Polyploidy Phenomenon as a Cause of Early Miscarriages in Abortion Materials.

Objectives: Chromosomal abnormalities are an important cause of especially early miscarriages. The aim of this study was to analyze the chromosomal aberrations and determine the frequencies of numerical and structural chromosome abnormalities in spontaneous abortion materials. Methods: This was a prospective research and ninety two abortion samples obtained from women who had one or more miscarriages were included in the study. Conventional karyotype analysis was performed on each sample to identify possible chromosomal abnormalities. Results: By karyotype analysis, 11 polyploidy cases, (9 triploids and 2 tetraploids), 8 trisomies (one of which was mosaic), 2 monosomies (monosomy X), 1 isochromosome, 1 Xq deletion, and 4 translocations were detected in abortion materials. Isochromosome and Xq deletion cases were also mosaic. In addition, five polymorphic variants were revealed. We found higher paternal age in polyploidy cases. Conclusion: The most common anomaly we found in abortion materials was polyploidy. This was followed by aneuploidy (trisomy and monosomy). Polyploidy (triploidy or tetraploidy) emerged as an important cause in cases of spontaneous abortion. Paternal age may be associated with polyploidy especially triploidy.

Healthcare professionals' beliefs regarding influenza vaccination: What has COVID-19 changed?

Background: Influenza poses a potential public health threat among healthcare professionals since an infected healthcare professional can spread the virus to patients at higher risk as well as his/her own family members and colleagues. Annual influenza vaccination is the most effective way to protect HCPs. Aim: This study was conducted to determine whether demand for and beliefs about influenza vaccination have changed among healthcare professionals in the COVID-19 era and the factors that might have influenced them in the early phase of the pandemic when COVID-19 vaccines were eagerly awaited. Patients and Methods: This observational descriptive study was conducted between November 16, and December 15, 2020. A total of 317 healthcare professionals completed an online survey. Bivariate analysis and binary logistic regression analysis were performed. Results: Nineteen (6.0%) healthcare professionals were regularly vaccinated against influenza every year, and 199 (62.8%) had never been vaccinated. During the 2019-2020 season, 30 (9.5%) participants had been vaccinated and the proportion desiring to be vaccinated against influenza during the 2020-2021 season was 49.8% (n = 158). The results revealed that those with chronic diseases, those who believed they had adequate information about influenza vaccination and those who believed healthcare professionals should be vaccinated against influenza regularly every year, respectively, had 3.5 times, 4.7 times, and 11 times higher vaccination rates. Conclusion: Although the proportion of healthcare professionals with the intention to be vaccinated for influenza increased with the COVID-19 pandemic, it is still not high enough. Influenza vaccination rates should be promoted by in-service training programs.

Impact of social contacts on SARS-CoV-2 exposure among healthcare workers.

BACKGROUND: Healthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure. AIMS: This study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm. METHODS: Contact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers. RESULTS: Of the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P < 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P < 0.001), in non-patient care settings (47%, P < 0.001) and in the social contacts (57%, P < 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62-4.69) in multivariate analysis. CONCLUSIONS: A significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.

The COVID-19 pandemic: The evaluation of the emergency remote parent training program based on at-home support for children with down syndrome.

During the COVID-19 pandemic, the development of emergency remote training programs for young children with Down syndrome, learning difficulties, and severe health problems and their parents became a requirement. The present study aimed to evaluate the impact of the "applied emergency remote training program", prepared to address the needs of parents with children with Down syndrome and to offer them at-home support. It is an evaluative case study conducted with 11 parents of 11-35 months old children with Down syndrome. The findings demonstrated that the program could be conducted in a home environment, it improved the interactional behavior of both parents and children, reduced the number of difficult routines, and was considered as an educational, instructive, and band-aid solution. Issues such as the development of systematic psycho-social support systems that increase full participation and motivation of parents in distance education programs are important during extreme times such as the pandemic. Difficulties in online data collection, the employment of coaching and counseling systems in information maintenance, individualization of the program, the improvement of the interactivity in the program, and the development of applied training programs on different topics still wait for a solution.

GRANULYSIN PEPTIDE AND GENE POLYMORPHISM IN THE PATHOGENESIS OF HASHIMOTO THYROIDITIS.

Background: Hashimoto thyroiditis (HT) is an autoimmune disease and the most common cause of hypothyroidism. The widespread lymphocyte infiltration in the thyroid gland and intolerance of the body against its thyroid antigens leads to the destruction of thyroid cells and impaired thyroid function. Granulysin (GNLY) is a cytolytic antimicrobial peptide that has been associated with a wide range of diseases such as various infections, cancer, transplantation, and skin problems. However, there are a few studies investigating the relationship between HT and granulysin. Aim: Our study aims to investigate whether granulysin levels and GNLY gene polymorphism contribute to the damaged immune response leading to HT. Material and Methods: 100 unrelated patients diagnosed with HT and 140 healthy individuals were included in our study. Frequencies of GNLY rs10180391 and rs7908 gene polymorphisms were determined using PCR- RFLP method and serum granulysin levels were determined using ELISA. Results: There is no statistical significance between patient and control groups in terms of genotype and allele frequencies of GNLY gene polymorphisms and serum levels of granulysin. Conclusion: In conclusion, granulysin and GNLY gene polymorphisms do not appear to relate to HT disease.

Association Between IL28B, IL29 Gene Polymorphisms and Clinical Manifestations of Behçet's Disease.

BACKGROUND: Behçet's disease (BD) is a chronic, multisystemic, inflammatory disease characterized by relapsing episodes of a wide spectrum of clinical findings. The role and mechanism of IFN-λs in BD remain unknown. The aim of this study was to investigate the relationship between IL29 and IL28B gene polymorphisms and BD or clinical manifestations. METHODS: Using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, single-nucleotide polymorphisms of IL28B rs8099917 (IL28 G/T), rs12979860 (IL28 C/T) and IL29 rs30461 (IL29 T/C) were studied in 94 patients with BD and 90 healthy controls. RESULTS: Our study did not show any relationship between Behçet Disease and genotype or allele frequencies of IL28B (rs8099917, rs12979860) and IL29 (rs30461) gene polymorphisms (p > .05). We found that the TT genotype of rs12979860 (IL28 C/T) polymorphism is higher in healthy controls and patients without central nervous system (CNS) involvement compared to patients with CNS involvement (p = .014 and p = .022). CONCLUSIONS: As a result, although the relationship was found between IL28 and IL29 gene polymorphisms with some clinical manifestations of BD, it was not directly related to the predisposition of the disease. The relationship between IL-28 and IL-29 which act as regulators in inflammatory processes, with Behçet disease, needs to be investigated in further studies.

The effect of alpha blocker treatment prior to prostate biopsy on voiding functions, pain scores and health-related quality-of-life outcomes: A prospective randomized trial.

PURPOSE: To evaluate the effect of alpha-blocker treatment prior to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) on voiding functions, pain scores and health-related quality-of-life outcomes. MATERIALS AND METHODS: From January 2018 to April 2019, a total of 112 patients underwent TRUS-Bx due to elevated prostate-specific antigen (PSA) or abnormal digital rectal examination findings. Patients were divided into 2 groups depending on whether they received pharmacological treatment before biopsy. Group 1 consisted of patients with no alpha-blocker treatment prior to biopsy and Group 2 consisted of patients who received Tamsulosin for one week before biopsy continuing for one week after biopsy. Voiding function was evaluated three times using the validated International Prostate Symptom Score (IPSS) and uroflowmetry (maximal flow rate (Qmax) and residual volume (PVR)). The Turkish version of the Medical Outcomes Study Short Form 36-item Questionnaire (SF-36) was used to assess health-related quality of life. Pain scores were rated according to the Visual Analogue Scale (VAS) just after the biopsy procedure. RESULTS: Mean IPSS and Qmax on the post-biopsy 7 day were significantly in favor of Group 2 (P<0.001, P=0.004). Although post-biopsy day 7 PVR was similar between the groups, Δ1 PVR was significantly in favor of Group 2 (P=0.004). Mean VAS score was 2.7±2.3 for the Tamsulosin group and 4.2±2.2 for the control group (P=0.001). There was no significant difference between two groups according to baseline and postoperative 1st month SF-36 scores. CONCLUSION: Alpha-blocker therapy prior to TRUS-Bx is effective in preventing voiding dysfunction and biopsy-related pain in patients undergoing TRUS-Bx. LEVEL OF EVIDENCE: 2.

Determination of candidate genes involved in schizophrenia using the whole-exome sequencing.

OBJECTIVES: We used the whole-exome sequencing to evaluate several genes suspected of being involved in the pathogenesis of schizophrenia. METHODS: The study sample was composed of two families. In the first family, two siblings had schizophrenia, and the parents were healthy. In the second family, two siblings had schizophrenia, while the other sibling and the parents did not. RESULTS: Indels were detected in some genes, including SPON1, GRIA3, SMAD5, PCLO, KMT2C, SRD5A2, SEMA3B, NCOR2, GPHB5, FAM174B, CLTCL1, and TMEM216. The insertion of three nucleotides (TGA) was detected in the sequence of the PCLO gene. The mutation resulted in the insertion of aspartic acid (Asp, D) in the amino acid sequence of the PCLO protein. Indels detected in SPON1, GRIA3, SMAD5, KMT2C, SRD5A2, SEMA3B, GPHB5, CLTCL1, and TMEM216 were shown to be frameshifting. Bioinformatics analysis showed that the indels in SPON1, GRIA3, SMAD5, KMT2C, SRD5A2, SEMA3B, NCOR2, GPHB5, FAM174B, CLTCL1, and TMEM216 had a damaging effect, while the indel in PCLO had a non-damaging effect on protein function. CONCLUSION: To the best of our knowledge, no previous studies have examined the relationship between the pathogenesis of schizophrenia and the gene mutations identified in this study (Tab. 1, Ref, 42).

Subclinical atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency.

OBJECTIVE: Homocysteine (Hcy) is an independent risk factor for predisposing to atherosclerosis and endothelial dysfunction. Hcy levels increase with Vitamin B12 deficiency. The aim of this study was to investigate the association between carotid intima-media thickness (CIMT) and the autonomic modulation of heart rate variability (HRV) in early detection of atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency. MATERIALS AND METHODS: Sixty patients with Vitamin B12 deficiency (14.4 ± 1.72 years, 36 female) and 40, age, sex, and body mass index-matched healthy controls (13.4 ± 1.86 years, 24 female) had performed 24-h Holter monitoring, carotid ultrasonography, and echocardiography. Linear regression models assessed associations between to HRV parameters and CIMT and the blood markers. RESULTS: We defined Vitamin B12 deficiency as a serum level, 200 pg/mL. Hcy (P < 0.001) and CIMT (P < 0.001) levels were significantly higher in the patient group compared with the control group. Hcy level was found to be the most important independent variable affecting CIMT. Each 1 degree increase in Hcy, it was observed that the CIMT value increased by 0.01 mm (B = 0.01; t = -2.39; P < 0.05). Low-frequency power (LF), high-frequency power (HF) (P < 0.001), and the square root of the mean of the squared differences of two consecutive RR intervals (rMSSd) (P = 0.04) were significantly lower in the B12 deficient patients. Furthermore, Hcy level was found to be the most important independent variable affecting LF, HF, and rMSSd. CONCLUSIONS: Subclinical atherosclerosis was associated with cardiovascular autonomic imbalance in pediatric patients with Vitamin B12 deficiency. Homocysteinemia may be an important marker for the prediction of future cardiovascular disease.

The dynamics of prehospital/hospital care and modes of transport during civil conflict and terrorist incidents.

OBJECTIVE: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. STUDY DESIGN: Multicentric prospective observational study. METHOD: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. RESULTS: The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044-1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639-0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. CONCLUSIONS: Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used.

Comparison of icodextrin with thymoquinone: A new hope for postoperative adhesions.

OBJECTIVE: The purpose of this study was to compare the effects of thymoquinone and icodextrin in rats within the framework of an experimental adhesion model. MATERIALS AND METHODS: Rats were separated into three groups: (1) a control group consisting of rats that had 2 ml of isotonic solution administered intraperitoneally, (2) an ICO group administered with 2 ml of 4% icodextrin, and (3) a TQ group administered thymoquinone (10 mg/kg), all following cecal abrasion. The three groups underwent a reoperation on the 7th postoperative day. Hydroxyproline levels were analyzed in the resected adhesive tissues, and histopathological investigations were conducted. Blood samples were collected for biochemical analyses. RESULTS: Fewer postoperative adhesions were observed in the ICO and TQ groups compared with the control group. A comparison of the TQ and ICO groups revealed lowers levels of postoperative adhesions in the TQ group. Compared with the control group, malondialdehyde, 8-OH-deoxyguanosine/deoxyguanosine (8-OHdG/10dG), Coenzyme Q10 (CoQ10), and CoenzymeQ10/reduced CoenzymeQ10 (CoQ10/CoQ10H) values were found to be lower in the TQ and ICO groups. When the TQ and ICO groups were compared with respect to their biochemical parameters, the results for all of the four parameters were found to be statistically significantly lower in the TQ group (P < 0.000). The levels of hydroxyproline in the control, ICO, and TQ groups were found to be (mean ± standard deviation) 502.25 ± 90.39 µg/g, 342.13 ± 66.61 µg/g, and 287.88 ± 49.59 µg/g, respectively. CONCLUSIONS: A comparison of the antiadhesive effects of thymoquinone and icodextrin revealed thymoquinone to be more effective. These results indicate that thymoquinone is an efficient and strong antiadhesive molecule.

Investigation of biological effects of some Mannich Bases containing Bis-1,2,4- Triazole.

In this study, the effects of Mannich bases containing bis-1,2,4-triazole on the levels of in vivo malondialdehyde (MDA) and antioxidant vitamins (A, E, C) were examined in serum, livers and kidneys of rats. DA and vitamin (A, E, C) levels were determined by high performance liquid chromatography (HPLC). Antioxidant effect was investigated by determining the MDA levels in Saccharomyces cerevisiae cells as in vitro. Furthermore, the antitumor effects of compounds were investigated against MCF-7 human breast cancer cells. Interrelations of results among control and compound groups were evaluated using SPSS statistical software package. As a result, some of the compounds showed effective biological activity when compared to control conditions. The test compounds used in this study may be effective for utilization in the selection and design of model compounds for further studies.

Androgenetic alopecia is associated with increased arterial stiffness in asymptomatic young adults.

BACKGROUND: Association of androgenetic alopecia (AGA) with increased incidence of hypertension, a strong risk factor for coronary artery disease, has been suggested. However, there are no data on arterial stiffness measures of asymptomatic young adults with AGA. OBJECTIVE: In this study, we aimed to investigate the association of the AGA with arterial stiffness assessed by cardio-ankle vascular index (CAVI), in asymptomatic young men. METHODS: A total of 162 asymptomatic men aged between 18 and 45 years were consecutively enrolled to the study. Subjects were considered to have AGA if they have ≥3 grade vertex alopecia according to Hamilton-Norwood scale. Arterial stiffness was assessed by CAVI and defined as abnormal if CAVI is ≥8. RESULTS: Frequency of abnormal CAVI was higher in patients with AGA (29.3% vs. 10.0%, P = 0.003). Subjects with AGA had higher mean CAVI than subjects without AGA (7.56 ± 0.93 vs. 7.15 ± 0.79, P = 0.004). Binary logistic regression analysis demonstrated that presence of AGA (OR, 5.6; 95% CI, 1.7-20.0, P = 0.006), age (OR, 1.1; 95% CI, 1.0-1.2, P = 0.03) and diastolic blood pressure (OR, 1.1; 95% CI, 1.0-1.3, P = 0.005) were independently associated with abnormal CAVI. CONCLUSION: We concluded that, AGA might be an indicator of arterial stiffness in asymptomatic young adults.

Link between aortic valve sclerosis and myocardial no-reflow in ST-segment elevation myocardial infarction.

OBJECTIVE: The"no-reflow" phenomenon is associated with a worse prognosis at follow-up for patients with acute ST-segment elevation myocardial infarction (STEMI). Predicting and preventing no-reflow is therefore a crucial step in improving the prognosis of STEMI patients. The purpose of this study was to investigate the association between aortic valve sclerosis (AVS) and myocardial no-reflow in patients with STEMI. PATIENTS AND METHODS: Patients with a first-time diagnosis of STEMI were enrolled consecutively. No-reflow was defined as a final TIMI 3 flow with a myocardial blush of grade < 2, temporary epicardial coronary no-reflow, and distal coronary occlusion. AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow. RESULTS: No-reflow developed in 41 patients. In univariate analysis, age, male gender, smoking, culprit lesion Syntax score (SX score), and hypertension were significantly associated with no-reflow. Multivariate binary logistic regression analyses demonstrated age [95 % confidence interval (CI), 1.024-1.096; p=0.001), AVS (95 % CI, 1.002-1.100; p=0.039], culprit lesion SX score (95 % CI, 1.08-1.021 p=0.008), and symptom-to-balloon time (95 % CI, 1.020-1.097; p=0.002) as independent determinants of myocardial no-reflow. CONCLUSION: AVS was significantly and independently associated with myocardial no-reflow in STEMI patients.

Hepatoprotective effect of pioglitazone in cases of chemotherapy induced steatohepatitis.

BACKGROUND/OBJECTIVES: To evaluate the harmful effects of 5-floururacil (5-FU) and Irinotecan on the liver and to determine the role of Pioglitazone in averting liver damage. METHODS: Sixty Sprague-Dawley female rats were divided into 4 groups. The first group (n=20) was administered 40 mg of 5-FU and 40 mg kg of Irinotecan intraperitoneally for 4 cycles, while the second group (n=20) received 4 mg kg of Pioglitazone by gastric gavage at 5 days a week for 20 days in addition to chemotherapy. The third group (n=10) was the sham group; chemotherapy regimen was given as in the first group. In addition, normal saline was given daily for 20 days by gastric gavage. The fourth group (n=10) was only given a standard diet as a control group. Then, blood samples were studied for the evaluation of alanine aminotransferase (AST)and alanine aminotransferase (ALT) levels. And left liver lobes of rats were taken for pathological analysis. RESULTS: Although short-term chemotherapy was administered,aminotransferase (AST) and alanine aminotransferase (ALT)levels were found to be significantly higher in the first and third groups compared to the others (p 0.0001). No significant difference was determined between the second and the control group. Pioglitazone reduced the adverse metabolic effects of chemotherapy on the liver, but had no effect on the histopathological changes. CONCLUSION: short-term CT causes metabolic disruption in hepatocytes, but not relevant with CASH. Preventive treatments like Pioglitazone should be used more carefully.

Comprehensive bio-imaging using myocardial perfusion reserve index during cardiac magnetic resonance imaging and high-sensitive troponin T for the prediction of outcomes in heart transplant recipients.

We sought to determine the ability of quantitative myocardial perfusion reserve index (MPRI) by cardiac magnetic resonance (CMR) and high-sensitive troponin T (hsTnT) for the prediction of cardiac allograft vasculopathy (CAV) and cardiac outcomes in heart transplant (HT) recipients. In 108 consecutive HT recipients (organ age 4.1±4.7 years, 25 [23%] with diabetes mellitus) who underwent cardiac catheterization, CAV grade by International Society for Heart & Lung Transplantation (ISHLT) criteria, MPRI, late gadolinium enhancement (LGE) and hsTnT values were obtained. Outcome data including cardiac death and urgent revascularization ("hard cardiac events") and revascularization procedures were prospectively collected. During a follow-up duration of 4.2±1.4 years, seven patients experienced hard cardiac events and 11 patients underwent elective revascularization procedures. By multivariable analysis, hsTnT and MPRI both independently predicted cardiac events, surpassing the value of LGE and CAV by ISHLT criteria. Furthermore, hsTnT and MPRI provided complementary value. Thus, patients with high hsTnT and low MPRI showed the highest rates of cardiac events (annual event rate=14.5%), while those with low hsTnT and high MPRI exhibited excellent outcomes (annual event rate=0%). In conclusion, comprehensive "bio-imaging" using hsTnT, as a marker of myocardial microinjury, and CMR, as a marker of microvascular integrity and myocardial damage by LGE, may aid personalized risk-stratification in HT recipients.

Aortic valve sclerosis in acute coronary syndrome patients : potential value in predicting coronary artery lesion complexity.

OBJECTIVE: The purpose of the present study was to investigate the relation between aortic valve sclerosis (AVS) and coronary artery lesion complexity as assessed using the SYNTAX score (SxScore) in acute coronary syndrome (ACS) patients. PATIENTS AND METHODS: A total of 164 patients with a first time diagnosis of acute coronary syndrome were consecutively enrolled. AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow. The SxScore was calculated using dedicated computer software. RESULTS: There were significantly higher SxScores in subjects with AVS than those without AVS (18 ± 6 vs 12 ± 5, p = 0.02). In the univariate analysis, age (p = 0.03) and presence of AVS (p = 0.007) were significantly associated with higher SxScores. Logistic regression analysis demonstrated AVS [95 % confidence interval (CI) 0.17-0.86, p = 0.017] and age (95 % CI 1.01-1.21, p = 0.028) as independent determinants of higher SxScores. CONCLUSION: Aortic valve sclerosis was significantly and independently associated with a high SxScore in acute coronary syndrome patients.

Primary idiopathic chylopericardium presenting with cardiac tamponade.

Primary idiopathic chylopericardium is an extremely rare condition especially in children and young adults. Although the exact pathophysiology of primary chylopericardium has not been established, the reflux of chylous fluid into the pericardial space was suggested as the etiology. Damage to the thoracic duct valves and the communication of the thoracic duct to the pericardial lymphatics or abnormally elevated pressure in the thoracic duct could cause chylous fluid reflux. In this report, we described the case of a 4-year-old boy with primary idiopathic chylopericardium presenting as cardiac tamponade who was treated with video-assisted thoracoscopic window and then surgical duct ligation.

Identification and anti-oxidant capacity determination of phenolics and their glycosides in elderflower by on-line HPLC-CUPRAC method.

INTRODUCTION: Development and application of an on-line cupric reducing anti-oxidant capacity (CUPRAC) assay coupled with HPLC for separation and on-line determination of phenolic anti-oxidants in elderflower (Sambucus nigra L.) extracts for their anti-oxidant capacity are significant for evaluating health-beneficial effects. Moreover, this work aimed to assay certain flavonoid glycosides of elderflower that could not be identified/quantified by other similar on-line HPLC methods (i.e. 2,2-diphenyl-1-picrylhdrazyl and 2, 2'-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid). OBJECTIVE: To identify anti-oxidant constituents in elderflower by HPLC and to evaluate their individual anti-oxidant capacities by on-line HPLC-CUPRAC assay with a post-column derivatisation system. METHODS: The separation and UV detection of polyphenols were performed on a C18 -column using gradient elution with two different mobile phase solutions, that is acetonitrile and 1% glacial acetic acid, with detection at 340 nm. The HPLC-separated anti-oxidant polyphenols in column effluent react with copper(II)-neocuproine in a reaction-coil to reduce the latter to copper(I)-neocuproine (Cu(I)-Nc) chelate having maximum absorption at 450 nm. RESULTS: The detection limits of tested compounds at 450 nm after post-column derivatisation were compared with those of at 340 nm UV-detection without derivatisation. LOD values (µg/mL) of quercetin and its glycosides at 450 nm were lower than those of UV detection at 340 nm. This method was applied successfully to elderflower extract. The flavonol glycosides of quercetin and kaempferol bound to several sugar components (glucose, rhamnose, galactose and rutinose) were identified in the sample. CONCLUSION: The on-line HPLC-CUPRAC method was advantageous over on-line ABTS and DPPH methods for measuring the flavonoid glycosides of elderflower.