Evaluation of angiogenic apelin/apelin receptor axis in normal prostate, high grade prostatic intraepithelial neoplasia and prostatic adenocarcinoma.

INTRODUCTION AND OBJECTIVES: Prostate cancer is one of the most commonly diagnosed cancers in American men. Apelin is an endogenous peptide identified as the ligand of the G protein-associated apelin receptor. Apelin and apelin receptor have many tissues distribution and they participate in pathological processes, such as cancer. Apelin stimulates cancer angiogenesis. However, there are insufficient data in the literature regarding the role of apelin/apelin receptor in normal tissue, highgrade prostatic intraepithelial neoplasia, and prostatic adenocarcinoma tissues. Therefore, this study aimed to investigate the apelin and apelin receptor expression levels in tissues of normal prostate tissue, high-grade prostatic intraepithelial neoplasia, and prostatic adenocarcinoma. MATERIALS AND METHODS: In this study, 38 samples of patients undergoing radical prostatectomy were used. Among 38 samples; 20 patients were with prostatic adenocarcinoma, 18 patients were with high-grade prostatic intraepithelial neoplasia and adjacent normal prostatic tissue areas. The immunolocalisation of apelin and apelin receptor in these tissues were determined immunohistochemically. RESULTS: Apelin and apelin receptor expressions were higher in prostatic adenocarcinoma than normal prostate tissue and high-grade prostatic intraepithelial neoplasia. Apelin receptor expression was also increased in high-grade prostatic intraepithelial neoplasia compared to normal tissue. CONCLUSION: Apelin and apelin receptor are increase in the process of prostate carcinogenesis. This increase may adversely affect the clinical course of prostate cancer patients by stimulating angiogenesis, which is important for invasion and metastasis in prostate cancer.

Biochemical predictors in presentations to the emergency department after a suicide attemp.

OBJECTIVE: This study was conducted with an aim to determine whether biochemical parameters could be used to identify the individuals at risk of suicide. METHODS: The experimental group consisted of a total of 46 patients that presented to the emergency department after a suicide attempt. 45 healthy individuals constituted the control group. All subjects were evaluated by using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Beck Scale for Suicidal Ideation (BSSI). All subjects were evaluated for leukocyte count, mean platelet volume (MPV), C-reactive protein (CRP), cholesterol, triglyceride levels and neutrophil-lymphocyte ratio (NLR). The Vitamin D levels of the subjects in the experimental group were also measured. RESULTS: The BAI (p < 0.01), BDI (p < 0.01), and BSSI (p < 0.01) scores of the two groups were significantly different. The two groups were also significantly different in terms of CRP (p < 0.01), cholesterol (p < 0.05), NLR (p < 0.01), MPV (p < 0.01), triglyceride (p < 0.01) and leukocyte (p < 0.01) results. The vitamin D levels of the experimental group were found to be below normal vitamin D levels. High CRP levels were found to be a predictor of anxiety symptoms, and MPV and triglyceride levels were found to be predictors of depressive symptoms. CONCLUSION: We believe that biochemical parameters can be used to identify people with increased suicide risk, and suicide rates can be reduced by ensuring that these patients receive mental health care in the early period (Tab. 5, Ref. 42).

Mutation spectrum of 260 dystrophinopathy patients from Turkey and important highlights for genetic counseling.

We genetically evaluated 260 dystrophinopathy patients from Turkey. Karyotyping as an initial test in female patients, followed stepwise by multiplex ligation-dependent probe amplification and by targeted next-generation sequencing of DMD revealed definitive genetic diagnoses in 214 patients (82%), with gross deletions/duplications in 153 (59%), pathogenic sequence variants in 60 (23%), and X-autosome translocation in one. Seven of the gross and 27 of the sequence variants found novel. In silico prediction, co-segregation and transcript assays supported the pathogenic nature of the novel silent (p.Lys534=) and the splice site (c.4345-12C>G) alterations. From a total of 189 singleton cases, 154 (82%) had pathogenic alterations. From 138 of those who had maternal carrier testing, 68 out of 103 (66%) showed gross and 11 out of 35 (31%) showed small pathogenic variants. This suggests that the de novo occurrences in DMD appear approximately 2.1 times more frequently in meiotic unequal crossing-over than in uncorrected replication errors. Our study also disclosed three mothers as obligate gonadal mosaic carriers. Family-based investigation of dystrophinopathy patients is crucial for the ascertainment of novel or rare variants and also for counseling and follow-up care of the families.

Magnetically driven suppression of nematic order in an iron-based superconductor.

A theory of superconductivity in the iron-based materials requires an understanding of the phase diagram of the normal state. In these compounds, superconductivity emerges when stripe spin density wave (SDW) order is suppressed by doping, pressure or atomic disorder. This magnetic order is often pre-empted by nematic order, whose origin is yet to be resolved. One scenario is that nematic order is driven by orbital ordering of the iron 3d electrons that triggers stripe SDW order. Another is that magnetic interactions produce a spin-nematic phase, which then induces orbital order. Here we report the observation by neutron powder diffraction of an additional fourfold-symmetric phase in Ba1-xNaxFe2As2 close to the suppression of SDW order, which is consistent with the predictions of magnetically driven models of nematic order.

Association of epicardial fat thickness with TIMI risk score in NSTEMI/USAP patients.

BACKGROUND: The association of epicardial adipose tissue (EAT) with coronary artery disease has been shown in previous studies. Furthermore, the relationship between EAT and acute coronary syndrome was studied recently. Herein, we investigated the relationship between EAT thickness and the thrombolysis in myocardial infarction (TIMI) risk score for non-ST-elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP). PATIENTS AND METHODS: The study included 144 patients with NSTEMI/USAP. The study population was divided into two subgroups according to TIMI risk scores as group I (≤ 4, n = 86) and group II (> 4, n = 58). Stepwise multivariable logistic regression analysis was used to assess the independent association of clinical parameters with TIMI risk score. RESULTS: EAT thickness was higher in group II than in group I (8.2 ± 2.1 vs. 6.2 ± 2.2, p < 0.001). Moreover, patients in group II had higher rates of multivessel disease and Gensini score (p < 0.001). In univariate linear regression analysis, EAT was positively correlated with TIMI risk score and Gensini score. Multivariate regression analysis showed that EAT thickness (OR: 1.56, 95 % CI: 1.17-2.08, p = 0.003), LVEF (OR: 0.93, 95 % CI: 0.85-0.98, p = 0.03), and Gensini score (OR: 1.36, 95 % CI: 1.24-1.98, p = 0.002) were independently associated with a higher TIMI risk score. CONCLUSION: In conclusion, EAT thickness is independently associated with TIMI risk score and may be an emerging risk factor for adverse events in NSTEMI/USAP patients.

Clinical and mutation data in 12 patients with the clinical diagnosis of Nager syndrome.

Nager syndrome (MIM #154400) is the best-known preaxial acrofacial dysostosis, mainly characterized by craniofacial and preaxial limb anomalies. The craniofacial abnormalities mainly consist of downslanting palpebral fissures, malar hypoplasia, micrognathia, external ear anomalies, and cleft palate. The preaxial limb defects are characterized by radial and thumb hypoplasia or aplasia, duplication of thumbs and proximal radioulnar synostosis. Haploinsufficiency of SF3B4 (MIM *605593), which encodes SAP49, a component of the pre-mRNA spliceosomal complex, has recently been identified as the underlying cause of Nager syndrome. In our study, we performed exome sequencing in two and Sanger sequencing of SF3B4 in further ten previously unreported patients with the clinical diagnosis of Nager syndrome, including one familial case. We identified heterozygous SF3B4 mutations in seven out of twelve patients. Four of the seven mutations were shown to be de novo; in three individuals, DNA of both parents was not available. No familial mutations were discovered. Three mutations were nonsense, three were frameshift mutations and one T > C transition destroyed the translation start signal. In three of four SF3B4 negative families, EFTUD2 was analyzed, but no pathogenic variants were identified. Our results indicate that the SF3B4 gene is mutated in about half of the patients with the clinical diagnosis of Nager syndrome and further support genetic heterogeneity for this condition.

Cutis marmorata telangiectatica congenita: an unusual cause of lower extremity hypoplasia.

Cutis marmorata telangiectatica congenita is a relatively benign, rare cutaneous disorder with various manifestations. A seven-year-old girl, who presented with extremity hypoplasia, had the characteristic reticular, patchy, blue-pink cutaneous lesions, which became more prominent with exposure to cold temperatures. She had 4.8 cm shortening of her right lower extremity, which was also thinner than on the left side. The patient did not have skin atrophy, ulcers, glaucoma or macrocephaly. She is being followed for a future extremity lengthening procedure.

Lateral premalleolar bursitis as a result of sitting on the foot.

Lateral premalleolar bursitis develops on the dorsolateral aspect of the foot in people who sit on their feet for prolonged periods. Twenty-nine premalleolar bursae in 21 patients were diagnosed. The patients presented with one or more of the complaints of swelling, pain and difficulty in wearing shoes. One bursa was infected. Initial treatment was non-surgical. With avoidance of the sitting position, the problem resolved in eight of the sixteen patients who were followed. Four bursae were injected with cortisone, three without success. Six bursae were surgically excised, and four of them, with a minimum of one year follow-up were doing well.

Carpal tunnel release using a short palmar incision and a new knife.

A new knife with its own battery powered light source (Knifelight, Stryker Instruments, Kalamazoo, Michigan, USA) was used for carpal tunnel release in 31 wrists of 25 patients. Under local anaesthesia, a short palmar incision was used and the carpal tunnel contents were visualized during division of the flexor retinaculum. The mean operation time was 11 minutes and no major complications were seen. The patients could use their hands for self-care after 3 days and returned to work at a mean of 23 days. At a minimum follow-up of 6 months, all but one of the patients were satisfied with the final result. Mild scar tenderness was seen in two patients and pillar pain in one patient.

Skin blood flow level and stump healing in ischemic amputations.

Skin blood flow was measured with xenon 133-histamine mixture in 20 lower extremities of 18 patients before performing amputations. The amputation levels were chosen according to clinical criteria; 13 below-knee, 3 distal femoral, 1 midfemoral, 2 transmetatarsal, and 1 Syme's amputations were performed. Fourteen stumps had normal healing, 2 had delayed healing, and 3 had necrosis. All of the stumps with normal healing had a skin blood flow >1.76 ml/100 g tissue/minute. Bleeding from the skin also was a good predictor of healing. Skin blood flow measurement may be helpful for level selection in ischemic amputations.

Adenosine deaminase and guanosine deaminase activities in sera of patients with viral hepatitis.

In order to investigate purin and primidin metabolism pathways in hepatitis, adenosine deaminase (ADA) and guanosine deaminase (GDA) activities in sera of patients with different types and manifestations of viral hepatitis disease (A, B, C, D, E, chronic, acute) were investigated and compared with the control group of healthy individuals. Hepatitis cases were classified with respect to their serological findings and clinics. When compared all the hepatitis cases with the controls, levels of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase enzymes, as well as ADA and GDA, were significantly higher than the control group (p<0.01). Levels of ADA and GDA in hepatitis cases were determined as 26.07 11.98 IU/l and 2.37 1.91 IU/l, respectively. When compared their ADA and GDA levels amongst the classified hepatitis groups, there was no difference in ADA levels amongst cases (p>0.05). However, GDA levels in hepatitis A group were closed to the controls. Increase in serum ADA activities in hepatitis forms may be dependent on and reflect the increase in phagocytic activity of macrophages and maturation of T-lymphocytes, and may be valuable in monitoring in viral hepatitis cases.

Effects of antimonial therapy on serum zinc, copper and iron concentrations in patients with cutaneous Leishmaniasis in Turkey.

The effects of cutaneous leishmaniasis (CL) infections on total content of the essential trace elements and alterations of these elements content during antimonial therapy, serum iron (Fe), copper (Cu) and zinc (Zn), were determined in 40 patients with CL. 32 healthy subjects were selected as control group. Pentavalent antimonial compounds (Glucantime) were given intramuscularly (20 mg/kg/day) for three weeks in patients group. Serum Cu and Zn levels were determined by flame atomic absorption spectrometry and Fe levels were determined by colorimetrically. Before antimonial therapy; Cu levels were found significantly higher. However, Zn and Fe levels were found significantly lower in the patients group than those of controls. Cu levels were found tended to decrease, while Zn and Fe levels tended to increase during antimonial therapy. There was a negative correlation between serum Cu and Zn levels in CL patients (r = -0.322, p < 0.05). The findings showed that CL affects the essential trace element content and these changes began to disappear during antimonial therapy.

2- to 10-year follow-up study of acetabular revisions using allograft bone to repair bone defects.

The failure rates of revision of acetabular components have been high; however, long-term success has been reported with the use of particulate allografts or autografts with large-diameter prosthetic cups to correct bone deficiencies when host-cup contact is at least 30% to 50%. The purpose of this study was to review 2- to 10-year follow-up data on complex acetabular revisions in which contact between allograft bone and the prosthetic cup was at least 50%. In the 47 hips monitored clinically and radiographically for a mean of 5 years, results were classified as excellent in 37%, good in 26%, fair in 17%, and poor in 19%. The mean Harris hip score was 82.5 (range, 39-100). The prosthetic cups migrated in 3 hips, but 2 stabilized within 1 year. Three cups had complete radiolucent lines without migration; the lines did not correlate with location of the allografts. Although bone ingrowth into porous surfaces from allografts is debatable, the results of the study show that massive allograft reconstruction of the acetabulum can provide both immediate and long-term stability of the prosthetic cup and restore bone stock.

Alterations of serum selenium, zinc, copper, and iron concentrations and some related antioxidant enzyme activities in patients with cutaneous leishmaniasis.

The aim of this study was to measure the alterations in serum selenium (Se), copper (Cu), zinc (Zn), and iron (Fe) concentrations and their carrier proteins, ceruloplasmin (Cp), transferrin (Tf) albumin, and related antioxidant enzyme activities, erythrocyte Cu-Zn superoxide dismutase (Cu-Zn SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activities in patients with cutaneous leishmaniasis (CL). Erythrocyte Cu-Zn SOD activities, serum Cu concentrations, and Cp levels were found to be significantly higher in the patients group than those of controls. However, GSH-Px and CAT activities and Se, Zn, Fe, and Tf levels were lower in patients than in the control subjects. There were positive important correlation's between Cu-Zn SOD and Cp, Cu-Zn SOD and Cu, Cp and Cu, GSH-Px and Se, and Fe and CAT in the patients group. Our results showed that serum essential trace elements Se, Zn, Cu, and Fe concentrations and their related enzymes Cu-Zn SOD, GSH-Px, and CAT activities change in CL patients. The changes may be a part of defense strategies of organism and are induced by the hormonelike substances.

Role of lipids, lipoproteins and lipid peroxidation in thrombocytopenia in patients with vivax malaria.

Possible roles of oxidative and metabolic changes of lipids in the development of thrombocytopenia in patients with vivax malaria were investigated. Serum total cholesterol, HDL and LDL cholesterols, triglycerides, lipid peroxidation level and platelet counts were determined in 60 patients with vivax malaria and compared with 50 healthy individuals. Inter-relationships of parameters were investigated. In patients, serum total cholesterol, HDL and LDL cholesterol concentrations and platelet counts were lower, and serum triglycerides and plasma lipid peroxidation concentrations were higher than those of control subjects. Significant relationships were found among serum lipid parameters, plasma lipid peroxidation and thrombocyte counts. Decrease in total cholesterol, HDL and LDL cholesterols and platelet counts may be related or secondary to oxidative stress. In the treatment of thrombocytopenia required in the some cases of malaria, the supplementation of antioxidative vitamins may be considered.