scale scores were also higher in the evening type at a rate of 29.2% compared to other chronotypes (p < .05). The Fear of COVID-19 scale and Morningness-Eveningness Questionnaire scores were significantly correlated with the Night Eating Questionnaire (R = .391 R2 = .153 p < .05). The variables of the Fear of COVID-19 Scale and the Morningness-Eveningness Questionnaire explained 15% of the total variance of the Night Eating Questionnaire scores. Considering that academics are a group that works without the concept of overtime and whose work intensity is high, it is clear that studies should be conducted to raise awareness to protect the physical health of academics and prevent the development of eating disorders. There is a need for studies that question the relationship between chronotype, diet, and health.

Undergraduate nursing students' experiences of distance education during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to significant changes in the field of education, including not least of all the adoption of distance education, which nursing students have had limited experience with in Turkey. PURPOSE: This study aimed to determine the factors affecting nursing students' success in distance education and to evaluate their experiences during this process. METHODS: The study was designed as a descriptive, cross-sectional study and involved the participation of 454 nursing who were members of the Student Nurses Association in Turkey. An evaluation form for assessing students' sociodemographic and distance education-related characteristics and the Distance Education Assessment Questionnaire for Nursing Students (DEAQNS) were used for data collection. RESULTS: The students further reported that the main factors affecting the success of distance education were provision of preliminary information, proficiency level of technological software use, economic status, proficiency level of use of technological devices, and asynchronous learning. CONCLUSIONS: In order to increase the success of distance education, students need information on the protection of personal data and use of technological software and devices in the nursing curriculum.

High mobility group box-1 levels in schizophrenia: Potential biomarker of remission phase.

Background: Schizophrenia is a chronic mental disorder, characterized byacute exacerbation and remission phases. Immune system has a role in the pathophysiology of schizophrenia. High mobility group box-1 (HMGB-1) is a macrophage secreted protein activating immune cells to produce cytokines. The aim of this study was to evaluate HMGB-1 levels among patients with schizophrenia both in acute exacerbation and remission phases. Methods: Consecutive schizophrenia patients in acute exacerbation and remission phases were enrolled and compared with each other and with age-sex matched healthy subjects. Patients were assessed with the Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI). Results: Mean HMGB-1 levels were not significantly different in acute exacerbation phase versus remission phase schizophrenia patients (2.139±0.564 g/L vs. 2.326± 0.471 g/L, p=0.335) and both were individually higher than the control group (1.791±0.444 g/L, p=0.05 for acute exacerbation vs control, p=0.002 for remission vs control). In remission phase schizophrenic patients, HMGB-1 levels were positively correlated with Scale For The Assessment of Positive Symptoms (r=0.447, p=0.015) and BPRS (r=0.397, p=0.033) scores and HMGB-1 levels were independently associated with BPRS. Conclusions: Serum HMGB-1 levels were shown to be increased in patients with schizophrenia patients irrespective of phase, there were no differences between patients in acute exacerbation and remission phase in terms of biomarker and HMGB-1 levels were related to symptom severity according to psychiatric scales among patients in remission phase of schizophrenia.

Effects of hyaluronic acid-collagen nanofibers on early wound healing in vocal cord trauma.

BACKGROUND: Vocal cord scarring is the most crucial obstacle in voice quality after surgery. This study aimed to evaluate the effectiveness of hyaluronic acid (HA)-collagen nanofibers on the healing of vocal cords after surgical trauma. METHOD: Right vocal cords of 12 New Zealand white rabbits were traumatized, and the experimental group was received 1.08 mg/75 ml topical HA-collagen nanofiber (Gelfix® spray) for 3 days. Three animals in each group were sacrificed on the 7th day, and the remaining of the animals were sacrificed on the 21st day. The laryngeal specimens in the experimental and control groups were examined histopathologically. RESULT: The 7th-day H&E staining evaluation revealed pink, dense, and thin collagen fibers. Besides, the collagen content was scattered and irregular in the experimental group. The 21st-day assessment showed that the collagen bundles in the granulation tissue were almost with the same formation in both of the groups. Masson Trichrome staining on the 7th day of the study showed that the collagen fiber bundles were less frequent in the control group than the experimental group. The 7th-day Van Gieson staining analysis showed that the pattern of reticular fibers was more regular with the parallel formation in the experimental group than the control group. CONCLUSION: HA-collagen nanofiber can be used in diseases that impair voice quality due to the thickening of the lamina propria layer in the vocal cord and impaired viscoelasticity due to fibrosis after tissue trauma.

Fear, Anxiety, Burnout, and Insomnia Levels of Healthcare Workers during COVID-19 Pandemic in Turkey.

BACKGROUND: This study aims to assess fear, anxiety, anxiety sensitivity, burnout, and insomnia of healthcare workers (HCWs) during novel coronavirus-2019 (COVID-19) outbreak and to identify their relation to sociodemographic and clinical characteristics. SUBJECTS AND METHODS: Totally 600 HCWs were included in this cross-sectional study. A Sociodemographic Data Form, Coronavirus Anxiety Scale (CAS), Fear of COVID-19 Scale (FCV-19S), Anxiety Sensitivity Index-3 (ASI-3), Maslach Burnout Inventory (MBI), and Insomnia Severity Index (ISI) were used. RESULTS: Of participants, 364 were females and 236 were males with a mean age of 33.49±7.29 years. About 95.3% of HCWs had a fear of infecting their loved ones. Mean MBI and ISI scores were significantly higher among HCWs working in COVID-19 clinics and intensive care units (p=0.000; p=0.039). Mean CAS, FCV-19S, MBI, and ISI scores were significantly higher in women than men (p=0.000; p=0.000; p=0.027; p=0.005). Mean CAS and ISI scores were significantly higher among nurses (p=0.008; p=0.004), while mean ASI-3 of the other HCWs and MBI scores of physicians were significantly higher (p=0.009; p=0.000). CONCLUSION: The COVID-19 pandemic is a major health issue associated with psychiatric illnesses in HCW subgroups with distinct sociodemographic characteristics. It is of utmost importance to develop individualized preventive and therapeutic psychiatric services for HCWs.

The birth prevalence of selected major congenital anomalies: Six-year's experience in a tertiary care maternity hospital.

AIM: To evaluate the birth prevalence of specifically selected major congenital anomalies and to determine the correlated neonatal and maternal characteristics. MATERIAL AND METHODS: Data were collected retrospectively from hospital-based records of infants who were born at 22 completed weeks of gestation with a birth weight of more than 500 g in Zekai Tahir Burak Gynecology Training and Research Hospital between 2013 and 2018. Abortions, stillbirths, and terminated pregnancies due to fetal anomalies were excluded. Average annual prevalences were calculated for each selected major congenital anomaly. RESULTS: The total prevalence of congenital anomalies was 9.97 per 1000 in 102 379 live birth cohorts. The prevalence of severe congenital heart anomalies (SI-SII) was found as 21.1 per 10 000 live births. Down syndrome and meningomyelocele were the second and third most common anomalies, after congenital heart defects (13.87 and 9.97 per 10 000 live births, respectively). The prevalence of anomalies requiring specific surgery was found as 4.3 per 1000 live births. Congenital heart disease was present in 31.7% of patients who had Down syndrome. Atrioventricular septal defect accounted for 53.3% of congenital heart anomalies detected in Down syndrome. The prevalence of Down syndrome in babies of mothers aged 35 years and older was found as 46.67 per 10 000, which was significantly higher than in the group aged under 35 years (8.24 per 10 000). On the other hand, the prevalence of gastroschisis in babies of mothers aged 19 years and under was found as 5.81 per 10 000, which was higher than in the group aged 20 years and over (0.84 per 10 000). CONCLUSION: The actual magnitude of the number of births affected by congenital anomalies in Turkey is unknown. In our study, congenital heart diseases, Down syndrome, and meningomyelocele were found to be the most common congenital anomalies, respectively.

The effects of different packing materials on healing and hearing after trauma to middle ear mucosa, an experimental study in rats.

PURPOSE: To compare the performance of Spongostan, Otopore, Spongostan soaked with dexamethasone and Spongostan soaked with Hyaluronic acid (HA) as middle ear packing material after mucosal trauma. METHODS: Twenty rats were divided into 4 groups. In control group (group 1), the middle ear cavities of animals were bilaterally packed with Spongostan; in group 2, with Otopore; in group 3, with Spongostan soaked with dexamethasone; and in group 4, with Spongostan soaked with HA. Auditory brainstem responses (ABRs) were performed preoperatively and 1 and 6 weeks postoperatively. Histological analyses were performed to evaluate the inflammatory reaction and wound healing in the middle ear cavity. RESULTS: ABR recordings demonstrate that threshold level changes from baseline were minor in Otopore and Spongostan soaked with dexamethasone packed ears. Threshold levels were higher in the Spongostan and Spongostan soaked with HA packed ears compared with both Otopore and Spongostan soaked with dexamethasone packed ears. Histological analyses showed that Spongostan caused inflammation more intense than Otopore and Spongostan soaked with dexamethasone. Residual material at postoperative week 6, new bone formation and adhesion were common in the Spongostan group compared with other groups. Fibrosis was more common in Spongostan group compared with other groups but the difference was not significant. CONCLUSION: Otopore appears to be safe and effective for use in otologic surgery. The inflammation, adhesion and new bone formation decreased when Spongostan was used with steroid or HA, when compared to Spongostan alone.

Predicting Severe Sleep Apnea in Patients with Complaints: Pulse Oximetry and Body Mass Index.

OBJECTIVE: An adequate evaluation combined with an easily accessible test would be a useful way to direct the appropriate patients to sleep centers in circumstances with a limited opportunity for polysomnography (PSG). For this reason, it is necessary to use a screening method prior to PSG evaluation. The aim of the present study was to investigate whether the use of body mass index (BMI) and pulse oximetry is sufficient to predict the severity of obstructive sleep apnea syndrome (OSAS) without PSG. METHODS: A total of 956 patients who were admitted to a tertiary referral center with complaints of witnessed apnea, excessive daytime sleepiness, and previously performed PSG were included in the study. Data of PSG (included pulse oximetry) and BMI were investigated for the determination of cut-off points for parameters in the patients. RESULTS: Based on the presence of severe OSAS, the cut-off points were ≥31.7 kg/m2 for BMI, <81% for minimum oxygen saturation (Min O2), and ≥14.1 min for sleep time with oxygen saturation <90% (ST90). Severe OSAS risk was found to be higher in patients with BMI ≥31.7 kg/m2, ST90 ≥14.1 min, and Min O2 ≤81% than in those without (OR: 37.173; 95% CI: 22.465-61.510, p=0.001). Specificity and accuracy were 94.85% and 72.49%, respectively, when all three cut-off scores were provided. CONCLUSION: The appropriate cut-off values obtained from combining BMI and pulse oximetry data can provide accurate results for predicting the severity of OSAS.

Correlation of sleep-disordered breathing and laryngopharyngeal reflux: a two-channel triple-sensor pHmetry catheter study.

PURPOSE: To investigate the relationship between sleep-disordered breathing with gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) using a two-channel triple-sensor pHmetry catheter. METHODS: The study was carried out on a total of 34 people with complaints of snoring, witnessed apnea and daytime sleepiness. 24-h pH monitoring with a two-channel, triple-sensor antimony pH catheter was applied to individuals simultaneously with polysomnography (PSG) on the day they would sleep in the sleep laboratory. Obstructive sleep apnea syndrome (OSAS) severity and reflux grade were compared with each other. Data obtained from PSG and pHmetry results were numerically compared with each other. The relationship between apnea, hypopnea, and arousal periods and reflux episodes was then examined by overlaying pHmetry graphics for each patient. RESULTS: A total of 34 individuals (18 males-52.9% and 16 females-47.1%), age ranging from 27 to 71 years (mean 50.5 ± 11.0) participated in the study. GER was detected in 52.9% and LPR in 85.3% of the patients. In 35.3% of cases, pathologic GER was not observed despite LPR detection. No statistically significant relationship was found between the numerical values of apnea-hypopnea index (AHI) and arousal numbers and reflux parameters of individuals and between OSAS severity and LPR and GER (p > 0.05). There was no statistically significant correlation between respiratory events and reflux episodes with regard to timing (p > 0.05). CONCLUSION: The prevalence of GER and LPR is found to be high in patients with sleep-disordered breathing. There is no significant relationship between OSAS severity and GER and LPR grade or respiratory events and reflux episodes with regard to timing.

Effects of parenteral papaverine and piracetam administration on cochlea following acoustic trauma.

INTRODUCTION: Noise exposure, the main cause of hearing loss in countries with lot of industries, may result both in temporary or permanent hearing loss. The goal of this study was to investigate the effects of parenteral papaverine and piracetam administration following an acoustic trauma on hearing function with histopathologic correlation. MATERIALS AND METHODS: Eighteen Wistar albino rats exposed to noise for 8 h in a free environment were included. We divided the study population into three groups, and performed daily intraperitoneal injections of papaverine, piracetam, and saline, respectively, throughout the study. We investigated the histopathologic effects of cellular apoptosis on inner hair cells (IHCs) and outer hair cells (OHCs) and compared the distortion product otoacoustic emissions (DPOAEs) thresholds among the groups. RESULTS AND DISCUSSION: On the 3rd and 7th days, DPOAE thresholds at 8 kHz were significantly higher both in papaverine and piracetam groups compared with the control group (P = 0.004 for 3rd day, P = 0.016 and P = 0.028 for 7th day, respectively). On the 14th day, piracetam group had significantly higher mean thresholds at 8 kHz (P = 0.029); however, papaverine group had similar mean thresholds compared to the control group (P = 0.200). On the 3rd and 7th days following acoustic trauma, both IHC and OHC loss were significantly lower in both papaverine and piracetam groups. On the 7th day, the mean amount of apoptotic IHCs and OHCs identified using Caspase-3 method were significantly lower in both groups, but the mean amount identified using terminal deoxynucleotidyl transferase dUTP nick end labeling method were similar in both groups compared to the control group. CONCLUSION: We demonstrated the effects of papaverine and piracetam on the recovery of cochlear damage due to acoustic trauma on experimental animals using histopathologic and electrophysiologic examinations.

Ultrasound guided percutaneous central venous catheters in neonatal intensive care unit.

Ates U, Derme T, Yilmaz Y, Özkan-Ulu H, Canpolat FE. Ultrasound guided percutaneous central venous catheters in neonatal intensive care unit. Turk J Pediatr 2018; 60: 478-481. Central venous catheters can be life-saving, especially in very low birth weight and sick newborns for whom peripheral access is difficult. However, the placement of a central venous catheter is technically difficult, especially in premature and newborn infants. To demonstrate the efficacy of placement of central venous catheters under guidance of ultrasonography (US) in neonatal intensive care units. The patients who were hospitalized in newborn intensive care unit and central venous catheters were placed into the internal jugular vein under the guidance of US were analyzed retrospectively. Successful cannulation rate was 90.9% in patients. The rate of success at first attempt was 68.1% in patients. The rate of three and more attempts was 9.1% in patients. The rate of complication was 9.1% in patients. The average intervention time was 8 minutes in patients. Central venous cannulation under the guidance of two-dimensional US is an effective method which can be easily and safely applied to low birth weight premature and newborn infants in newborn intensive care units.

The Effects of MESNA on the Facial Nerve, an Experimental Animal Study.

OBJECTIVE: MESNA (Sodium-2-mercaptoethanesulfonate) is a mucolytic substance that is used for chemically assisted tissue dissection in various surgical operations. The aim of this study was to address the issue of possible neurotoxicity from topical administration of MESNA solution on the facial nerve. We used different concentrations of MESNA solution and evaluated their effects on facial nerve by histopathological and functional analysis. MATERIALS AND METHODS: These groups were the saline administered group (control) (3 rats, 6 facial nerves), the 25% MESNA solution group (3 rats, 6 facial nerves), and the 100% MESNA solution group (3 rats, 6 facial nerves). Under general anesthesia (ketamine 150 mg/kg, xylocaine 4 mg/kg), the bilateral facial nerves of rats were dissected. The saline, 25% MESNA, and 100% MESNA solutions. Facial nerve functions of the rats were evaluated using mustachewhisker and blink reflex scores at day 20 days. On day 20, the rats were sacrificed and the buccal and marginal mandibular branches of the facial nerve were removed. The specimens were examined in terms of inflammation, granulation tissue, and foreign body reaction formation around the nerve. The functional and histopathological changes on facial nerves were compared between groups. RESULTS: Mustache and blink reflex scores of the rats were 5 (normal) in both the control and study groups. There were no statistically significant differences between the three groups in terms of facial nerve functions (p=1.00). On histopathologic examination, the 25% and 100% MESNA groups had significantly more inflammation compared with the control group (p=0.038 and p=0.007, respectively). There were no statistically significant differences between the 25% and 100% MESNA groups in term of inflammation (p > 0.05). There were no statistically significant differences between the three groups in terms of foreign body reaction formation (p > 0.05). CONCLUSION: Topical administration of MESNA solution onto the facial nerve causes increased inflammation in both the 25% and 100% concentrations. Nevertheless, it does not cause any facial nerve dysfunction.

A Rare Complication of Chronic Otitis Media: Cerebellar Abscess.

Chronic otitis media (COM) and its associated complications are currently less common because of the popularity of imaging modalities such as computed tomography and magnetic resonance imaging and the increased use of antibiotics. Patients can be treated without any complications owing to early diagnosis. Despite all these new developments and opportunities, complications of autogenous cerebellar abscess may develop and be fatal. In this case report, we present our own clinical experience regarding a patient with cerebellar abscess as a complication of COM.

Incremento de la expresión de Bax (proapoptótico) y disminución de la expresión de Bcl-2 (antiapoptótico) en recién nacidos con enterocolitis necrosante / Increase in pro-apoptotic Bax expression and decrease in anti-apoptotic Bcl-2 expression in newborns with necrotizing enterocolitis

Antecedentes/Objetivo: El objetivo de este estudio fue determinar si se producía un incremento de la expresión de Bax (proapoptótico) y una disminución de la expresión de Blc-2A1 (antiapoptótico) en el intestino de los recién nacidos con enterocolitis necrosante. Materiales y métodos: Comparamos a ocho pacientes recién nacidos de manera consecutiva sometidos a resección intestinal debido a enterocolitis necrosante con ocho recién nacidos sometidos a resección intestinal debido a atresia ileal. La evaluación histopatológica de la lesión tisular y la apoptosis se realizó mediante microscopía óptica y el método TUNEL. El nivel de ARNm en los genes apoptóticos (CASP3, CASP6, CASP7, Bax, BIRC2) y antiapoptóticos se evaluó con el método de matriz de RCP (PCR array). La expresión de proteínas se evaluó mediante inmunohistoquímica. Resultados: Los puntajes de las lesiones tisulares y los puntajes medios de apoptosis fueron significativamente más altos en el grupo con enterocolitis necrosante en comparación con el grupo de referencia (p < 0,01). La expresión de los genes proapoptóticos aumentó significativamente en el grupo con enterocolitis necrosante frente al grupo de referencia (p < 0,01). La expresión del gen Bcl-2A1 (antiapoptótico) disminuyó significativamente en el grupo con enterocolitis necrosante (p < 0,01). La expresión de las proteínas Bax y CASP3 aumentó significativamente en el grupo con enterocolitis necrosante (p < 0,01). Conclusión: Según nuestros datos, la alteración del equilibrio entre la expresión de Bax (proapoptótico) y la expresión de Bcl-2A1 (antiapoptótico) en el lugar de la lesión es un posible mecanismo de la patogenia en recién nacidos que presentan enterocolitis necrosante.

Background/Aim. The aim of the present study was to find out if there is an increase in the expression of pro-apoptotic Bax and reduction in expression of anti-apoptotic Blc-2A1 in newborn intestines with necrotizing enterocolitis (NEC). Material and Methods. We compared 8 consecutive newborn patients undergoing bowel resection for NEC with 8 neonates undergoing intestinal resection for ileal atresia. Histopathological evaluation of tissue injury and apoptosis was performed by using light microscopic examination and TUNEL method. The mRNA level of apoptotic (CASP3, CASP6, CASP7, Bax, BIRC2) and anti-apoptotic genes were evaluated by PCR array method. Protein expression was assessed by immunohistochemistry. Results. Tissue injury scores and mean apoptosis scores were significantly higher in NEC group when compared with control group (p <0.01). Expression of pro-apoptotic genes were significantly increased in NEC group when compared with control group (p <0.01). Expression of anti-apoptotic Bcl-2A1 gene was significantly decreased in NEC group, (p <0.01). Protein expression of Bax and CASP3 was significantly increased in NEC group, (p <0.01). Conclusion. Our data in humannewborns suggest that alteration of the balance between pro-apoptotic Bax expression and anti-apoptotic Bcl-2A1 expression in the site of injury is a possible mechanism in the pathogenesis of NEC.

Increase in pro-apoptotic Bax expression and decrease in anti-apoptotic Bcl-2 expression in newborns with necrotizing enterocolitis. / Incremento de la expresión de Bax (proapoptótico) y disminución de la expresión de Bcl-2 (antiapoptótico) en recién nacidos con enterocolitis necrosante.

BACKGROUND/AIM: The aim of the present study was to find out if there is an increase in the expression of pro-apoptotic Bax and reduction in expression of anti-apoptotic Blc-2A1 in newborn intestines with necrotizing enterocolitis (NEC). MATERIALS AND METHODS: We compared 8 consecutive newborn patients undergoing bowel resection for NEC with 8 neonates undergoing intestinal resection for ileal atresia. Histopathological evaluation of tissue injury and apoptosis was performed by using light microscopic examination and TUNEL method. The mRNA level of apoptotic (CASP3, CASP6, CASP7, Bax, BIRC2) and anti-apoptotic genes were evaluated by PCR array method. Protein expression was assessed by immunohistochemistry. RESULTS: We compared 8 consecutive newborn patients undergoing bowel resection for NEC with 8 neonates undergoing intestinal resection for ileal atresia. Histopathological evaluation of tissue injury and apoptosis was performed by using light microscopic examination and TUNEL method. The mRNA level of apoptotic (CASP3, CASP6, CASP7, Bax, BIRC2) and anti-apoptotic genes were evaluated by PCR array method. Protein expression was assessed by immunohistochemistry. CONCLUSIONS: Our data in humannewborns suggest that alteration of the balance between pro-apoptotic Bax expression and anti-apoptotic Bcl-2A1 expression in the site of injury is a possible mechanism in the pathogenesis of NEC.

ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue determinar si se producía un incremento de la expresión de Bax (proapoptótico) y una disminución de la expresión de Blc-2A1 (antiapoptótico) en el intestino de los recién nacidos con enterocolitis necrosante. MATERIALES Y MÉTODOS: Comparamos a ocho pacientes recién nacidos de manera consecutiva sometidos a resección intestinal debido a enterocolitis necrosante con ocho recién nacidos sometidos a resección intestinal debido a atresia ileal. La evaluación histopatológica de la lesión tisular y la apoptosis se realizó mediante microscopía óptica y el método TUNEL. El nivel de ARNm en los genes apoptóticos (CASP3, CASP6, CASP7, Bax, BIRC2) y antiapoptóticos se evaluó con el método de matriz de RCP (PCR array). La expresión de proteínas se evaluó mediante inmunohistoquímica. RESULTADOS: Los puntajes de las lesiones tisulares y los puntajes medios de apoptosis fueron significativamente más altos en el grupo con enterocolitis necrosante en comparación con el grupo de referencia (p < 0,01). La expresión de los genes proapoptóticos aumentó significativamente en el grupo con enterocolitis necrosante frente al grupo de referencia (p < 0,01). La expresión del gen Bcl-2A1 (antiapoptótico) disminuyó significativamente en el grupo con enterocolitis necrosante (p < 0,01). La expresión de las proteínas Bax y CASP3 aumentó significativamente en el grupo con enterocolitis necrosante (p < 0,01). CONCLUSIONES: Según nuestros datos, la alteración del equilibrio entre la expresión de Bax (proapoptótico) y la expresión de Bcl-2A1 (antiapoptótico) en el lugar de la lesión es un posible mecanismo de la patogenia en recién nacidos que presentan enterocolitis necrosante.

The PCome of Ascaris suum as a model system for intestinal nematodes: identification of phosphorylcholine-substituted proteins and first characterization of the PC-epitope structures.

In multicellular parasites (e.g., nematodes and protozoa), proteins and glycolipids have been found to be decorated with phosphorylcholine (PC). PC can provoke various effects on immune cells leading to an immunomodulation of the host's immune system. This immunomodulation allows long-term persistence but also prevents severe pathology due to downregulation of cellular immune responses. PC-containing antigens have been found to interfere with key proliferative signaling pathways in B and T cells, development of dendritic cells and macrophages, and mast cell degranulation. These effects contribute to the observed modulated cytokine levels and impairment of lymphocyte proliferation. In contrast to glycosphingolipids, little is known about the PC-epitopes of proteins. So far, only a limited number of PC-modified proteins from nematodes have been identified. In this project, PC-substituted proteins and glycolipids in Ascaris suum have been localized by immunohistochemistry in specific tissues of the body wall, intestine, and reproductive tract. Subsequently, we investigated the PCome of A. suum by 2D gel-based proteomics and detection by Western blotting using the PC-specific antibody TEPC-15. By peptide-mass-fingerprint matrix-assisted laser-desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS), we could identify 59 PC-substituted proteins, which are in involved multiple cellular processes. In addition to membrane proteins like vitellogenin-6, we found proteins with structural (e.g., tubulins) and metabolic (e.g., pyruvate dehydrogenase) functions or which can act in the defense against the host's immune response (e.g., serpins). Initial characterization of the PC-epitopes revealed a predominant linkage of PC to the proteins via N-glycans. Our data form the basis for more detailed investigations of the PC-epitope structures as a prerequisite for comprehensive understanding of the molecular mechanisms of immunomodulation.