Comparison of Intra-articular Steroid and Platelet-Rich Plasma Injections in Patients With Knee Osteoarthritis.

INTRODUCTION: This study aimed to compare the effects of intra-articular steroid (IAS) and platelet-rich plasma (PRP) injections on femoral cartilage thickness and quality of life in patients with knee osteoarthritis (OA). METHODS: This research was designed as a retrospective study with propensity score matching and included 80 treatment-naive patients with knee OA. All patients' demographic characteristics and Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36) scores before treatment, one month after treatment, and six months after treatment were recorded. Femoral cartilage thickness measurements were taken with ultrasonography. To determine the efficiency of IAS and PRP injections, data was collected before treatment, one month after treatment, and six months after treatment and then compared. RESULTS: All VAS values and WOMAC scores were significantly better one month and six months after treatment in both the IAS group and PRP group. However, IAS treatment was associated with significantly lower VAS scores during the night and during movement one month after treatment (p=0.044 and p=0.042). VAS at rest and the WOMAC scores one month after treatment were similar (p=0.435 and p=0.616). All VAS scores (night, rest, and movement) and WOMAC scores were comparable between groups six months after treatment (p=0.569, p=0.504, p=0.584, and p=0.441). There were no significant differences in femoral thickness at the eight measurement points between the groups at the follow-ups. CONCLUSION: Our findings have shown that IAS and PRP injection treatments have a significantly positive effect on the pain and quality of life of patients with knee OA, although this positive effect for pain was significantly better for IAS at night and during movement at the one-month follow-up. Additionally, IAS and PRP injections had positive and comparable healing impacts on femoral cartilage thickness.

Comparison of Hand-Wrist Findings of Rheumatoid Arthritis Patients According to the Use of Synthetic and Biological Disease-Modifying Antirheumatic Drugs (DMARDs): A Clinical, Radiographic, and Ultrasonographic Study.

OBJECTIVE: The aim of this study is to evaluate the hand-wrist findings in patients with rheumatoid arthritis (RA) using synthetic and a combination of synthetic and biological disease-modifying antirheumatic drugs (DMARDs) in terms of ultrasonographic, clinical, and radiographic data. METHODS: The study is designed as a cross-sectional study, and 31 RA patients followed up in the rheumatology outpatient clinic were enrolled. Nineteen patients were using only synthetic DMARDs, and 12 patients were using a combination of synthetic and biological DMARDs. The clinical data of each patient were recorded simultaneously. Disease Activity Score-28 (DAS-28) was used for the assessment of disease activation, and the Health Assessment Questionnaire (HAQ) score was used for the evaluation of general health status. Bilateral proximal interphalangeal (PIP), metacarpophalangeal (MCP) joints, and the radiocarpal, ulnocarpal, and midcarpal joints of the patients were examined by ultrasonography (US). The Sharp-van der Heijde modified score was used to determine the radiographic damage. RESULTS: There was no significant difference between the two groups in terms of demographic data, clinical findings, ESR, and CRP. When the groups were compared in terms of right and left PIP, MCP, and radiocarpal, ulnocarpal, and midcarpal synovitis grade total scores, no significant difference was found between the two groups. Radiographic total joint space scores were significantly lower in the group receiving only synthetic DMARD treatment (p=0.047) and 25-OH vitamin D levels were significantly higher (p=0.008). CONCLUSION: This study revealed that there was no significant difference between groups except radiographic total joint space scores.

Analyzing Public Interest in Osteoarthritis and Its Minimally Invasive Treatments: A Google Trends Analysis.

Introduction In recent years, online search engines have become a source of information about medical issues. We aimed to evaluate the public's interest in osteoarthritis and minimally invasive treatments of osteoarthritis in the last 10 years using Google Trends (GT). Methods Interventional physiatrist analyzed 14 selected terms (joint pain, joint pain treatment, joint cartilage damage, narrowing of the joint, osteoarthrosis, osteoarthritis, intra-articular injection, intra-articular steroid, intra-articular hyaluronic acid, intra-articular plasma rich platelet (PRP), essential oil for joint pain, joint pain supplements, home remedies for joint pain, and stem cell for joint) related with osteoarthritis and minimally invasive treatments of osteoarthritis in physical medicine and rehabilitation discipline. All keywords were searched in the GT application using the 'all categories,' 'web search,' and 'worldwide' filters. The last 10 years have been divided into two equal parts, each spanning five years (from January 1, 2013 to December 31, 2017, and January 1, 2018 to December 31, 2022). Public interest in the 14 keywords mentioned above was recorded for these two periods, and the GT for all 14 keywords were compared across the two five-year periods. Results Searching rates for the terms 'joint pain,' 'joint pain treatment,' 'joint cartilage damage,' 'narrowing of the joint,' 'osteoarthritis,' 'intra-articular injection,' 'intra-articular PRP,' and 'joint pain supplements' have increased significantly in the last five years (p= 0.001, p= 0.001, p= 0.005, p= 0.001, p= 0.001, p= 0.004, p= 0.001, and p= 0.001, respectively). The average Google Trends (GT) score for all terms was 40 between January 1, 2013, and December 31, 2017, and the average GT score for all terms was 48 between January 1, 2018, and December 31, 2022 (p= 0.001). Conclusion The present study stated that public interest in osteoarthritis and minimally invasive treatments for osteoarthritis has increased significantly in the last five years. Study outcomes demonstrated that public attention to 'joint pain,' 'joint treatment,' 'joint cartilage damage,' 'narrowing of the joint,' 'osteoarthritis,' 'intra-articular injection,' 'intra-articular PRP,' and 'joint pain supplements' has also significantly increased in the last five years.

Analyzing the Performance of ChatGPT About Osteoporosis.

INTRODUCTION: This study evaluates the knowledge of ChatGPT about osteoporosis. METHODS: Osteoporosis-related frequently asked questions (FAQs) created by examining the websites frequently visited by patients, the official websites of hospitals, and social media. Questions based on these scientific data have been prepared in accordance with National Osteoporosis Guideline Group guides. Rater scored all ChatGPT answers between 1 and 4 (1 stated that the information was completely correct, 2 stated that the information was correct but insufficient, 3 stated that although some of the information was correct, there was incorrect information in the answer, and 4 stated that the answer consisted of completely incorrect information). The reproducibility of ChatGPT responses on osteoporosis was assessed by asking each question twice. The repeatability of the ChatGPT answer was considered as getting the same score twice. RESULTS: ChatGPT responded to 72 FAQs with an accuracy rate of 80.6%. The highest accuracy in ChatGPT's answers about osteoporosis was in the prevention category, 91.7%, and in the general knowledge category, 85.8%. Only 19 of the 31 (61.3%) questions prepared according to the National Osteoporosis Guideline Group guidelines were answered correctly by ChatGPT, and two answers (6.4%) were categorized as grade 4. The reproducibility rate of ChatGPT answers on 72 FAQs was 86.1% and the reproducibility rate of ChatGPT answers on National Osteoporosis Guideline Group guidelines was 83.9%. CONCLUSION: Present study outcomes for the first time showed that ChatGPT provided adequate answers to more than 80% of FAQs about osteoporosis. However, the accuracy of ChatGPT's answers to inquiries based on National Osteoporosis Guideline Group guidelines was decreased to 61.3%.

A Comparison of the Quality and Reliability of YouTube Videos Uploaded by Healthcare Professionals About Scoliosis in the Past Decade.

INTRODUCTION: Internet-based medical education plays a crucial role in bolstering public health awareness and the competence of medical professionals; however, it must be dependable. We aimed to examine the quality and reliability of the videos uploaded to YouTube (YouTube, LLC, San Bruno, California, United States) by professional healthcare professionals about scoliosis from 2014 to 2023. METHODS: The study was performed between August 1 and August 15, 2023. The keywords 'scoliosis', 'scoliosis-kyphosis brace', 'scoliosis exercises', 'scoliosis surgeries', and 'scoliosis-kyphosis exercises' were searched on YouTube. Only YouTube videos uploaded by healthcare professionals between January 1, 2014, and July 31, 2023, and only videos in the English language were examined. Video characteristics were evaluated and recorded for all videos. The quality and reliability of videos were assessed with two different questionnaire scales including the modified DISCERN score and the Global Quality Score (GQS). RESULTS: The mean number of views per video was 3778 in videos uploaded between 2014 and 2018, and 3120 in videos uploaded between 2019 and 2023 (p= 0.004). Video length and number of likes were statistically significantly lower in the videos of the last five years (p=0.001, and p=0.001). Thirty-one percent of the professional videos uploaded between 2014 and 2018 were directed at healthcare professionals. This rate was 12% in the last five years and was statistically significantly lower (p=0.001). The DISCERN score average was 3.7 between 2014 and 2018 and it was 3.2 between 2019 and 2023 (p=0.001). Similarly, the mean GQS was statistically significantly higher in the last five years compared to the five years prior (3.8 vs. 3.3, p=0.001). CONCLUSION: The present study determined that the quality and reliability of YouTube videos about scoliosis significantly increased in the last five years compared to the previous five years with a significant decrease in video duration. Also, among videos uploaded in the last five years, the number of videos for the patient was significantly higher. In contrast, the 'like' and 'view' numbers were significantly lower in YouTube videos about scoliosis in the last five years.

The correlation of results of panel reactive antibody, identification, and single antigen beads in detection of anti-HLA antibodies: Istanbul Faculty of Medicine, tissue typing laboratory experience.

BACKGROUND: We have performed a retrospective analysis of anti-HLA class I MHC and class II MHC antibodies measured using a single antigen bead (SAB) assay and a panel reactive antibody (PRA) assay. MATERIAL AND METHODS: A group of 256 patients with end-stage renal disease (ESRD) was tested for anti-HLA antibodies in the tissue typing laboratory between 2017 and 2020. In the cohort, the serum samples of patients waiting for transplantation were tested. Both the PRA and SAB tests of these patients were analyzed using the Luminex (Immucor) method. The threshold of positivity was accepted as median fluorescence intensities (MFI) ≥1000 for PRA screening and MFI ≥750 for SAB screening. RESULTS: Overall, antibodies to HLA antigens were detected in 202 (78.9%) out of 256 patients in the PRA study. Antibodies against both class I/II antigens were detected only in 15.6% of these patients, whereas antibodies against only against class I HLA in 31.3% and only against class II HLA in 32.0%. By comparison, the SAB study found that 66.8% of patients were positive for HLA antigens. Furthermore, donor-specific antibodies (DSA) were detected in 52.0% of PRA-positive patients and 52.6% of SAB-positive patients. It was shown that 168 patients (83.2%) out of 202 PRA-positive patients were found to be SAB-positive. In addition, 51 patients negative in the SAB assay (94.4%) were also negative in the PRA assay. Statistical analysis established a significant correlation between the PRA and SAB positivity (p > 0.001). It was also shown that MFI ≥3000 PRA positivity for class I HLA antigens (p = 0.049) and MFI ≥5000 PRA positivity for class II antigens (p < 0.001) correlated with the SAB positivity in patients. CONCLUSION: Our results showed the importance of both PRA and SAB assays to define the status of sensitization in patients.

Increasing Apoptotic Effect of Cord Blood and Wharton's Jelly-derived Mesenchymal Stem Cells on HT-29.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide. Recently, mesenchymal stem cells (MSCs) have been considered a suitable cell therapy option for cancer due to their high migration rate to the tumor site. OBJECTIVES: The study aimed to compare the effects of human umbilical cord blood derived-MSC (UCMSC) and human Wharton's Jelly derived-MSC (WJ-MSC) on the HT-29 cell line. METHODS: UC-MSC was obtained by Ficoll-Paque density gradient and WJ-MSC by explant method. The characterizations of MSCs and apoptosis assays were performed by flow cytometry, and caspase-3 protein levels were measured by ELISA. RESULTS: After 72 hours of HT-29 cancer cells incubation, it was indicated that WJ-MSC was more effective at 1:5 and 1:10 ratios. Similar results were found for caspase-3 by ELISA. Moreover, WJ-MSC (1:5, p < 0.006; 1:10, p < 0.007) was found to be more effective at both doses compared to UC-MSC. CONCLUSION: In this study, we used two different MSC sources at two different ratios to evaluate the apoptotic effect of MSC in vitro on HT-29 CRC cells. As a result, WJ-MSC indicated a more apoptotic effect on HT-29 cells compared to CB-MSC. We anticipated that this preliminary in vitro study would be extended in future in vitro/in vivo studies. Moreover, investigating the behavior of MSC in colorectal tumor microenvironment will be beneficial for the stem cell therapy approach.

The in vitro treatment of mesenchymal stem cells for colorectal cancer cells.

Colorectal cancer is the most common tumor of the gastrointestinal system. The conventional treatment options for colorectal cancer are troublesome for both patients and clinicians. Recently, mesenchymal stem cells (MSCs) have been the novel focus for cell therapy due to their migration to tumor sites. In this study, the apoptotic effect of MSCs on colorectal cancer cell lines has been aimed. HCT-116 and HT-29 were selected as the colorectal cancer cell lines. Human umbilical cord blood and Wharton's jelly were used as mesenchymal stem cell sources. To discriminate against the apoptotic effect of MSC on cancer, we also used peripheral blood mononuclear cells (PBMC) as a healthy control group. Cord blood-MSC and PBMC were obtained by ficoll-paque density gradient, and Wharton's jelly-MSC by explant method. Transwell co-culture systems were used as cancer cells or PBMC/MSCs at ratios of 1/5 and 1/10, with incubation times of 24 h and 72 h. The Annexin V/PI-FITC-based apoptosis assay was performed by flow cytometry. Caspase-3 and HTRA2/Omi proteins were measured by ELISA. For both ratios in both cancer cells, it was found that the apoptotic effect of Wharton's jelly-MSC was significantly higher in 72-h incubations (p < 0.006), whereas the effect of cord blood mesenchymal stem cell in 24-h incubations were higher (p < 0.007). In this study, we showed that human cord blood and tissue-derived MSCs treatment led to colorectal cancers to apoptosis. We anticipate that further in vivo studies may shed light on the apoptotic effect of MSC.

COSMC expression as a predictor of remission in IgA nephropathy.

PURPOSE: The impact of core 1,3-galactosyltransferase-specific molecular chaperon (COSMC) gene expression and methylation profile on clinical progression of IgA nephropathy (IgAN) is unclear. The aim of this study was to determine the clinical significance and the relation of the COSMC gene expression and methylation pattern with the progression of IgAN. METHODS: Thirty-nine biopsy-confirmed IgAN patients, 11 healthy relatives and 20 healthy controls were recruited. The COSMC mRNA levels and methylation profile of COSMC gene promoter were measured using the quantitative real-time PCR. The galactose-deficient IgA1 (Gd-IgA1) levels were measured using ELISA in serum and cell culture supernatant. The effect of IL-4 and AZA on COSMC expression and methylation and the correlation of COSMC gene expression and methylation levels with baseline kidney function tests, histology and long-term outcomes were examined. RESULTS: The mean COSMC mRNA level was significantly lower, and serum Gd-IgA1 level was higher in IgAN patients compared with the control groups (p < 0.001, and p = < 0.001, respectively). The COSMC mRNA levels were correlated with intensity of hematuria (r = - 0.41, p = 0.009), serum creatinine level (r = - 0.37, p = 0.002) and eGFR (r = 0.36, p = 0.002). The COSMC methylation levels were correlated with age (r = 0.25, p = 0.04) and baseline eGFR (r = - 0.326, p = 0.006). Twenty IgAN patients (51.3%) reached to complete (5, 12.8%) or partial remission (15, 38.5%) after a median of 34.5 months (IQR, 13.75-71). In multivariable Cox regression analysis, COSMC mRNA expression (adjusted HR (aHR) 1.871, 95% CI 1.287-2.722, p = 0.001) and Oxford T score (aHR 0.355, 95% CI 0.146-0.859, p = 0.022) predicted the remission. CONCLUSION: COSMC mRNA level is a novel biomarker candidate to predict the remission in IgAN patients.

Immune modulation as a consequence of SARS-CoV-2 infection.

Erroneous immune responses in COVID-19 could have detrimental effects, which makes investigation of immune network underlying COVID-19 pathogenesis a requisite. This study aimed to investigate COVID-19 related alterations within the frame of innate and adaptive immunity. Thirty-four patients clinically diagnosed with mild, moderate and severe COVID-19 disease were enrolled in this study. Decreased ILC1 and increased ILC2 subsets were detected in mild and moderate patients compared to healthy controls. NK cell subsets and cytotoxic capacity of NK cells were decreased in severe patients. Moreover, CD3+ T cells were reduced in severe patients and a negative correlation was found between CD3+ T cells and D-dimer levels. Likewise, moderate and severe patients showed diminished CD3+CD8+ T cells. Unlike T and NK cells, plasmablast and plasma cells were elevated in patients and IgG and IgA levels were particularly increased in severe patients. Severe patients also showed elevated serum levels of pro-inflammatory cytokines such as TNF-α, IL-6 and IL-8, reduced intracellular IFN-γ and increased intracellular IL-10 levels. Our findings emphasize that SARS-CoV-2 infection significantly alters immune responses and innate and acquired immunity are differentially modulated in line with the clinical severity of the disease. Elevation of IL-10 levels in NK cells and reduction of CD3+ and CD8+ T cells in severe patients might be considered as a protective response against the harmful effect of cytokine storm seen in COVID-19.

Mentoring Medical Students Towards Oncology: Results from a Pilot Multi-institutional Mentorship Programme.

The mounting global cancer burden has generated an increasing demand for oncologists to join the workforce. Yet, students report limited oncology exposure in undergraduate medical curricula, while undergraduate oncology mentorships remain underutilised. We established an undergraduate oncology society-led mentorship programme aimed at medical students across several UK universities to increase medical student oncology exposure. We electronically recruited and paired oncologist mentors and medical student mentees and distributed a dedicated questionnaire (pre- and post-mentorship) to compare mentees' self-reported cancer specialty knowledge and oncology career motivation after undertaking a 6-week mentorship. We also determined students' interest across specialties and subspecialties and measured mentor availability via percentage programme uptake. Statistical analysis included univariate inferential tests on SPSS software. Twentynine (23.4%) of 124 oncology specialists agreed to become mentors. The mentorship was completed by 30 students across three medical schools: 16 (53.3%) Barts, 10 (33.3%) Birmingham, and 4 (13.3%) King's; 11 (36.7%) mentored by medical oncologists, 10 (33.3%) by clinical/radiation oncologists, and 9 (30%) by surgical oncologists. The mentorship generated a statically significant increase in students' knowledge of the multidisciplinary team and all oncology-related specialties including academia/research but not interest towards a career in oncology. Undergraduate oncology mentoring is an effective educational, networking and motivational tool for medical students. Student societies are a valuable asset in cultivating medical student oncology interest by connecting students to faculty and increasing mentor accessibility. Further research should focus on developing an optimal mentorship structure and evaluating long-term outcomes of such educational initiatives.

Blood and bone marrow donor registry of Istanbul medical faculty activity and experience in past 3 years : A cross-sectional documentation of TRIS activity: the first blood and marrow registry in Turkey.

Allogeneic stem cell transplantation (SCT) offers a potential cure for some hematological malignancies. For those patients without a family donor, unrelated donor (MUD) registries serve for identifying the best donor. In the present study, we aimed to give a cross-sectional report of our registry's activity and experience as the first established national MUD registry in the country. The study is retrospective and covers the period of 2016 to 2019. A total of 1855 donor searches were performed, and 642 were included in the study. All data were electronically obtained from the institutional database system. All SCTs were either 10/10 or 9/10 HLA matched and originated from an international registry. The most preferred stem cell source was peripheral blood (70.2%). A quarter of transplants were performed using bone marrow, and cord blood was used with a rate of 1.4%. The pandemic-related problems were similar for the other two national registries. During the pandemic, 71 of 432 patients who were searched for donors underwent stem cell transplant(SCT). The low number was related mostly with postponing of SCTs and/also difficulties in continuing of volunteering and in achievement of stem cells from international registry. During the Covid19 pandemic, the SCT activity of centers decreased according to the national, and international guidelines. The study revealed an organized, and multidirectional capacity of the registry and also the adaptation to unpredicted conditions such as pandemic. On the other hand, there is a need for more effective strategies for donor recruitment and retention programme.

Effect of robotic-assisted gait training on functional status, walking and quality of life in complete spinal cord injury.

The purpose of this study was to investigate the effect of robotic-assisted gait training (RAGT) on functional status and the quality of life in patients with subacute complete spinal cord injury (SCI). Thirty-seven patients with complete SCI were included in this study. All patients underwent conventional rehabilitation 5 days a week for 8 weeks. The patients were divided into two groups: those who received RAGT (group I, n = 17) and those who received only conventional rehabilitation (group II, n = 20) for 30 min twice a week for a total of 8 weeks. Evaluations were performed using the Walking Index SCI II (WISCI II) for ambulation, Functional Independence Measure (FIM) for functional status and Short Form 36 (SF-36) for the quality of life at the beginning and end of rehabilitation. The mean duration of injury was 3.5 ± 2.1 months in group I and 3.8 ± 2.6 months in group II (P > 0.05). Significant improvement was observed in both groups as per WISCI II and FIM scores (P < 0.05). However, no significant inter-group difference was noted in pre- and post-treatment FIM and WISCI II change scores (P > 0.05). In groups I and II, there was significant improvement only in physical activity scores of SF-36 compared with baseline scores (P < 0.05); however, other SF-36 subparameter scores did not differ significantly between pre- and post-treatment (P > 0.05). Treatment with RAGT has positive effects on functional independence, ambulation and the quality of life in patients with subacute complete SCI. RAGT combined with conventional therapy in patients with complete SCI may facilitate the improvement of patient condition more than conventional therapy alone.

Ultrasonographic evaluation of abdominal muscle thickness symmetry in adolescent idiopathic scoliosis: a case-controlled study.

BACKGROUND: To date, there are limited studies evaluating abdominal muscle symmetry in adolescent idiopathic scoliosis (AIS) patients and these studies in the literature do not evaluate the rectus abdominis (RA) muscle in AIS patients. AIM: To evaluate the symmetry of the thickness of the abdominal muscles while standing and supine position in AIS patients. DESIGN: A case control study. POPULATION: A total of 80 people, 40 subjects with ASI and 40 healthy adolescent subjects were included in the study. METHODS: Radiographic examination data of patients with AIS (N.=40). Radiographic examination data of patients with AIS (N.=40) were collected. An ultrasound assessment was performed of the side-to-side differences of the RA, external oblique (EO), internal oblique (IO), and transversus abdominalis (TrA) muscles in the standing and supine positions in AIS and control groups (N.=40). Three repeat measurements of the thickness of each muscle were performed and relative thicknesses were compared. RESULTS: The mean percentage (%) difference between the right and left sides muscle measurement of the control group was between on standing position 1.54% and 3.00%, in supine 0.8% and 5.87% for different muscles; however, the meanpercentage (%) of this difference in the ASI group ranged from 6.28% to 15.13% (standing) and 7.21% to 17.24% (supine). Muscle asymmetry in the ASI group was significantly higher than in the control group for all muscles in measurements in the standing and supine position (P<0.001). CONCLUSIONS: All abdominal relative muscle thicknesses in the AIS patients were more asymmetric than healthy adolacents. CLINICAL REHABILITATION IMPACT: Examining the correlation between the degree of rotation and abdominal muscle symmetry should be one of the topics for future studies.

Can Direct-Acting Antiviral Treatment Change the Immunologic Risk Profile in Patients Infected with Hepatitis C Virus Who Are on the Cadaveric Waiting List?

BACKGROUND: In patients with hepatitis C virus (HCV) infection, the activation of the immune system by the virus or viral proteins leads to the production of numerous autoantibodies and clinical manifestations. The objectives of this study were to investigate the relationship between HCV and anti-HLA antibodies, as well as the effect of viremia on the antibody response and of direct-acting antivirals (DAAs) on anti-HLA antibody persistence in patients on the waiting list for a cadaveric kidney transplant. METHODS: A total of 395 patients from the cadaveric renal transplant waiting list were included in the study. The patients were grouped according to the presence of HCV infection, and patients with HCV positivity were further divided into a spontaneous clearance group and a persistent group. Anti-HLA antibodies were examined before and after treatment of the patients in the persistent group. The One Lambda Luminex method (Thermo Fisher Scientific, Waltham, MA, United States) was used to assess both HLA class I and II alleles and the anti-HLA antibody profile. RESULTS: Anti-HLA class I and II antibodies were detected in 48.2% and 55.1%, respectively, of the patients infected with HCV and in 21.8% and 20.4%, respectively, of the patients who were not infected. The level of anti-HLA A3, A11, B72, B52, Cw6, Cw16, DR3, and DQ4 antibodies was significantly higher in the patients infected with HCV. There was no statistically significant difference in class I and II antibody titration between the HCV-infected spontaneous clearance group and the persistent group (class I mean fluorescence intensity [MFI] ± SD: 13,583 ± 6224, 13,450 ± 9540, P = .808; Class II MFI ± SD: 13,000 ± 8673, 8440 ± 8302, P = .317, respectively). There was no significant difference in the class I and class II anti-HLA antibody profile and titration in the persistent group after treatment with DAAs (P > .05). CONCLUSIONS: The results of this study demonstrated that hepatitis C DAA treatment did not change the anti-HLA antibody profile and titration.

EFI region 8 Balkan external proficiency testing for HLA typing: Results of 15 years.

Istanbul Medical Faculty, Department of Medical Biology, as the first EFI-accredited HLA laboratory in Turkey since 1999 has been organizing both national and international quality control tests for HLA typing under the banner of the "Balkan external proficiency testing (BEPT)" encompassing countries from EFI regions 8. The first round of BEPT in 2004 was organized for low-resolution HLA-A,-B typing by molecular methods and 12 centres participated in the exercise. In 2005, low-resolution HLA-DR typing was added, and in 2007, low-resolution HLA-C and DQ typing were added to the exercise and 28 centres participated. In 2015, high-resolution (four digits or higher typing) HLA-A,-B,-C,-DR and -DQ typing added to the exercise and 40 centres participated. In the last 2 years, 2017 and 2018, the number of participating centres increased to 48 and 52, respectively. When the distribution of low-resolution typing methods applied in the exercises were investigated, it was found that 82% of the centres in the first round of BEPT in 2004 used PCR-SSP, whereas in the last round in 2018, 26% of the centres preferred SSP, while the rest used SSO (50%) or SSP and SSO (24%) methods. Methods for high-resolution typing were SBT (41%), NGS (18%), SSO (18%), SSP (6%), SBT + NGS (6%) and SBT + SSP (11%). In 15th trial for BEPT, nomenclature mistake rate was 12%, and erroneous result rate was 6% for HLA samples. The most common mistakes in the exercises were nomenclature mistakes. The EFI Standards Version 7.0 is stated "HLA type can be reported using a hyphen if homozygosity is not proven by family studies." In order to provide standard results among HLA laboratories and since accurate HLA typing leads to significant increase of graft and patient survival, quality control exercises should be performed in all HLA-based tests periodically.

Cytokine Polymorphism and HLA Genotyping in Patients with Temporal Lobe Epilepsy Related to Hippocampal Sclerosis.

OBJECTIVE: Hippocampal sclerosis (HS) is the most common pathological substrate associated with mesial temporal lobe epilepsy (MTLE), where inflammatory processes are known to play an increasingly important role in the pathogenesis. To further investigate the role of the immune system, both cytokine gene polymorphisms and human leukocyte antigen (HLA) genotyping in patients with MTLE-HS were investigated. METHODS: The DNA samples of 100 patients with MTLE-HS and 201 healthy individuals were genotyped for cytokines (IL-6,IL-10, TNF-α, TGF-ß1 and IFN-γ) and HLA using polymerase chain reaction (PCR)-SSP and SSO methods. The results were statistically analyzed in patient and healthy control groups and then according to the presence of febrile seizures (FS) in the patient group. RESULTS: Analysis of cytokine genotyping did not reveal any significant difference between patients with MTLE-HS and controls and patients with or without FS. However, the HLA DRB1*13 allele was found to be more frequent in the patient population after Bonferroni correction. CONCLUSION: This study suggests the possible role of HLA in the pathogenesis of MTLE-HS, although it failed to show any relationship with the cytokine system. However, data regarding the role of HLA are still lacking, and further studies are necessary to verify our results.

Sperm fluorescence in situ hybridization analysis reveals normal sperm cells for 14;14 homologous male Robertsonian translocation carrier.

OBJECTIVE: To report the presence of normal sperm cells for chromosome 14 in a homologous 14;14 Robertsonian translocation carrier. DESIGN: Case report. SETTING: In vitro fertilization clinic and genetics laboratory in a private hospital. PATIENT(S): Infertile couple referred for IVF. INTERVENTION(S): Conventional cytogenetic and fluorescence in situ hybridization (FISH) techniques were used in karyotype and sperm FISH analysis. Three IVF treatments were performed, two of which included preimplantation genetic diagnosis (PGD). MAIN OUTCOME MEASURE(S): Cytogenetic analysis revealed pure 45,XY,t(14;14)(q10;q10) karyotype. Sperm FISH analysis for chromosome 14 revealed 13% normal sperm cells in the sperm sample. RESULT(S): Sperm FISH analysis revealed 13% normal sperm cells for chromosome 14 in the homologous 14;14 Robertsonian translocation carrier. The couple underwent two IVF cycles together with PGD. In the first trial there was no suitable embryo for transfer. In the second trial one normal blastocyst was transferred on day 6. However, pregnancy was not established in this second PGD cycle. CONCLUSION(S): To our knowledge, this is the first sperm FISH study revealing the presence of normal sperm in the ejaculate of a pure homologous translocation carrier. The PGD study performed for this couple is also unique in the literature.

Preimplantation genetic diagnosis (PGD) for extremes--successful birth after PGD for a consanguineous couple carrying an identical balanced reciprocal translocation.

OBJECTIVE: To report a healthy birth after preimplantation genetic diagnosis (PGD) performed for a consanguineous couple carrying an identical familial reciprocal translocation in both partners. DESIGN: Case report. SETTING: In vitro fertilization (IVF) clinic and genetic laboratory in a private hospital. PATIENT(S): Consanguineous couple carrying the same balanced reciprocal translocation: 46,XX,t(1;16)(q12;q11.2) and 46,XY,t(1;16)(q12;q11.2). INTERVENTION(S): 25 oocyte-cumulus complexes were retrieved 36 hours after human chorionic gonadotropin injection; metaphase II oocytes were fertilized by intracytoplasmic sperm injection; single blastomere biopsy was performed on 15 embryos on day 3; one embryo was found to be normal or balanced according to fluorescent in situ hybridization studies, embryo transfer was performed on day 4. MAIN OUTCOME MEASURE(S): Healthy birth of homozygous double translocation carrier twins with 46,XY,t(1;16)(q12;q11.2)mat,t(1;16)(q12;q11.2)pat karyotype. RESULT(S): Healthy monozygotic male twins were born at 36 weeks of gestation. Karyotype studies of the babies revealed that they are double translocation homozygotes: 46,XY,t(1;16)(q12;q11.2)mat,t(1;16)(q12;q11.2)pat. They are healthy and more than 4 years old later show no physical or mental abnormalities. CONCLUSION(S): To our knowledge, this is the first PGD study performed for a couple who carry the same reciprocal translocation. The twins born after this study are rare examples in the literature of healthy balanced reciprocal translocation homozygotes.

A genetic survey of 1935 Turkish men with severe male factor infertility.

Male factor infertility is the sole reason in approximately 25% of couples who suffer from infertility. Genetic factors such as numerical and structural chromosomal abnormalities and microdeletions of the Y chromosome might be the cause of poor semen parameters. The results of karyotype analyses and Y-chromosome microdeletions of 1935 patients with severe male factor infertility, which is the largest series from Turkey, were assessed retrospectively. The frequency of cytogenetic abnormalities among 1214 patients with non-obstructive azoospermia (NOA) and 721 patients with severe oligoasthenoteratozoospermia (OAT) were 16.40 and 5.83% respectively. The overall incidence of Y-chromosome microdeletion was 7.70%. The incidence of Y chromosome microdeletion in patients with NOA and OAT was 9.51 and 1.86% respectively. The abnormality rate increased with the severity of infertility. Some patients (n = 22) were carriers of both chromosomal abnormalities and Y-chromosome microdeletions. Results suggest the need for genetic screening and proper genetic counselling before initiation of assisted reproduction treatment.