Effects of dietary betaine and protected calcium butyrate supplementation on growth performance, blood biochemical status, and meat quality in growing Japanese quail (Coturnix coturnix Japonica).

This study aimed to evaluate the impact of betaine (Bet) and protected calcium butyrate (PCB) supplementation individually and together on the performance, carcass traits, blood biochemistry, and meat quality of growing Japanese quails ( Coturnix coturnix Japonica) from 1 to 42 days old. 144 one-day-old unsexed Japanese quails were randomly assigned to four dietary treatments with six replicates each. All birds were fed a maize-soybean meal diet for 42 days. The control group received no feed additives, while the treatment groups received 1.2 g/kg Bet, 1.0 g/kg PCB, or a combination of both in their diets. The results indicated that Bet and PCB supplementation individually and together did not differ performance, relative weights of heart, gizzard, proventriculus, bursa of Fabricius and pancreas, water holding capacity (WHC), cooking loss (CL), blood biochemical values except for glucose and triglyceride. Bet supplementation significantly increased relative liver weights, while PCB supplementation decreased glucose levels in serum. Moreover, carcass yield was increased and triglyceride value in blood serum, malondialdehyde (MDA), and the pH levels of breast meats both on the 1st and 30st day of post-mortem were decreased in all treatment groups. Therefore, based on these results, the combination of betaine and butyrate improves both carcass yield and meat quality in growing Japanese quails. More research is needed to determine the impact of betaine and butyrate on the structure of amino acids in meat, antioxidant enzyme activity, and the immune system in poultry.

Endothelial nitric oxide synthase G894T, intron 4 VNTR, and T786C polymorphisms in retinopathy of prematurity.

BACKGROUND: Our objective in this study was to assess the association between eNOS gene, that achieves synthesis of nitric oxide especially in the endothelial cells known to have an important role in angiogenesis and vasculogenesis, G894T, intron 4 VNTR (27-bp repeat) and T786C functional polymorphisms and retinopathy of prematurity (ROP), which is an important cause of morbidity in premature or low birth weight babies. METHODS: A total of 139 babies who were followed up in our neonatal intensive care unit because of premature birth in our hospital or admitted to our unit. 69 of them had retinopathy of prematurity and comprised the patients group. The remaining 70 babies who did not have ROP comprised the control group. An additional of 1 ml of blood samples were drawn from babies who were in the study groups during routine laboratory analysis. eNOS gene polymorphisms were determined by using polymerase chain reaction method. RESULTS: eNOS G894T, intron 4 VNTR and T786C gene polymorphisms did not differ between the patient and control groups (p > 0.05). Using logistic regression analysis; while gender did not differ between two groups; gestational age, birth weight, time on mechanical ventilation differ between two groups. After adjustment for variables other than eNOS gene polymorphisms, we found no significant difference in the genotype distribution of eNOS G894T, intron 4 VNTR and T786C polymorphisms (p > 0.05). CONCLUSION: We observed no association between ROP and eNOS gene polymorphisms but needs more investigation.

MRI Spectrum of Brain Involvement in Sphingosine-1-Phosphate Lyase Insufficiency Syndrome.

SGPL1 encodes sphingosine-1-phosphate lyase, the final enzyme of sphingolipid metabolism. In 2017, a condition featuring steroid-resistant nephrotic syndrome and/or adrenal insufficiency associated with pathogenic SGPL1 variants was reported. In addition to the main features of the disease, patients often exhibit a range of neurologic deficits. In a handful of cases, brain imaging results were described. However, high-quality imaging results and a systematic analysis of brain MR imaging findings associated with the condition are lacking. In this study, MR images from 4 new patients and additional published case reports were reviewed by a pediatric neuroradiologist. Analysis reveals recurring patterns of features in affected patients, including isolated callosal dysgenesis and prominent involvement of the globus pallidus, thalamus, and dentate nucleus, with progressive atrophy and worsening of brain lesions. MR imaging findings of abnormal deep gray nuclei, microcephaly, or callosal dysgenesis in an infant or young child exhibiting other typical clinical features of sphingosine-1-phosphate lyase insufficiency syndrome should trigger prompt genetic testing for SGPL1 mutations.

Relationship between genetic polymorphisms of drug efflux transporter MDR1 (ABCB1) and response to losartan in hypertension patients.

OBJECTIVE: Losartan is a selective angiotensin II receptor type 1 blocker and a substrate of drug efflux transporter MDR1 (ABCB1). MDR1 shows inter-individual variations due to genetic polymorphisms. C3435T, G2677T and C1236T polymorphic alleles of the MDR1 gene encoding the transporter have been shown to alter the transport, bioavailability and efficacy of certain drugs. The purpose of this study was to investigate the relationship between genetic polymorphisms of MDR1 (C3435T, G2677T/A and C1236T) and response to the treatment in newly diagnosed hypertensive patients being treated with losartan. PATIENTS AND METHODS: A total of 74 newly diagnosed hypertension patients were included in the study. Genotyping was performed using PCR-RFLP. Systolic and diastolic mean blood pressure changes of the patients were expressed as a percentage (± SD). Blood pressure values prior to initiation of the treatment and subsequent measurements 6 weeks after starting the treatment were compared. RESULTS: Regarding the C3435T polymorphism, a mean decrease of systolic blood pressure in individuals with CT or TT genotype (n= 55; 11.6% ± 9.7 mmHg) was significantly higher compared with that of the CC genotype (n = 19; 6.7% ± 9.6 mmHg, p = 0.03). No significant systolic blood pressure changes observed in G2677T/A and C1236T genotypes (p = 0.13 and 0.07, respectively). There was not any significant difference in diastolic blood pressure changes between pre- and post-treatment for any of the genotypes with C3435T, G2677T/A, or C1236T variations. CONCLUSIONS: This study revealed that hypotensive response to losartan was significantly affected by the C3435T genetic polymorphism of MDR1 and hypertensive patients with MDR1 3435T allele may present a better response to losartan treatment.

Randomised clinical trial of comparing effects of acupuncture and varicocelectomy on sperm parameters in infertile varicocele patients.

The aim of the study was to evaluate the effect of the acupuncture treatment on sperm parameters and pregnancy rates in patients with primary infertility. Between January 2008 and May 2010, 30 men with the primary infertility (one year of unprotected intercourse, healthy wife) and varicocele with normal hormone levels and abnormal semen analysis were randomised into two groups. Group 1 underwent subinguinal microscopic varicocelectomy, and Group 2 underwent acupuncture treatment twice a week for 2 months. Both groups were evaluated with semen analysis at 6 months after the treatment. Patients in both groups evaluated with telephone calls and e-mail in terms of pregnancy. The mean age of the patients was 27.2, and groups were comparable regarding the age (P = 0.542). The pre-treatment sperm concentration, motility and morphological characteristics were similar in both groups. Sperm concentration and motility improved significantly in both groups after the treatment. Increase in sperm concentration was higher in the acupuncture group compared to the varicocelectomy group (P = 0.039). The average follow-up was 42 months, and pregnancy rates were emphasised 33% in both groups. Acupuncture treatment in primary infertile varicocele patients with semen abnormalities seems to be effective and has comparable results with the varicocelectomy treatment.

Oncologic results, functional outcomes, and complication rates of robotic-assisted radical prostatectomy: multicenter experience in Turkey including 1,499 patients.

BACKGROUND: Robot-assisted radical prostatectomy (RARP) is a rising minimally invasive treatment of localized prostate cancer (PC). We present our multicenter experience of 1,499 consecutive cases with an analysis of complication rates, oncologic, and functional outcomes. PATIENTS AND METHODS: From March 2005 through December 2012, details of 1,499 patients were retrospectively analyzed. Transperitoneal approach using a da-Vinci robotic system was used to perform RARP. Perioperative characteristics and postoperative oncologic and functional outcomes are reported. RESULTS: The mean age was 61.3 years (37-77). Mean PSA level was 8.3 ng/ml. According to D'Amico classification, the percentage of patients with low-, intermediate-, and high-risk disease cases were 65.0, 30.1, and 4.8 %, respectively. Mean operative time was 181.9 min. Mean estimated blood loss was 225.4 cc (30-1,250). Positive surgical margin (PSM) was detected in 212 (14.1 %) patients. PSM rates in pT2, pT3, and pT4 stages were 6.1, 37.1, and 100 %, respectively. The overall complication rate due to modified Clavien classification was 6.1 %. Mean follow-up time was 26.7 months. Continence, potency, and biochemical recurrence rates were 88.7, 58.2, and 2.9 %, respectively. CONCLUSIONS: Our analyses including high-volume centers, which is the first largest series in Turkey, show that RARP is a safe procedure, has low PSM rates, high continence, and potency rates for the treatment of localized PC at experienced centers.

The association of the cribriform pattern with outcome for prostatic adenocarcinomas.

With the revision of the Gleason system at the 2005 International Society of Urological Pathology Consensus Conference, there was consensus that most cribriform glands should be classified as pattern 4. There is now increased understanding that invasive cribriform carcinoma is a relatively aggressive disease. This study was based on 233 radical prostatectomy (RP) specimens collected at the Department of Pathology, Umraniye Education and Research Hospital, from 2006 to 2013. We assessed the cribriform foci associated with the more definitive patterns 3, 4, and 5 elsewhere on the RP specimens and evaluated the association of the presence of cribriform pattern (CP) with biochemical prostate-specific antigen recurrence (BPR). In Cox regression model, taking into account the Gleason score (GS), pathologic stage, surgical margin (SM) status, presence of a CP, and preoperative prostate-specific antigen (PSA), a positive SM, and the presence of a CP were independent predictors of BPR after RP. We observed BPR more frequently in GS 3+3 cases with a CP than in those without a CP (p=0.008). There was no significant difference in BPR status for cases with GS 3+4, 4+3, 4+5, and 5+4 when the patients were stratified by the presence of a CP. On the basis of these data, we suggest that the classification of CP into Gleason pattern 4 has value in predicting BPR status after RP. However, as many of these modifications are empirical and supported by only a few studies, long-term follow-up studies with clinical endpoints are necessary to validate these recommendations.

Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 11 adult intensive care units from 10 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC).

PURPOSE: To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey. METHODS: A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach. RESULTS: In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42-0.7; P value, 0.0001.) CONCLUSIONS: The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey.

Impact of a multidimensional infection control strategy on central line-associated bloodstream infection rates in pediatric intensive care units of five developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).

PURPOSE: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control strategy including a practice bundle to reduce the rates of central line-associated bloodstream infection (CLAB) in patients hospitalized in pediatric intensive care units (PICUs) of hospitals, which are members of the INICC, from nine cities of five developing countries: Colombia, India, Mexico, Philippines, and Turkey. METHODS: CLAB rates were determined by means of a prospective surveillance study conducted on 1,986 patients hospitalized in nine PICUs, over a period of 12,774 bed-days. The study was divided into two phases. During Phase 1 (baseline period), active surveillance was performed without the implementation of the multi-faceted approach. CLAB rates obtained in Phase 1 were compared with CLAB rates obtained in Phase 2 (intervention period), after implementation of the INICC multidimensional infection control program. RESULTS: During Phase 1, 1,029 central line (CL) days were recorded, and during Phase 2, after implementing the CL care bundle and interventions, we recorded 3,861 CL days. The CLAB rate was 10.7 per 1,000 CL days in Phase 1, and in Phase 2, the CLAB rate decreased to 5.2 per 1,000 CL days (relative risk [RR] 0.48, 95% confidence interval [CI] 0.29-0.94, P = 0.02), showing a reduction of 52% in the CLAB rate. CONCLUSIONS: This study shows that the implementation of a multidimensional infection control strategy was associated with a significant reduction in the CLAB rates in the PICUs of developing countries.

Cytoskeletal changes in oocytes and early embryos during in vitro fertilization process in mice.

The cytoskeleton plays crucial roles in the development and fertilization of germ cells and in the early embryo development. The growth, maturation and fertilization of oocytes require an active movement and a correct localization of cellular organelles. This is performed by the re-organization of microtubules and actin filaments. Therefore, the aim of the present study was to determine the changes in cytoskeleton during in vitro fertilization process using appropriate immunofluorescence techniques. While the chromatin content was found to be scattered throughout the nucleus during the oocyte maturation period, it was seen only around nucleolus following the completion of the maturation. Microtubules, during oocyte maturation, were regularly distributed throughout the ooplasm which was then localized in the subcortical region of oocytes. Similarly microfilaments were scattered throughout the ooplasm during the oocyte maturation period whereas they were seen in the subcortical region around the polar body and above the meiotic spindle throughout the late developmental stages. In conclusion, those changes occurred in microtubules and microfilaments might be closely related to the re-organization of the genetic material during the oocyte maturation and early embryo development.

[The relationship between uretero-cloacal structure in birds and sigmoidorectal pouch surgery]. / Verwandtschaft zwischen der ureterokloakalen Struktur bei Vögeln und der sigmoidorektalen Pouch-Chirurgie.

PURPOSE: The present study was planned to investigate morphological, functional and histological properties of the natural ureterocloacal for in birds as well as to provide an appropriate information which may contribute to rectosigmoidal pouch surgery and to decrease its complications. MATERIALS AND METHODS: Thirty chickens (Gallus domesticus, 26 broilers, 4 layers) with a mean weight of 1870 +/- 88 g were used for this study. Histological and morphological evaluation of the cloaca was performed. Urethral reflux was estimated using X-rays. RESULTS: We found that the cloaca had three parts from cranial to caudal: coprodeum, urodeum and proctodeum respectively. A coprourodeal fold (CUF) between the coprodeum and urodeum and a uroproctodeal fold between the urodeum and proctodeum were detected. Settling of the muscle clusters both in the ureter and urodeum near the opening area appeared to be a strong sphincter structure and the ureters are opened to a structure covered by a transitional epithelium, which is similar to bladder in humans (connecting two identical epithelia). According to X-rays following the administration of a radio-opaque substance, there was no ureteral reflux in any of them. CONCLUSIONS: The natural urointestinal structure in birds has a spontaneous ureterointestinal anti-reflux opening. The coprourodeal fold that prevents the mixing of faeces and urine, inhibits the effects of increased pressure and prevents the reflux of urine to the upper segments is provided with many of desired hinders properties for urointestinal diversion.

Rectodynamic and radiological assessment in modified mainz pouch II cases.

OBJECTIVE: To evaluate the radiologic findings and to measure the pressure changes in a modified sigmoidorectal pouch (Mainz pouch II procedure). METHODS: A total of 26 patients who had a radical cystectomy because of muscle-invasive bladder tumor underwent a Mainz pouch II procedure between 1993 and 1998. The differences from the original definition was a reverse ureteral anastomosis and a detubularized segment at least 30 cm in length. In all cases, sigmoidoscopy was done and sigmoidal pressure and capacity were measured preoperatively and at the 3rd and 6th months postoperatively besides the colon X-rays. The 24-hour pouch pressure changes called 'natural pouch pressure' was measured using a handmade system with a central venous pressure (CVP) manometer at the 3rd month postoperatively. RESULTS: Preoperative colon X-rays showed a passage of opaque substance through the descending colon at an average volume of 150 ml (average sigma capacity), whereas postoperative anteroposterior and oblique pouch X-rays showed no passage up to an average volume of 520 ml (270-650) though the descending colon. The sigmoidal colon pressure that was on average 20 cm H(2)O at the preoperative evaluation was measured as 6 cm H(2)O at the 3rd month and 6.5 cm H(2)O at the 6th months during the postoperative period. 24 hour natural pouch pressure was found to be 8.7 cm H(2)O on average while the pressure was found to be 13.8 cm H(2)O on average when the patient felt abdominal discomfort, in other words the desire to defecat (miction). CONCLUSIONS: A modified sigmoidorectal pouch procedure not only provides a reservoir with a higher capacity and lower pressure without a reflux to the upper urinary tract and descending colon with lower metabolic acidosis problem, but it is also a good alternative diversion procedure that whould be preferable especially in Muslim countries as it does not cause any difficulties in terms of Islamic worship.

Effect of long-term sitting on serum prostate-specific antigen levels.

OBJECTIVE: The aim of this study was to evaluate the effect of long-term sitting on serum prostate-specific antigen (PSA) levels. METHOD: The serum PSA levels of 50 bus drivers under the age of 45 (mean 37.7) years who worked at least 8 h a day for more than 3 weeks were compared with those of 50 healthy surgeons in similar age groups (mean 37.7 years) who spent most of their working time standing. RESULTS: There was no statistically significant difference between the mean PSA level of the study group (1.211 +/- 0.96 ng/ml) and that of the control group (1.214 +/- 0.74 ng/ml; p > 0.05). The PSA levels returned to normal after a 5-day resting period in cases who had higher values than the anticipated 2.5 ng/ml for this age group at the initial determination. CONCLUSIONS: These results suggest that there is no relationship between long-term sitting and serum PSA levels. A second PSA determination after a 5-day resting period may be helpful in cases with higher than normal initial values.

Reiter syndrome following intracavitary BCG administration.

BCG vaccine was given intravesically to a patient with bladder tumour. After the fifth dose she developed bilateral conjunctivitis, painful swelling in her wrist, dysuria and arthritis in her left knee and right metacarpophalangial joints. The diagnosis was Reiter syndrome and is the second case in the literature.