Development of real time-pH sensitive intelligent indicators for monitoring chicken breast freshness/spoilage using real packaging practices.

Real-real time CO2-sensitive freshness indicators, phenol red (PR) and bromothymol blue (BTB) dyes, in three-layer system using cellulose based binder was developed to determine the freshness/spoilage of chicken breast. The developed indicators were used to monitor chicken meat spoilage packaged in polyamide/polyethylene (PA/PE) pouches under air and 100% nitrogen (N2) at 4 °C for 10 days. Changes in the ΔE and ΔRGB values of the indicators, CO2/O2 gas composition of packs, and chemical (TVBN, pH, trimethylamine), microbial, and sensory quality parameters of chicken breast meat were analyzed. The visual color change in the PR-based indicator was insufficient for the consumer to detect the spoilage with the naked eye in both simulation and food trial. However, three stage color (dark blue-turquoise-green) change was occurred in BTB-based indicators, and the color transition in the spoilage level of CO2 (10-15% (v/v)) is supported by the physicochemical, microbiological and sensorial properties of the chicken breast. The shelf life of chicken breast under air was limited to 4 days, while the shelf life under 100% N2 was 6 days which are supported by the visual color change of BTB indicator. The BTB-based indicators were found promising on a real packaging conditions and could be adapted to industrial scale for monitoring real-time freshness/spoilage of poultry, ensuring food safety.

Influence of preoperative enema application on the return of gastrointestinal function in elective Cesarean sections: a randomized controlled trial.

AIM: There is an extensive literature on the mechanical bowel preparation by an enema in colorectal, abdominal, and gynecologic surgeries that provide evidence against the use of enema. There are, however, few studies investigating the effect of enema prior to elective Cesarean sections. The aim of this study is to investigate whether preoperative enema facilitates the return of gastrointestinal activity in pregnant women undergoing elective Cesarean section. MATERIALS AND METHODS: The surgeon-blinded prospective randomized controlled study included 225 elective Cesarean patients between the ages of 18 and 44. The patients were randomized into two groups: those who had enema preoperatively (n = 114) and those who did not (n = 111). The outcome measures were first bowel sound time and first flatus time, the length of hospital stay, the rate of mid ileus symptoms, and additional analgesic and antiemetic need. RESULTS: In the non-enema group, the time of the first bowel sound, flatus time, length of hospital stay, the rates of additional analgesic need, additional antiemetic need, and mild ileus symptoms were respectively 10.5 ± 5.8 hours, 16.0 ± 7.6 hours, 1.9 ± 0.3 days, 8.1%, 7.2%, and 2.7%. For the enema group, the same parameters were respectively 11.6 ± 4.7 hours, 17.5 ± 6.5 hours, 1.8 ± 0.3 days, 7%, 6.1% ,and 1.8%. For all parameters, the difference between the groups was not statistically significant (p values were respectively .09, .12, .8, .79, .68, and .26). CONCLUSIONS: The study suggests that preoperative enema in elective cesarean sections does not prevent postoperative gastrointestinal complications and does not shorten the recovery of bowel movements or length of hospital stay.

Prognostic factors, treatment and outcome in a Turkish population with endometrial stromal sarcoma.

PURPOSE: To analyze treatment modalities and prognostic factors in patients with Stage I-II endometrial stromal sarcoma (ESS). MATERIALS AND METHODS: Twenty four patients (nineteen with low-grade ESS [LGESS] and five with high-grade ESS [HGESS]) were assessed retrospectively in terms of general characteristics, prognostic factors, treatment methods and survival. RESULTS: Twenty patients were at Stage I and three were at Stage II. The stage of one patient could not be determined. With respect to age and comorbidity, no statistically significant difference was found among disease-free survival (DFS) (p=0.990; p=0.995). However, DFS was significantly shorter in Stage II than Stage I patients (p=0.002). It was also significantly shorter in HGESS patients than in LGESS patients (p=0.000). There was no statistically significant differences among the overall survival (OVS) times of patients with respect to age at diagnosis and comorbid disease (p=0.905; p=0.979) but OVS was significantly shorter in patients with HGESS (p=0.00) and Stage II disease (p=0.001). No statistically significant difference was found with respect to OVS between patients who received radiotherapy (RT) and those who did not receive RT (p=0.055). It was not statistically possible to include other treatment modalities in the analysis because of the small sample size. CONCLUSIONS: Grade and stage of a tumour were found to be the most important prognostic factors. It was not possible to determine the optimal surgical method and the effect of adjuvant treatment since the number of cases was insufficient.

Proliferation of trophoblasts and Ki67 expression in preeclampsia.

BACKGROUND/AIMS: Preeclampsia is a pregnancy-specific disease with the increased risk of maternal morbidity and mortality. It is characterised by placental vascular dysfunction. Despite the numerous studies on preeclampsia, studies evaluating proliferation of villous trophoblasts in preeclamptic placentas are limited. Ki67 is a proliferation marker that expresses in the nuclei of proliferating cells. In this study, we examined the proliferation of villous trophoblasts in placentas of preeclamptic patients by using Ki67 and compared it with placentas of normal pregnant patients. MATERIAL AND METHODS: The current study is a prospective one, including 15 placentas from preeclamptic patients and 14 placentas from normal pregnancies as controls. For detection of proliferation in villous trophoblasts, Ki67 was used. RESULTS: The Ki67 index was 11.48±1.67% in normal patients and 15.53±2.28% in preeclamptic patients. There was a difference in Ki67 index between the two groups (p < 0.001). CONCLUSION: Our results support the opinion that trophoblasts undergo regeneration hyperplasia as a result of injuries arising on the villous surface in preeclampsia. Proliferation of trophoblasts may contribute the development of preeclampsia.

Surgical removal of intra-abdominal intrauterine devices at one center in a 20-year period.

OBJECTIVE: To review 20 years of experience of the removal of intra-abdominal intrauterine devices (IUDs) and to compare the surgical methods used. METHODS: In a retrospective study, charts dating from between September 1, 1992, and August 31, 2012, were reviewed. Patients were eligible for inclusion when they had an IUD surgically removed by minilaparotomy or laparoscopy at a tertiary referral center in Izmir, Turkey. RESULTS: Among the 36 eligible women, 18 (50%) had undergone laparoscopy and 18 (50%) had undergone minilaparotomy. Mean operation length was 55.3±6.3 minutes in the laparoscopy group and 29.1±4.2 minutes in the minilaparotomy group (P=0.008). Conversion to full laparotomy was necessary in 4 (22%) women in the laparoscopy group and 1 (6%) in the minilaparotomy group (P=0.02). Perioperative complications were observed in 5 (14%) women, with no difference in frequency between groups (P=0.09). Total cost of medical/surgical procedures was US$436.4±35.4 for the laparoscopy group and $323.4±21.3 for the minilaparotomy group (P=0.04). CONCLUSION: Minilaparotomy seems to be an important alternative to laparoscopy for the removal of intra-abdominal IUDs. This procedure should be an integral part of gynecologic surgical training.

The impact of thrombocytosis on clinicopathological prognostic factors and survival in patients with vulvar cancer.

PURPOSE: Reactive thrombocytosis in many solid tumors has widely been studied. In the present study we aimed to investigate whether thrombocytosis is a common and prognostic factor in women with vulvar cancer MATERIAL & METHODS: The preoperative platelet counts of 41 women, treated for vulvar cancer in our onco-gynecology center between March 1994 and January 2007, were retrospectively reviewed and correlated to clinical and pathological prognostic factors and 5-year survival. The chi-square or Fisher exact tests were used to compare categorical variables. P value < 0.05 was accepted for statistical significance. RESULTS: The mean age was 65.4 +/- 11.3 years (range 39-83y). All patients had squamous histology The mean platelet count was 335.42 x 109/L +/- 82.03 (range 142-1155x109/L). Thrombocytosis was detected in 8 (19.5%) patients. No correlation was found between thrombocytosis and grade (p = 0.65), LVSI (p = 0.82), tumor size (p = 0.73), depth of invasion (p = 0.18), lymph node metastasis (0.93), and FIGO stage (p = 0.78). The mean follow up time was 118.0 +/-43.1 months (range 60-213 months). At the end of the study period 14 patients (34.2%) had died, 8 (19.5%) had recurrence, 19 (46.3%) were disease-free. General 5-year survival was 68.3% (28/41). The 5-year survival rate for patients with thrombocytosis was 75.0% (6/8), which was not significantly different from the 5-year survival of patients with normal platelet counts (22/33; 66.7%) (p = 0.75). CONCLUSION: Our study showed that, overall, thrombocytosis was found in about 20% of patients with vulvar cancer and proved to be not linked to the best known prognostic factors and survival. Thus, disease stage and inguinofemoral lymph node status continue to be the best prognostic factors for this disease.

HPV types in Turkey: multicenter hospital based evaluation of 6388 patients in Turkish gynecologic oncology group centers.

OBJECTIVE: To evaluate the prevalence of HPV DNA and cervical cytological abnormalities, to compare cervical cytology results and HPV DNA and to define HPV types distribution in a large series of Turkish women who have undergone HPV analysis in hospitals that are members of the Turkish Gynecological Oncology Group. MATERIAL AND METHOD: Between 2006 and 2010, a total of 6388 patients' data was retrospectively evaluated at 12 healthcare centers in Turkey. Demographic characteristics, cervical cytology results, HPV status and types were compared. RESULTS: The mean age of the patients was 38.9±10.2. Overall, 25% of the women were found to be HPV positive. Presence of HPV-DNA among patients with abnormal and normal cytology was 52% and 27%, respectively. There was significant difference with respect to decades of life and HPV positivity (p < 0.05). HPV was positive in (within the HPV (+) patients) 37%, 9%, 27%, 20%, 22%, and 41% of the ASCUS, ASC-H, LSIL HSIL, glandular cell abnormalities, and SCC cases respectively The most common HPV types in our study were as follows; HPV 16 (32%), HPV 6 (17%), HPV 11 (9%), HPV 18 (8%), HPV 31 (6%), HPV 51 (5%), HPV 33 (3%). CONCLUSION: In this hospital based retrospective analysis, HPV genotypes in Turkish women with normal and abnormal cytology are similar to those reported from western countries. Further population based prospective multicenter studies are necessary to determine non-hospital based HPV prevalence in Turkish women.

The predictors of response to neoadjuvant chemotherapy in advanced epithelial ovarian cancer.

OBJECTIVES: To investigate the predictors of response to neoadjuvant chemotherapy (NACT) in advanced stage epithelial ovarian cancer (EOC). METHODS: Thirty-five patients with nonoptimally cytoreductable at stage III-IV EOC who were treated with NACT and interval cytoreductive surgery in our center between January 2002 and February 2009 were enrolled into this retrospective pilot study. Response to NACT was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). RESULTS: All patients received three courses platinum-based chemotherapy [24 (69%) received pactitaxel plus carboplatin and 11 (31%) received paclitaxel plus cisplatin]. There were 12 (34%) partial response to and 23 (66%) stable disease after NACT. Optimal cytoreduction was subsequently achieved in 32 of 35 patients (91%). Among age, hystology, ovarian size, CA-125 level, severity of pleural effusion, extensive omental disease, diaphragmatic implants, liver parenchyma metastasis, used chemotherapy regimen; only extensive omental disease was found to be predictive (P = 0.004). CONCLUSIONS: Ovarian cancer patients with extensive omental disease were possibly better treated with primary cytoreductive surgery, since they were more likely to have less responsive to NACT. This finding can be used to identify patients who will get poor response to NACT and to design future tailored randomized clinical trials.

Second primary cancers following borderline ovarian tumors.

BACKGROUND: Several studies have reported an increased risk of second primary cancers subsequent to invasive epithelial ovarian cancer. However, there is no adequate data regarding such risk in borderline ovarian tumors (BOTs). The aim of this study was to evaluate the risk of subsequent second primary cancers among women with BOTs. METHODS: BOT patients treated in our center between December 1985 and April 2009 were retrospectively screened for developing second primary cancer during follow-up period. RESULTS: There were 96 women diagnosed with BOT. Mean age at the time of diagnosis was 47 ± 14.3, ranging from 19 to 79. Eighty-eight (91.6%) patients had stage I disease, two patients (2.1%) had stage II and six (6.2%) had stage III. Twenty-five (26.0%) patients received platinum-based adjuvant chemotherapy. Mean follow-up time was 96.5 ± 442 months (range: 9-280 months). There were ten (10.4%) recurrences. Only one patient developed second primary cancer. Second primary cancer observed in this case was basal cell carsinoma of the eyelid, which was diagnosed 2 years after primary disease. There were no patients with common women's cancers such as breast and colorectal cancers. CONCLUSIONS: These findings do not suggest increased risk of subsequent cancers in patients with BOT. However, population-based studies are needed for evaluating exact risk of developing second primary malignancies in women with BOTs.

The value of frozen section evaluation in the management of borderline ovarian tumors.

PURPOSE: To evaluate the accuracy of a frozen section and to analyze the factors affecting frozen section results in cases of borderline ovarian tumors (BOTs). MATERIALS AND METHODS: The files and pathological reports of 82 cases diagnosed with BOT at our clinic, between January 1994 and June 2009, have been retrospectively evaluated. The frozen section results were compared to the permanent paraffin section results. Accuracy, overdiagnosis, and underdiagnosis rates were estimated. The factors affecting the diagnosis were also evaluated using logistic regression analysis. RESULTS: The mean age was 40.16 ± 14.01 years. Of the patients, 47.6% had serous and 42.7% had mucinous histology. About 90% of the cases were in stage I. The rate of correct diagnosis with frozen section was 69.5%. The rates of overdiagnosis and underdiagnosis were 1.2 and 29.3%; respectively. The factors affecting the diagnosis were determined as, the dimension of the ovarian mass (P = 0.005), presence of a solid component (P = 0.000), preoperative CA 125 value (P = 0.016), and intraoperative rupture of the ovarian cyst (P = 0.049). CONCLUSION: In the frozen section evaluation of BOTs, the underdiagnosis that restricts the diagnostic performance of the method seems to be a major problem. A more careful approach is therefore needed, while choosing a proper surgical technique during laparotomy for ovarian masses. In order to reduce the false diagnosis and surgical morbidity, the frozen section analysis should be applied by experienced pathologists and the possible predictive factors affecting a false diagnosis should carefully be taken into consideration.

Color Doppler analysis of pelvic arteries following bilateral internal iliac artery ligation for severe postpartum hemorrhage.

OBJECTIVE: To compare Doppler blood flow characteristics of the uterine, arcuate, and ovarian arteries of women who underwent bilateral internal iliac artery ligation with those of controls. METHODS: Thirteen women who underwent bilateral internal iliac artery ligation for severe postpartum hemorrhage (PPH) were matched with 15 healthy women of reproductive age. Transvaginal color and pulsed (duplex) Doppler modes were used to visualize the pelvic arteries. The pulsatility index, the resistance index, the systolic/diastolic blood flow ratio, the peak systolic velocity, and the end-diastolic velocity were measured. RESULTS: The mean age was 26.1+/-5.2 years in the study group and 27.0+/-5.4 years in the control group. All participants had regular menstrual periods. There were no significant differences between the groups regarding each of the vascular indices for the uterine, arcuate, and ovarian arteries. CONCLUSION: These findings are consistent with published data demonstrating that pelvic circulation is not compromised after bilateral internal iliac artery ligation.