Comparison of the efficacy and safety between subthreshold micropulse laser, standard-fluence and low-fluence photodynamic therapy for chronic central serous chorioretinopathy.

PURPOSE: To compare the efficacy and safety of subthreshold micropulse laser treatment (SML), standard-fluence photodynamic therapy (PDT) and low-fluence PDT in patients with chronic central serous chorioretinopathy (cCSC). METHODS: This retrospective study included 52 eyes of 46 patients with chronic CSC who were treated with 577nm SML (n=23), standard-fluence PDT (verteporfin 6mg/m2 and light energy 50J/cm2) (n=13), or low-fluence PDT (verteporfin 6mg/m2 and light energy 25J/cm2) (n=16). The mean changes in best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) parameters, including central retinal thickness (CRT), subretinal fluid (SRF) height, and ellipsoid zone (EZ) disruption, over the follow-up period were evaluated. RESULTS: The mean follow-up period was 8.42±3.34 months. In the SML group, the SRF resolution time was longer than the other groups. At 1 month, the SML group's mean CRT was higher than the other groups. The BCVA improvement was statistically significant in all groups (P<0.05), but in the SML group, it was slower than the other groups. Three eyes in the low-fluence and one eye in the standard-fluence PDT group received a second PDT treatment. The mean number of SML treatments was 2.48±1.08. If the EZ was intact, the rate of complete resolution of SRF was higher than if the EZ was disrupted or lost. CONCLUSION: SML, standard-fluence PDT, and low-fluence PDT can all improve visual acuity in cCSC. Standard-fluence and low-fluence PDT induced a more rapid reabsorption of the fluid, improvement of BCVA, and equal safety compared with SML. More treatment sessions of SML were required than with the other treatment modalities.

Does synchronous endometrioid endometrial cancer have any prognostic effect on Stage I endometrioid ovarian cancer?

OBJECTIVE: To determine the effect of synchronous endometrial endometrioid cancer (SEEC) on the prognosis of patients with Stage 1 endometrioid ovarian cancer (EOC). STUDY DESIGN: Clinicopathological data of cases with Stage 1 EOC from January 2000 to November 2013 were retrieved from the computerized database of Etlik Zubeyde Hanim Women's Health and Research Hospital. Of the 31 patients included in the study, 15 patients had primary synchronous endometrial and ovarian cancer (SEOC) (Group 1) and 16 patients had EOC alone (Group 2). RESULTS: Ovarian cancer substage and grade were compared between the two groups, and no significant differences were found. Most of the patients with SEEC had Grade 1 tumours (n=13, 86.7%). In Group 1, nine (60.0%) patients had endometrial tumours with superficial myometrial invasion, and six (40.0%) patients had deep myometrial invasion. Median follow-up was 94 months. Ten-year disease-free survival rates were 92.9% for Group 1 and 84.6% for Group 2 (p=0.565). CONCLUSION: Patients with Stage 1 EOC have excellent long-term survival. The presence of SEEC does not influence the prognosis of patients with Stage 1 EOC, even in the presence of deep myometrial invasion.

Two photon absorption properties of four coordinated transition metal complexes of tetraarylazadipyrromethene compounds.

New tetraarylazadipyrromethene metal complexes with four coordinate metals (cobalt(ii), nickel(ii), copper(ii) and zinc(ii)) and with three moieties (4-methylphenyl,4-methoxyphenyl and 1-naphthyl) were designed and synthesized targeting applications utilizing two photon absorption. The effects of metals with filled or unfilled d orbitals and substituents with various electron donor properties on the charge transfer mechanism and two photon absorption properties of tetraarylazadipyrromethene compounds were investigated by ultrafast pump-probe spectroscopy and open aperture Z-scan experiments as well as density functional theory (DFT) calculations. Ultrafast transient absorption spectra provide evidence of an efficient photoinduced intramolecular charge transfer between the ligand and metals which is independent of filled or unfilled d orbitals of metals. Although zinc has filled d orbitals, its complexes possess an absorption maximum including a shoulder which is attributed to partial ligand to metal L(π) → M(d*) charge transfer character (LMCT). Due to the charge transfer mechanism, metal complexes of tetraarylazadipyrromethene compounds exhibited two photon absorption properties in the femtosecond regime at 800 nm wavelength. The greatest two photon absorption cross section value was measured as 2690 GM for Zn(L(2))2 and 2374 GM for Co(L(3))2 complexes.

The importance of age and menopausal status in endometrial complex hyperplasia with atypia.

The effects of menopausal status and age on the intra-operative and post-operative pathology results of patients operated on with a pre-operative diagnosis of complex hyperplasia with atypia (CHA) were assessed. A hundred and eleven patients diagnosed in our centre between January 1993 and March 2013 were included. Cancer was detected in the paraffin blocks (PBs) of 52 (46.8%) patients. Among these, 50 patients had stage-IA disease. In 31.1% of the pre-menopausal patients and 66% of the post-menopausal patients, PB revealed cancer (p < 0.0001). The results of frozen section (FS) and PB were concordant in 51% and 70% in the pre-menopausal and post-menopausal patients, respectively (p = 0.041). In the patients operated on with a pre-operative diagnosis of CHA, the probability of detecting cancer in PB increases with increasing age and menopause. The reliability of FS is limited in younger and pre-menopausal patients.

Plasma pentraxin 3 levels in preeclamptic patients.

The authors evaluated plasma pentraxin 3 (PTX 3) levels in preeclamptic patients and determined the relationship between albuminuria and plasma PTX 3 levels. During a period of one year, 29 patients with severe or mild preeclampsia and 49 healthy pregnant women were included in the cross-sectional study. The two groups were compared each other with PTX 3 levels. The relationship between PTX 3 levels and urea, creatinine, AST, ALT, CRP, LDH, platelet count, and spot urine protein/creatinine rate were evaluated. PTX 3 level was significantly high in the preeclamptic group (p < 0.05). No significant correlation was found between serum PTX 3 level and urea, creatinine, AST, ALT, CRP, LDH, platelet, and spot urine protein/creatinine rate (p > 0.05). PTX 3 is a biochemical parameter that shows endothelial dysfunction. The authors believe that PTX 3 can be a valuable parameter to predict preeclampsia according to the significantly high PTX 3 levels in preeclamptic patients.

Fetal nuchal skin-fold thickness during the 2nd trimester of pregnancy.

A prospective study was conducted to determine the cut-off values of nuchal skin-fold thickness (NFT) with false-positive rates for each gestational week (GW) for chromosomal abnormalities during the 2nd trimester of pregnancy. A total of 2,313 women with normal singleton pregnancies were included in the study. Cases of multiple gestations, aneuploidy and major congenital malformations were excluded. The distribution of NFT between the 15th and 24th GW and the cut-off values of NFT with false-positive rates for chromosomal abnormalities were determined. A significant positive correlation was noted between NFT and GW. Statistically significant differences were observed in NFT for the each GW. The 95th percentile values of NFT between 15 and 24 weeks' gestation were 4.7, 4.77, 5.0, 5.5, 5.76, 5.9, 6.0, 6.1, 6.5 and 6.8 mm, respectively. In all fetuses, if the cut-off value of NFT was considered as 6 mm, the false-positive rate ranged from 1.8% to 37% in 15-24 weeks' gestation. Evaluation of NFT according to cut-off values determined by population-based percentiles for each GW might be a more appropriate screening method for chromosomal abnormalities than accepting NFT ≥ 6 mm for all fetuses as abnormal, regardless of gestational age.

The criterion value of fetal cerebral lateral ventricular atrium width for diagnosis of ventriculomegaly.

AIM: To determine the distribution of cerebral lateral ventricular atrium width (LVAW) as established according to gestational weeks, and calculate the criterion value of LVAW that differentiates normal fetuses from abnormal fetuses. MATERIALS AND METHODS: A total of 832 patients meeting the study's criteria were included in the control group. An additional 43 fetuses with LVAW > ten mm formed the case group. RESULTS: The criterion value ofLVAW was 9.7 mm. It did not change significantly throughout gestation. In the case group, 23 fetuses were terminated for fetal abnormalities, two fetuses died in utero, and 18 infants were born alive. Most of the abnormal development coincided with LVAW values greater than 12 mm. CONCLUSION: The authors suggest 9.7 mm as the criterion value, based on receiver operating characteristic (ROC) curve analysis. When the LVAW is between 9.8 and 12 mm without other fetal abnormalities, it may be regarded as a variation of the normal.

Takayasu's arteritis and tuberculosis: a case report.

The aetiology of Takayasu's arteritis is unknown, but an association with tuberculosis has been reported. We report the case of a 12-year-old-boy with Takayasu's arteritis: his blood pressure was 150/90 mmHg and fundoscopic examination showed grade I hypertensive changes. A tuberculin test was positive and acid-fast bacteria were seen in the urine. Angiography revealed involvement of the descending aorta, thoracic aorta and upper abdominal aorta, with fusiform enlargement and no filling of the left renal artery. He was started on prednisolone therapy, with cyclophosphamide being added subsequently. Despite vigorous treatment, including three courses of nitroprusside infusion, the severe hypertension persisted and his blood pressure became regulated only after left nephrectomy. Acid-fast bacteria were seen in the nephrectomy material. The exact role of Mycobacterium tuberculosis in the pathogenesis of Takayasu's arteritis is still unknown. In this patient the tuberculin test was positive and acid-fast bacteria were seen in both the urine and nephrectomy material. This finding is suggestive of the association between tuberculosis and the disease process.