A new promising indicator in prostate cancer screening: Prostate-specific antigen fluctuation rate.

OBJECTIVES: To evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer. MATERIALS AND METHODS: The study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA1 and PSA2) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values. RESULTS: PSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% (20.5) and 9.6% (14.4), P=.019). A Simple linear regression was used to examine the relationship between PSAfr and other factors such as age, PSA, PSAD, and prostate volume, but it was shown that these had no effect on PSA fluctuations. ROC analysis revealed a relatively low Area Under the Curve (AUC) for PSAfr (AUC, 0.584 (0.515-0.653)). However, the cut-off value of 12.35% was found to be significant, with a sensitivity of 58% and a specificity of 59% (P:.019, 95%CI). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33-0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations. CONCLUSION: PSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.

Caloric restriction improves the redox homeostasis in the aging male rat heart even when started in middle-adulthood and when the body weight is stable.

Evidence indicates that maintenance of redox homeostasis is fundamental for cellular longevity. Caloric-restriction (CR) is said to decrease the formation of oxidatively modified cellular macromolecules and improve health. On the other hand, some studies indicate that many CR studies are flawed, because ad libitum fed rats are not well-controlled. Thus, it is claimed that purported beneficial effects of CR could be not due to real CR effect, but due to control animals going obese. Also, it remains to be elucidated whether effects of CR could be observed even when CR is started in mid-adulthood. Male Sprague-Dawley rats were grouped as: non-CR 6-month-old rats (n = 7), 24-month-old rats subjected to 40% CR for 6 months between 18th and 24th months (n = 8), and non-CR 24-month-old animals (n = 8). We investigated 16 previously validated biomarkers of macromolecular redox homeostasis, ranging from protein and lipid oxidation to glycation and antioxidative capacity. In the present study, the protein, lipid and antioxidant capacity redox homeostasis biomarkers overwhelmingly indicate that, CR, even though not started very early in adulthood, could still offer potential therapeutic effects and it could significantly improve various redox homeostasis biomarkers associated with disease reliably in the heart tissue of aging male Sprague-Dawley rats. Therefore, the effects of CR likely operate through similar mechanisms throughout adulthood and CR seems to have real ameliorative effects on organisms that are not due to confounding factors that come from ad libitum fed rats.

Neutrophil lymphocyte ratio predicts postoperative pain after orthognathic surgery.

BACKGROUND AND AIM: Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate possible relationship between preoperatively measured neutrophil-lymphocyte ratio (NLR) - as an inflammation marker - and postoperative analgesic demand in patients underwent orthognathic surgery. MATERIALS AND METHODS: We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery. Demographical data, preoperative NLR, type of surgery, modified Mallampati score, difficulty degree of intubation, duration of surgery, and postoperative analgesic (tenoxicam - as the first drug of choice, paracetamol, tramadol, or pethidine) usage were recorded. A cutoff value of NLR ≥2 was determined for inflammation threshold. Two groups (Group 1 NLR ≥2, Group 2 NLR <2) were compared for analgesic doses, numbers of patients needed analgesic treatment, and other parameters. RESULTS: Mean administered tenoxicam dose was significantly higher in Group 1 than in Group 2 (P < 0.0001). Further, ratio of patients treated with tenoxicam in Group 1 was significantly higher than that in Group 2 (χ2 = 4.779, P = 0.029). CONCLUSIONS: Preoperatively measured NLR may help to predict postoperative analgesic demand in patients undergoing orthognathic surgery, and thus sufficient postoperative pain control can be achieved with various preventive treatments taken at the perioperative period such as preemptive analgesia, local anesthetic administration at the end of surgery, or early administration of analgesics.

A case of Cryptococcus neoformans meningitis in a patient with abnormal levels of isolated immunological markers.

Cryptococcal meningitis is considered rare in immunocompetent patients and is mainly a disease of immunocompromised patients. We report a case of cryptococcal meningitis, due to Cryptococcus neoformans, in an apparently healthy individual with abnormal levels of isolated immunological markers. Regardless of the patient's immune status, the result of the disease can be serious unless the disease is diagnosed early.

Investigation of telomerase activity and apoptosis on invasive ductal carcinoma of the breast using immunohistochemical and Western blot methods.

OBJECTIVE: Invasive ductal carcinoma (IDC) comprises the largest group of breast cancers. This study aimed to investigate telomerase activity and apoptosis using immunohistochemical and Western blot methods. PATIENTS AND METHODS: In total, 75 cases that had been diagnosed as IDC and 20 cases that had undergone a freezing procedure were included. The histological sections were stained with Bax, Bcl-2, hTERT and BNIP3. The ages of the patients, as well as their hormonal status and tumour sizes and grades were evaluated, as well as the staining characteristics of the antibodies in question. RESULTS: A decrease in Bcl-2 positivity and an increase in Bax positivity were found immunohistochemically with increasing tumour grades. The data obtained by western blot method showed that Bcl-2 was highest in grade 1 tumours although these results were not statistically significant. The relationship between estrogen and progesterone receptor positivity and Bcl-2 was statistically significant, suggesting there is hormonal control through apoptosis. BNIP3 was found to be decreased with increasing tumour grades. Similarly, BNIP3 was found to be having the lowest value in grade 3 tumours by western blot method. Furthermore, hTERT was found to be increased with increasing tumour grades. In the western blot method, hTERT increased nearly four-fold compared to the control. In addition, hTERT, which was seen in very high levels in tumours, may be a helpful cancer marker. Both hTERT and BNIP3 are important markers that can provide information about prognosis. CONCLUSIONS: Big improvements can be achieved in tumour progression control with new treatment modalities that stop telomerase activity and hypoxic cell death.

Free radical reaction products and antioxidant capacity in beating heart coronary artery surgery compared to conventional bypass.

Oxygen-derived free radicals are important agents of tissue injury during ischemia and reperfusion. The aim of this study was to investigate changes in protein and lipid oxidation and antioxidant status in beating heart coronary artery surgery and conventional bypass and to compare oxidative stress parameters between the two bypass methods. Serum lipid hydroperoxide, nitric oxide, protein carbonyl, nitrotyrosine, vitamin E, and ß-carotene levels and total antioxidant capacity were measured in blood of 30 patients undergoing beating heart coronary artery surgery (OPCAB, off-pump coronary artery bypass grafting) and 12 patients undergoing conventional bypass (CABG, on-pump coronary artery bypass grafting). In the OPCAB group, nitric oxide and nitrotyrosine levels decreased after reperfusion. Similarly, ß-carotene level and total antioxidant capacity also decreased after anesthesia and reperfusion. In the CABG group, nitric oxide and nitrotyrosine levels decreased after ischemia and reperfusion. However, protein carbonyl levels elevated after ischemia and reperfusion. Vitamin E, ß-carotene, and total antioxidant capacity decreased after ischemia and reperfusion. Significantly decreased nitration and impaired antioxidant status were seen after reperfusion in both groups. Moreover, elevated protein carbonyls were found in the CABG group. The off-pump procedure is associated with lower degree of oxidative stress than on-pump coronary surgery.

The effect of mandibular setback or two-jaws surgery on pharyngeal airway among different genders.

Cephalometric studies show significant gender differences in the size of the pharyngeal airway space. This study aimed to investigate and compare morphologic changes after mandibular setback or two-jaws surgery on the pharyngeal airway in men and women using computed tomography (CT). The sample included 34 women and 13 men diagnosed with Class III skeletal deformities, who had been treated by mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback). Anteroposterior, lateral and cross-sectional area dimensions of the airway, at the level of soft palate and base of tongue, were measured pre- and postoperatively on CT images. In the mandibular setback group, the anteroposterior and cross-sectional area of the pharyngeal airway at the level of the soft palate and base of tongue were significantly reduced for men or women (P<.05). In the two-jaws surgery group, only midsagittal anteroposterior dimensions at the same levels were significantly decreased for men or women (P<.05). The difference between any values measured between men and women who received bilateral sagittal split ramus osteotomy setback surgery or two-jaws surgery for the treatment of class III anteroposterior discrepancy were not statistically significant (P>.05). This study suggests that oropharyngeal airway measurements, important for airway patency, do not demonstrate sex dimorphism.

Hydrothorax in 2 children on CAPD: review of clinical approach and treatment options.

Pleural effusions are seen relatively common in end-stage renal disease (ESRD) patients, on the other hand, hydrothorax secondary to pleuroperitoneal leak in continuous ambulatory peritoneal dialysis (CAPD) patients is rare. Since treatment modalities differ widely from that of other causes of pleural effusion seen in CAPD patients such as uremia, volume overload, congestive heart failure, infection and malignancy, pleuroperitoneal leak should always be kept in mind in the differential diagnosis and should be excluded urgently. To draw attention to this point, in this paper, 2 children on CAPD who developed a hydrothorax secondary to a pleuroperitoneal communication are presented with an overview of diagnostic tools and treatment modalities.

A comparative study of mandibular fractures in the United States and Turkey.

This study compared the data on mandibular fractures that occurred in a city in the United States and one in Turkey between 1991 and 2000. The 210 Turkish patients had 252 mandibular fractures, whereas the 665 US patients had 1042 mandibular fractures. Males accounted for 84% (560 patients) and females for 16% (105 patients) of the cases in the US. The male:female ratio was 5.5:1. In Turkey, males accounted for 76% (160 patients) and females for 24% (50 patients) of cases. The male:female ratio was 3.2:1. Assault (53.7%) was the most common cause of fracture in the US, whereas in Turkey the most common cause was a motor vehicle accident (36.2%). The most common site of mandibular fracture in the US was the angle (27.57%); in Turkey the most common site was the body (28.97%). Many of these variations may be related to socioeconomic, cultural and environmental differences between the two countries.

Evaluation of allantoin levels as a new marker of oxidative stress in Behçet's disease.

The increased production of reactive oxygen species (ROS) from activated neutrophils in Behçet's disease (BD) and recurrent aphthous stomatitis (RAS) may result in increased oxidative stress. Uric acid can react rapidly with neutrophil-derived ROS to form allantoin. The purpose of the study was to evaluate the serum levels of allantoin as a new marker of oxidative stress in BD compared with malondialdehyde (MDA) levels as a well-known marker. Blood samples were obtained from 23 BD patients, 22 RAS patients as positive controls, and 21 healthy controls. When compared to the healthy controls, we found higher allantoin and MDA levels in the BD patients and higher MDA levels in the RAS patients. Serum ascorbic acid levels in the BD patients were significantly lower than in the controls. Increased allantoin and MDA levels suggest the possible involvement of free radicals in BD. As allantoin is only a product of uric acid oxidation by reactive oxygen and nitrogen species, it may also be used as a marker of oxidative stress in BD.

Chondrosarcoma of the parapharyngeal space. A case report.

Chondrosarcomas are the malignant cartilagenous tumors and they are seen rarely in the head and neck area. They are usually slow growing lesions. The head and neck chondrosarcomas may show an aggressive course and the occurrence of this malignant cartilagenous tumor in the parapharyngeal space is only a few. They are mostly located in relation with jaw bones and base of the skull. Chondrosarcomas of the parapharyngeal space are limited in number and among them there is no low-grade one. In this case report, a case of low-grade chondrosarcoma which was treated with a simple excision without neck dissection was reported.

Comparison of different fixation methods following sagittal split ramus osteotomies using three-dimensional finite elements analysis. Part 1: advancement surgery-posterior loading.

The purpose of this study was to evaluate the mechanical behavior of different fixation methods used in bilateral sagittal split ramus osteotomy (BSSRO). Part 1 comprises of the results of the analysis for mandibular advancement, four different fixation configurations of six hole fragmentation mini plates with monocortical screws and lag screws and posterior loading conditions in the molar and premolar region. The finite element analysis method (FEA) appears suitable for simulating complex mechanical stress situations in the maxillofacial region. The mechanical behavior of selected lag screws with linear or triangular configuration and double parallel or single oblique six hole mini plates with monocortical screws were compared by FEA after 5 mm BSSRO advancement procedure. Four separate three-dimensional finite element models of the mandible were created to simulate the BSSRO and corresponding fixation methods. These models consisted of 122,717 elements and 25,048 nodes. The mechanical parameters of the materials studied were adopted from the literature or were based on manufacturer's information. 500 N posterior occlusal loads were simulated on the distal segments. The commercial finite element solver MSC Marc software was utilized to calculate the stress fields on both the segments and fixative appliances. It was concluded that the use of 2.0mm lag screws placed in a triangular configuration following the BSSRO advancement surgery provides sufficient stability with any rotational movement and less stress fields at the osteotomy site, when compared with the other rigid fixation methods used in the current study.

Plasma malondialdehyde (MDA) levels in breast and lung cancer patients.

OBJECTIVE: To measure the levels of malondialdehyde (MDA), a marker of lipid peroxidation, in patients with breast and lung cancer. METHOD: Analysis of plasma MDA, and serum uric acid, albumin, cholesterol and triglycerides in 26 breast and 12 lung cancer patients and 41 healthy controls. The effects of age, body mass index (BMI), and menopausal status on plasma MDA were evaluated in the 26 patients with breast cancer. RESULTS: Plasma MDA levels in cancer patients were significantly higher than those in controls (P < 0.001). Average MDA levels were 6.33 micromol/L in breast cancer patients and 5.87 micromol/L in lung cancer patients. There was no correlation between MDA and triglyceride levels in either controls or cases. There was no correlation between MDA and cholesterol levels in patients with breast cancer, but there was a correlation in patients with lung cancer. Albumin levels did not differ significantly between controls and cases (P > 0.05), but uric acid levels in breast cancer patients were significantly higher than those of controls (P < 0.01). CONCLUSION: The results of this study provide further evidence of the relationship between lipid peroxidation and cancer and should contribute to the interpretation of epidemiological studies in this area and the planning of future research.

Ascorbic acid and uric acid levels in lung cancer patients.

OBJECTIVE: To study any possible association between serum ascorbic acid and uric acid levels with lung cancer. METHOD: Serum ascorbic acid and uric acid levels in lung cancer patients (n = 30) and healthy controls (n = 45) were measured. RESULTS: The mean values for serum ascorbic acid were found to be significantly lower (P< 0.05) in patients (0.112+/-0.020) than in controls (0.394+/-0.029). Serum uric acid levels of patients were also significantly lower than those of controls (P< 0.05). CONCLUSION: There was no association between serum levels of ascorbic acid and uric acid, cholesterol, triglyceride and albumin levels with lung cancer.

Serum uric acid levels in cardiovascular diseases.

OBJECTIVE: Comparison of the serum uric acid levels of healthy people (n=71) and patients with cardiovascular diseases (CVD) (n=62). SUBJECTS AND METHODS: The patients included had either experienced acute myocardial infarction (AMI) (n=31), atherosclerosis (AT) (n=23) or ischaemia (n=8). The mean values (x+/-SD) of serum uric acid levels of the control group, the patients with CVD as a whole, and patients with AMI, AT and ischaemia were 4.15+/-0.45 mg%, 5.6+/-2.06 mg%, 5.96+/-2.60 mg%, 5.38+/-1.22 mg% and 4.94+/-1.40 mg%, respectively. A statistically higher level of serum uric acid was found in the controls compared to the CVD patients (P < 0.05). CONCLUSION: The higher serum uric acid levels found in CVD patients suggests that any protective antioxidant effect which uric acid has is overwhelmed by other negative effects on pathogenesis.

Serum beta-carotene, vitamin E, vitamin C and malondialdehyde levels in several types of cancer.

We measured the levels of serum carotenoids (beta-carotene), total tocopherol (vitamin E), ascorbic acid and malondialdehyde (MDA) in newly diagnosed cancer cases. Levels of the antioxidants and MDA in serum samples from 208 subjects with cancer affecting different sites (59 breast, 38 head and neck, 46 genitourinary, 12 lung, 20 gastrointestinal and 33 other sites) were compared with levels in 156 controls. Cases and controls were compared with respect to a number of potentially confounding factors: age, sex, smoking status, Quetelet index (kg/m2), diet and alcohol intake. Mean (+/- SD) levels of beta-carotene, vitamin E and vitamin C were significantly lower among the cases than the controls (49.35 +/- 36.55 micrograms/l, 0.60 +/- 0.14 mg/dl, 0.40 +/- 0.27 mg/dl and 75.31 +/- 28.59 mg/dl, 0.98 +/- 0.13 mg/dl, 0.88 +/- 0.47 mg/dl, respectively) (P < 0.05). On the other hand, mean levels of MDA were significantly higher among the cases than the controls (6.79 +/- 1.22 nmol/ml and 3.52 +/- 0.97 nmol/ml, respectively) (P < 0.05). The results obtained suggest that measurement of serum antioxidants and MDA levels may provide further useful information when evaluating cancer patients.

Evaluation of serum beta-carotene levels in patients with cardiovascular diseases.

Serum beta-carotene levels in patients with cardiovascular disease and control subjects were measured. The mean values for beta-carotene were found to be 82.2 +/- 3.5 micrograms/dl for the cases as a single group, 74.83 +/- 5.6 micrograms/dl in acute myocardial infarction (AMI) cases, 88.19 +/- 6.1 micrograms/dl in atherosclerotic cases, 85.11 +/- 6.1 micrograms/dl in others and 118.2 +/- 4.3 micrograms/dl in controls. beta-carotene levels in the cases were significantly lower than in the controls (P < 0.05). Serum beta-carotene levels in cases and controls were also compared to take account of age, sex and smoking status. Our data indicate that there are apparent associations between serum beta-carotene levels, sex and smoking status.