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PURPOSE Hereditary cancer syndromes infer high cancer risks and require intensive surveillance. Identification of high-risk individuals among patients with colorectal cancer (CRC) needs improvement. METHODS Three thousand three hundred ten unselected adults who underwent surgical resection for primary invasive CRC were prospectively accrued from 51 hospitals across Ohio between January 1, 2013, and December 31, 2016. Universal Tumor screening (UTS) for mismatch repair (MMR) deficiency was performed for all, and pathogenic germline variants (PGVs) were identified using multigene panel testing (MGPT) in those who met at least one inclusion criterion: MMR deficiency, diagnosed < 50 years, multiple primary tumors (CRC or endometrial cancer), or with a first-degree relative with CRC or endometrial cancer. RESULTS Five hundred twenty-five patients (15.9%) had MMR deficiency. Two hundred thirty-four of 3,310 (7.1%; 16% of the 1,462 who received MGPT) had 248 PGVs in cancer susceptibility genes. One hundred forty-two (4.3%) had a PGV in an MMR gene, and 101 (3.1%) had a PGV in a non-MMR gene. Ten with Lynch syndrome (LS) also had a non-MMR PGV and were included in both groups. Two (0.06%) had constitutional MLH1 hypermethylation. Of unexplained MMR-deficient patients, 88.4% (76 of 86) had double somatic MMR mutations. Testing for only MMR genes in MMR-deficient patients would have missed 18 non-MMR gene PGVs (7.3% of total PGVs identified). Had UTS been the only method used to screen for hereditary cancer syndromes, 38.6% (91 of 236) would have been missed, including 6.3% (9 of 144) of those with LS. These results have treatment implications as 5.3% (175 of 3,310) had PGVs in genes with therapeutic targets. CONCLUSION UTS alone is insufficient for identifying a large proportion of CRC patients with hereditary syndromes, including some with LS. At a minimum, 7.1% of individuals with CRC have a PGV and pan-cancer MGPT should be considered for all patients with CRC.

Objective Lynch syndrome is the most common cause of inherited endometrial cancer, attributable to germline pathogenic variants (PV) in mismatch repair (MMR) genes. Tumor microsatellite instability (MSI-high) and MMR IHC abnormalities are characteristics of Lynch syndrome. Double somatic MMR gene PV also cause MSI-high endometrial cancers. The aim of this study was to determine the relative frequency of Lynch syndrome and double somatic MMR PV. Methods 341 endometrial cancer patients enrolled in the Ohio Colorectal Cancer Prevention Initiative at The Ohio State University Comprehensive Cancer Center from 1/1/13–12/31/16. All tumors underwent immunohistochemical (IHC) staining for the four MMR proteins, MSI testing, and MLH1 methylation testing if the tumor was MMR-deficient (dMMR). Germline genetic testing for Lynch syndrome was undertaken for all cases with dMMR tumors lacking MLH1 methylation. Tumor sequencing followed if a germline MMR gene PV was not identified. Results Twenty-seven percent (91/341) of tumors were either MSI-high or had abnormal IHC indicating dMMR. As expected, most dMMR tumors had MLH1 methylation; (69, 75.8% of the dMMR cases; 20.2% of total). Among the 22 (6.5%) cases with dMMR not explained by methylation, 10 (2.9% of total) were found to have Lynch syndrome (6 MSH6, 3 MSH2, 1 PMS2). Double somatic MMR PV accounted for the remaining 12 dMMR cases (3.5% of total). Conclusions Since double somatic MMR gene PV are as common as Lynch syndrome among endometrial cancer patients, paired tumor and germline testing for patients with non-methylated dMMR tumor may be the most efficient approach for LS screening.

Atherosclerosis is a chronic, progressive, inflammatory disease. Recognition of subclinical atherosclerotic vascular changes before clinical manifestation in an asymptomatic population is important for risk stratification and optimal management, which finally leads to the prevention of cardiovascular disease. We aimed to determine the risk of premature subclinical atherosclerosis by evaluating epicardial adipose tissue thickness (EATT) and arterial stiffness parameters in patients with ankylosing spondylitis (AS).We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS compared to 60 controls matched for age and sex. Patients with traditional cardiovascular risk factors were excluded. Arterial stiffness parameters and EATT (examined via echocardiography) values of all patients and control groups were measured.There was no difference between basal characteristic and echocardiographic parameters in patients with AS and in the control group. EATT and pulse wave velocity (PWV) were higher in the AS patients compared to the control group. EATT was 5.74 ± 1.22 mm and 4.91 ± 1.21 mm (EATT and PWV, markers of atherosclerosis and cardiovascular disease, were significantly higher in patients with AS than the control group. In addition, in this study, it has been shown that there is a significant relationship between PWV and EATT in patients with AS.

Introduction and objective Hepatitis A Virus (HAV), reportedly the most common cause of acute viral hepatitis in developing countries, infects millions of people worldwide each year. The aim of the study is to investigate the seropositivity of anti-hepatitis A virus (HAV) IgG and IgM in all age groups in Erzurum, and to determine the effect of various factors such as age, gender, climatic conditions and HAV vaccination (included in 2012 in the National Immunization Schedule on seroprevalence) on the seropositivity. Material and methods The serological results of 25,007 individuals referred to Erzurum Public Health Microbiology Laboratory between January 2015 – December 2018 were retrospectively reviewed to test for the presence of anti-HAV IgG and IgM. The patient ages were 0–93 years. Serum samples were analyzed by ELISA. S/CO values of ≥1.00 and >1.21 were considered positive for anti-HAV IgG and IgM, respectively; results below this value were considered negative. Results Anti-HAV IgG and IgM seropositivities were 87.3% and 0.2%, respectively. Anti-HAV IgG prevalence – 88.5% and 86.4%, anti-HAV IgM positivity – 0.1% and 0.3% in men and women. Anti-HAV IgG seroprevalence – 87%, 73.2%, 58.7%, 75.2%, 86.1%, 89.8%, 96.1%, 99.1%, 99.1% and 99.3%, respectively, at 0–4, 5–9 10–14, 15–19, 20–24, 25–29, 30–39, 40–49, 50–59 and >60 age groups. Anti-HAV IgM seropositivity – 0, 0.1%, 0.7%, 0.7%, 0.3%, 0, 0.1%, 0.2%, 0.1%, and 0.2%, respectively, in the same age groups. Anti-HAV IgM positivity was the highest in November – 36(0.97%. Conclusions In Erzurum, anti-HAV IgG prevalence is tremendously high, whereas prevalence of anti-HAV IgM is exceptionally low, especially in the paediatric age group. Therefore, HAV vaccine is provided free of charge in Turkey, including Erzurum, since 2012.

Legionnaires' disease, which is a waterborne disease leading to pneumonia that can result in death, is one of the major health issues today. The study aims to carry out a three-year retrospective review of routine Legionella follow-up analyses in various samples taken mostly from hospitals in the province of Erzurum and nearby provinces, and to discover a the frequency of isolation of the agent and serogroups from each kind of media.The study included a total of 2,025 water samples taken from hospitals, hotels, Turkish baths and shopping malls in Erzurum,and 13 nearby cities between 2016 and 2018. Samples were filtered by 0.45 μm-diameter membrane filter paper in the Public Health Laboratory of Erzurum and examined forThe presence ofThe Prevalence rat of

The aim of this study was the validation of AYC.2.2 agar and AYC.2.1 broth for the breakpoint values of first- and second-line drugs for Mycobacterium tuberculosis.A total of 12 isolates including 5 reference strains and 7 well-defined clinical isolates were tested for their antituberculosis susceptibilities. Inhibitory effects of first- and second-line antituberculous drugs including isoniazid, rifampicin, streptomycin, ethambutol, amikacin, capreomycin, kanamycin, para-aminosalicylic acid, ethionamide, rifabutin, ofloxacin, levofloxacin, and moxifloxacin were tested.According to the minimal inhibitory concentration values obtained in 7H10 agar, 7H9-S broth, AYC.2.2 agar, and AYC.2.1 broth, category agreement is 100%, and very major discrepancy (MAD), MAD, and minor discrepancy ratios were determined as 0 for all drugs.It was concluded that breakpoint values by CLSI recommendation for 7H10 agar can be also used for AYC.2.2 agar and AYC.2.1 broth. In addition, further multicenter studies are needed to use the new medium in routine mycobacteriology laboratories.

The aim of this multicenter study is to evaluate AYC.2.2 agar for the isolation of mycobacteria from clinical samples.Totally 5559 media were tested in 7 centers. AYC.2.2 agar media for the study were prepared by C1 and sent to other centers under appropriate conditions. Other media except AYC.2.2 agar were purchased commercially. The media were subjected to routine laboratory operations in the center where they were sent. After the samples received for routine processing (in all centers, samples were processed with the same method (NALC-NaOH)), they were cultivated on routine media and AYC.2.2 agar afterward.C1: Average growth time was determined as 12.74±3.74 days with MGIT 960 system; 24.42±4.75 days with LJ and 24.37±4.96 days with AYC.2.2 agar. C2: Average growth time was determined as 18.25±9.32 days with TK-Medium, 28.73±7.44 days with LJ, and 31.72±6.35 days with AYC.2.2 agar. C3: Average growth time was determined as 20.48±7.24 days with Ogawa medium, 20.74±7.12 days with LJ, and 20.26±7.43 days with AYC.2.2 agar. C4: Average growth time was determined as 15.27±6.37 days with MGIT 960 system, 22.14±9.1 days with LJ, and 22±8.45 days with AYC.2.2 agar. C5: Average growth time was determined as 13±4.24 days with MGIT 960 system, 32.16±6.23 days with LJ, and 33±5.73 days with AYC.2.2 agar. C6: Average growth time was determined as 9±3.11 days with MGIT 960 system, 18.68±5.32 days with LJ, and 18.34±4.63 days AYC.2.2 agar. C7: Average growth time was determined as 14.74±7.65 with MGIT 960 system, 26.01±8.21 days with LJ, and 26.24±7.88 days with AYC.2.2 agar.In conclusion, similar results were obtained with LJ and Ogawa media and AYC.2.2 agar. Furthermore, more studies should be conducted for isolation of M. tuberculosis and performing antibiotic susceptibility tests using AYC.2.2 agar before it can be used as a routine media in the laboratories.

Tuberculosis (TB) is one of the oldest health problems in the world and it remains unresolved. Multidrug-resistant-TB and extensively resistant-TB are a serious problem for control programs. The evaluation of available antibiotics has gained importance in recent years for the treatment of resistant TB. Beta-lactam antibiotics inhibit cell wall biosynthesis in the bacteria; the presence of beta-lactamase enzyme in TB bacilli raises the question of whether this group of antibiotics can be used in treatment. As a result, it has been reported that the combination of beta-lactam antibiotics with beta-lactamase is effective against Mycobacterium tuberculosis both in vitro and in vivo. The aim of this article is to review and discuss up-to-date knowledge and future perspective on beta-lactam antibiotics and TB.

Objective: This study aimed to investigate the prevalence of temporomandibular disorders (TMD) in patients with chronic hemodialysis and evaluate the risk factors of developing TMD.Methods: One hundred forty-six subjects were included in the study. The examination for TMD was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Axis I protocol was used to evaluate the prevalence of TMD sub-diagnoses.Results: The prevalence of TMD was 41.5% in hemodialysis patients and significantly higher than in the control group. The most common symptom was TMJ pain, and the most common TMD subtype was muscular type. Female patients had significantly higher TMD than males. C-reactive protein, hemoglobin, parathyroid hormone, and albumin were significantly associated with TMD.Conclusion: There was an elevated prevalence of TMD in hemodialysis patients.

No-reflow phenomenon (NRP) is an important problem in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Endocan is synthesized and secreted by activated vascular endothelium, and it has been shown to be related to endothelial dysfunction and inflammation. We aimed to evaluate the relationship between endocan levels and NRP. Consecutive patients (n = 137) with STEMI who had undergone coronary angiography and pPCI were enrolled into the study. The clinical characteristics of the patients were obtained and endocan levels were measured. Endocan levels were significantly higher in the NRP (+) group compared with the NRP (−) group ( P < .001). In multivariate analysis, endocan ( P < .001, OR = 2.39, 95% CI = 1.37-4.15) was found to be an independent predictor of NRP. An endocan value of >2.7 ng/mL has 89.6% sensitivity and 74.2% specificity for the prediction of the NRP (area under the curve: 0.832, P < .001). The present study demonstrated that the endocan level is an independent predictor of the NRP in patients with STEMI who underwent pPCI. Endocan levels may be helpful in detecting patients with a higher risk of insufficient myocardial perfusion and worse clinical outcome.

Objective:This study evaluated the use of a deep-learning approach for automated detection and numbering of deciduous teeth in children as depicted on panoramic radiographs.Methods and materials:An artificial intelligence (AI) algorithm (CranioCatch, Eskisehir-Turkey) using Faster R-CNN Inception v2 (COCO) models were developed to automatically detect and number deciduous teeth as seen on pediatric panoramic radiographs. The algorithm was trained and tested on a total of 421 panoramic images. System performance was assessed using a confusion matrix.Results:The AI system was successful in detecting and numbering the deciduous teeth of children as depicted on panoramic radiographs. The sensitivity and precision rates were high. The estimated sensitivity, precision, and F1 score were 0.9804, 0.9571, and 0.9686, respectively.Conclusion:Deep-learning-based AI models are a promising tool for the automated charting of panoramic dental radiographs from children. In addition to serving as a time-saving measure and an aid to clinicians, AI plays a valuable role in forensic identification.

WOS: 000458593300004, PubMed: 30476633, …

WOS: 000374722700029, PubMed: 26164686, Objectives: Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24 hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. Results: Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7 +/- 10.2 ms vs. 102.2 +/- 7.5 ms, p = 0.02; 40.6 +/- 7.6 ms vs. 33.6 +/- 5.9 ms, p < 0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5 +/- 7.8 ms vs.11.2 +/- 4.4 ms, p < 0.001; 9.0 +/- 7.3 ms vs. 6.0 +/- 3.8 ms, p = 0.002, and 7.4 +/- 5.2 ms vs. 5.1 +/- 3.2 ms, p = 0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r = 0.429, p < 0.001) and left atrial volume (r = 0.428,p < 0.001). Conclusions: In this study, there was significant EMD and Pd in patients with T2DM as compared with healthy volunteers. Additionally, interatrial EMD was correlated with Pd and left atrial volume index. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Background: Because pyrazinamide (PZA) is only effective for Mycobacterium tuberculosis at an acidic pH, susceptibility tests are more difficult to perform than those for other anti-tuberculosis (TB) drugs. The purpose of our work was to investigate the effectiveness of colorimetric methods to detect PZA susceptibility and to detect pncA gene mutations in resistant isolates by sequence analysis. Methods: In this study, 30 clinical isolates and 2 reference isolates were used, 15 of which were resistant to PZA. The PZA susceptibility of all the isolates was determined by the BACTEC MGIT 960 reference method. As colorimetric methods, Resazurin Microtiter Assay (REMA), Nitrate Reductase Assay (NRA), Malachite Green Decolorization Assay (MGDA), and Crystal Violet Decolorization Assay (CVDA) methods were included in the study. In addition, mutations in the pncA gene were investigated using sequence analysis in PZA-resistant isolates. Results: As a result of the comparison of the colorimetric methods with the reference method, agreement was determined as 93.3% in REMA and NRA, 90% in MGDA, and 93.3% in CVDA. In 13 of 15 resistant isolates, the pncA gene mutation was detected by sequence analysis. Conclusions: As a result of the work, the results from the colorimetric methods were found to be at a high level of concordance with the reference method. They are also inexpensive and easily applicable methods.

Effective control of tuberculosis is achieved by early diagnosis and drug susceptibility testing for initiation of appropriate treatment. The performance of crystal violet decolorization assay (CVDA) for susceptibility testing of Mycobacterium tuberculosis to isoniazid (INH) and rifampicin (RIF) was compared in a multicenter study.Seventy-two M. tuberculosis isolates were tested in two phases by CVDA.In Phase I, the specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and agreement for INH were 100%, respectively. Specificity, sensitivity, PPV, NPV, and agreement for RIF were 98.2%, 100%, 94.1%, 100%, and 98.6%, respectively. In Phase II, specificity, sensitivity, PPV, NPV, and agreement were 98%, 100%, 95.4%, 100%, and 98.6% for INH, respectively. Specificity, sensitivity, PPV, NPV, and agreement for RIF were 96.3%, 88.2%, 88.2%, 96.3%, and 94.4%, respectively. Results in the study were obtained on average 10.9 ± 3.1 days in Phase I and 9.8 ± 2.2 days in Phase II.CVDA can be performed for drug susceptibility testing in developed and developing countries. In addition, further studies with larger sample size are needed for evaluation of this method.

Sig, Ali Korhan/0000-0003-2907-257X; Akbal, Ahmet Ugur/0000-0002-0627-5326 WOS: 000464730900003 PubMed: 30417212 Streptomycin (STR) and ethambutol (EMB) are important drugs used for the treatment of tuberculosis. There is a need for fast, reliable and inexpensive methods for detecting resistance to these drugs. The aim of this study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for the detection of STR and EMB resistance that is important drugs in tuberculosis treatment. In this study, drug susceptibility testing was performed on 140 Mycobacterium tuberculosis isolates provided from nine centers. Three tubes were used for each isolate. One of the tubes had a concentration of 2mg/L STR and the other 5mg/L EMB. The third was drug-free control tube. Sensitivity, specificity, positive predictive value (PPD), negative predictive value (NPD) and agreement for STR were found to be 81.8%, 94.6%, 87.8%, 91.5% and 90.57%, respectively. For EMB, sensitivity, specificity, PPD, NPD, and agreement were found to be 76%, 98.23%, 90.47%, 94.87% and 94.2%, respectively. The results were obtained in 11.3 +/- 2.7days (8-21days). CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of STR and EMB resistance, and it could be adapted for drug susceptibility testing.

BACKGROUND There are very few studies investigating metabolic biomarkers to predict acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). Metabolic models can provide a framework for analyzing the information-rich omics data sets in this setting. METHODS Four hundred and fifty-six samples from one hundred and fourteen consecutive patients who underwent HSCT from January 2012 to May 2014 were collected for this study. The changes in serum metabolite levels were investigated using a gas chromatography-mass spectrometry-based metabolomics approach and underwent statistical analysis. RESULTS Significant metabolic changes were observed on day 7. The stearic acid/palmitic acid (SA/PA) ratio was effective in the diagnosis of grade II-IV aGVHD. Multivariate analysis showed that patients with high SA/PA ratios on day 7 after HSCT were less likely to develop II-IV aGVHD than patients with low SA/PA ratios (odds ratio [OR] = 0.06, 95% CI 0.02-0.18, P < 0.001). After the adjustment for clinical characteristics, the SA/PA ratio had no significant effect on overall survival (hazard ratio [HR] = 1.95, 95% CI 0.92-4.14, P = 0.08), and patients in the high SA/PA ratio group were significantly more likely to relapse than those in the low ratio group (HR = 2.26, 95% CI 1.04-4.91, P = 0.04). CONCLUSION Our findings suggest that the SA/PA ratio on day 7 after HSCT is an excellent biomarker to predict both aGVHD and relapse. The serum SA/PA ratio measured on day 7 after transplantation may improve risk stratification for aGVHD and relapse after allogeneic stem cell transplantation. FUNDING National Natural Science Foundation of China (81470346, 81773361), Priority Academic Program Development of Jiangsu Higher Education Institutions, Jiangsu Natural Science Foundation (BK20161204), Innovation Capability Development Project of Jiangsu Province (BM2015004), Jiangsu Medical Junior Talent Person award (QNRC2016707), and NIH (AI129582 and NS106170).

Importance Universal tumor screening for Lynch syndrome (LS) in colorectal cancer (CRC) is recommended and involves up to 6 sequential tests. Somatic gene testing is performed on stage IV CRCs for treatment determination. The diagnostic workup for patients with CRC could be simplified and improved using a single up-front tumor next-generation sequencing test if it has higher sensitivity and specificity than the current screening protocol. Objective To determine whether up-front tumor sequencing (TS) could replace the current multiple sequential test approach for universal tumor screening for LS. Design, Setting, and Participants Tumor DNA from 419 consecutive CRC cases undergoing standard universal tumor screening and germline genetic testing when indicated as part of the multicenter, population-based Ohio Colorectal Cancer Prevention Initiative from October 2015 through February 2016 (the prospective cohort) and 46 patients with CRC known to have LS due to a germline mutation in a mismatch repair gene from January 2013 through September 2015 (the validation cohort) underwent blinded TS. Main Outcomes and Measures Sensitivity of TS compared with microsatellite instability (MSI) testing and immunohistochemical (IHC) staining for the detection of LS. Results In the 465 patients, mean age at diagnosis was 59.9 years (range, 20-96 years), and 241 (51.8%) were female. Tumor sequencing identified all 46 known LS cases from the validation cohort and an additional 12 LS cases from the 419-member prospective cohort. Testing with MSI or IHC, followed by BRAF p.V600E testing missed 5 and 6 cases of LS, respectively. Tumor sequencing alone had better sensitivity (100%; 95% CI, 93.8%-100%) than IHC plus BRAF (89.7%; 95% CI, 78.8%-96.1%; P = .04) and MSI plus BRAF (91.4%; 95% CI, 81.0%-97.1%; P = .07). Tumor sequencing had equal specificity (95.3%; 95% CI, 92.6%-97.2%) to IHC plus BRAF (94.6%; 95% CI, 91.9%-96.6%; P > .99) and MSI plus BRAF (94.8%; 95% CI, 92.2%-96.8%; P = .88). Tumor sequencing identified 284 cases with KRAS , NRAS, or BRAF mutations that could affect therapy for stage IV CRC, avoiding another test. Finally, TS identified 8 patients with germline DPYD mutations that confer toxicity to fluorouracil chemotherapy, which could also be useful for treatment selection. Conclusions and Relevance Up-front TS in CRC is simpler and has superior sensitivity to current multitest approaches to LS screening, while simultaneously providing critical information for treatment selection.

WOS: 000351007900020, PubMed ID: 25764100, Background: Crimean-Congo hemorrhagic fever (CCHF) is a systemic viral disease that also affects the endothelium. Thrombocytopenia and hemorrhage are seen in this disease. But, the cause of thrombocytopenia is not clear. We hypothesized that endothelium dysfunction may be the cause of thrombocytopenia. We evaluated the endothelium functions by flow-mediated dilatation (FMD) in CCHF. Methods: Consecutive children with suspected CCHF who applied to our hospital were evaluated for recruitment into the study. FMD analysis was done in the active and healing period of the disease. Diagnosis was confirmed or ruled out by polymerase chain reaction and/or ELISA test. Basal brachial artery diameter (BBAD) and dilated brachial artery diameter (DBAD) after ischemic period were measured and percent dilatations [(DBAD-BBAD)/BBAD, FMD%] were computed from all subjects. Results: Fifty-four children (40 male, mean age 12.4 +/- 4.4 years) were recruited into the study. CCHF diagnosis was confirmed in 28 children and ruled out in 26 children. Groups were similar for age and gender. FMD% was significantly decreased in CCHF patients when comparing this with the control patients in the active period (2.65 +/- 2.76 vs. 13.76 +/- 7.95, P < 0.001). FMD% was correlated with platelet count in the active period of the disease (r = 0.599, P = 0.004). FMD% was recovered in the healing period (2.65 +/- 2.76 vs. 14.72 +/- 2.66, P < 0.001) and was not significantly different from basal values of control patients (P > 0.05). Conclusions: FMD is significantly decreased in CCHF and recovers in the healing period. So, endothelium functions are disturbed, and disturbance is correlated with thrombocytopenia in CCHF.

Objectives To determine the relationship between mismatch repair (MMR) classification and clinicopathologic features including tumor volume, and explore outcomes by MMR class in a contemporary cohort. Methods Single institution cohort evaluating MMR classification for endometrial cancers (EC). MMR immunohistochemistry (IHC)±microsatellite instability (MSI) testing and reflex MLH1 methylation testing was performed. Tumors with MMR abnormalities by IHC or MSI and MLH1 methylation were classified as epigenetic MMR deficiency while those without MLH1 methylation were classified as probable MMR mutations. Clinicopathologic characteristics were analyzed. Results 466 endometrial cancers were classified; 75% as MMR proficient, 20% epigenetic MMR defects, and 5% as probable MMR mutations. Epigenetic MMR defects were associated with advanced stage, higher grade, presence of lymphovascular space invasion, and older age. MMR class was significantly associated with tumor volume, an association not previously reported. The epigenetic MMR defect tumors median volume was 10,220mm 3 compared to 3321mm 3 and 2,846mm 3 , for MMR proficient and probable MMR mutations respectively ( P Conclusions MMR testing that includes MLH1 methylation analysis defines a subset of tumors that have worse prognostic features and reduced RFS.

Background: The objective of this study was to evaluate the prevalence and characteristics of ponticulus posticus (PP) in groups with sagittal skeletal anomalies in a Turkish population using cone beam computed tomography (CBCT). Materials and methods: A total of 181 CBCT images were evaluated according to gender, side and characteristics of PP in the three different sagittal skeletal groups. Results: The average age of the patients was 13.88 ± 2.99 years (ranging 8–18 years). The study population consisted of 104 (57.5%) females and 77 (42.5%) males. PP was detected in 66 (36.5%) patients. Unilateral and bilateral PP was identified in 29 (43.9%) and 37 (56.1%) patients, respectively. The prevalence of PP in the atlas vertebrae was found to be higher in males than in females and this was statistically significant (p ≤ 0.05). PP was most frequently detected in class III patients (25, 13.8%). Statistically significant differences between the different sagittal skeletal groups were observed (p ≤ 0.05). Conclusions: Ponticulus posticus is a common anomaly in Turkish populations and is associated with different sagittal skeletal patterns. The highest frequency of PP was found in angle class III patients. (Folia Morphol 2018; 77, 1: 65–71)

We assessed whether ultrasonography (US) can be used in combination with cone beam computed tomography (CBCT) to image intraosseous jaw lesions. Using CBCT and US, we evaluated 123 lytic intraosseous jaw lesions diagnosed in 121 patients with guidance from the CBCT findings. The lesions were classified into two groups based on histopathological evaluation: (1) cysts and (2) tumors and tumor-like lesions. US and histopathological findings on the lesions of the two groups and their relationships with each other were also assessed. Results are reported as means ± standard errors, and p

Background: Biliary tract cancers are rare, and surgical resection is the standard treatment at early stages. However, reports on the benefits of adjuvant treatment following surgical resection are conflicting. This study aimed to evaluate the factors affecting survival and adjuvant treatments in patients with surgically treated biliary tract cancers. Materials and Methods: Patient clinical features, adjuvant treatments, and efficacy and prognostic factor data were evaluated. Survival analyses were performed using SPSS 15.0. Results: The median overall survival was 30.7 months (95% confidence interval [CI], 18.4-42.9 months). Median survival was 19 months (95% CI, 6-33) for patients treated with fluorouracil based chemotherapy and 53 months (95% CI, 33.2-78.8) with gemcitabine based chemotherapy (p=0.033). On univariate analysis, poor prognostic factors for survival were galbladder localization, perineural invasion, hepatic invasion, a lack of adjuvant chemoradiotherapy treatment, and a lack of lymph node dissection. On multivariate analysis, perineural invasion was a poor prognostic factor (p=0.008). Conclusions: Biliary tract cancers generally have poor prognoses. The main factors affecting survival are tumour localization, perineural invasion, hepatic invasion, adjuvant chemoradiotherapy, and lymph node dissection. Gemcitabine-based adjuvant chemotherapy is more effective than 5-fluorouracil-based chemotherapy.

Objective. The aim of this study was to investigate the frequency of ponticulus posticus (PP) using cone beam computed tomography (CBCT) and to describe the radiologic characteristics of the detected cases. Study Design. The presence and types of PP were investigated on 730 CBCT images. Results. PP was found in 17.4% (127) of the 730 CBCT scans. Of these 127 patients, 79 (10.8%) had bilateral PP and 48 (6.6%) had unilateral PP. Male predominance was found with a prevalence of 19.5% (54 of 277) and female prevalence was 16.1% (73 of 453). The prevalence of PP increased with age; the highest prevalence of PP was seen in those who were 49 to 81 years of age. Conclusions. This study shows that PP is not an uncommon anatomic variation and is a natural incidental finding on CBCT. (Oral Surg Oral Med Oral Pathol Oral Radiol 2014;118:e210-e219) The atlas is the first cervical vertebra of the spine. This cervical vertebra has several morphologic features that differentiate it from other vertebrae, including the absence of a vertebral body; a unique ring-shaped arrangement surrounding the dens of the axis, which is called the second cervical vertebra; and a unique articulation with the cranium on its cephalad perspective. Ponticulus posticus (PP) is a variation occurring on the atlas vertebra. Ponticulus posticus, a Latin term that means “the little posterior bridge,” is a bony bridge between the posterior part of the superior articular process and the posterolateral part of the superior margin of the posterior arch of the atlas. 1,2 In the literature, there are many terms that describe this anomaly, including ponticulus posticus, foramen sagittale, foramen atlantoideum posterior, Kimmerle’s anomaly, foramen retroarticulare superior, canalis vertebralis, retroarticular vertebral artery ring, retroarticular canal, foramen arcuale, and retrocondylar vertebral artery. 1-5

Cigarette smoking is one of the most significant public health issues and the most common environmental cause of preventable cancer deaths worldwide. EGFR (Epidermal Growth Factor Receptor)-targeted therapy has been used in the treatment of LC (lung cancer), mainly caused by the carcinogens in cigarette smoke, with variable success. Presence of mutations in the KRAS (Kirsten rat sarcoma viral oncogene homolog) driver oncogene may confer worse prognosis and resistance to treatment for reasons not fully understood. NQO1 (NAD(P)H:quinone oxidoreductase), also known as DT-diaphorase, is a major regulator of oxidative stress and activator of mitomycins, compounds that have been targeted in over 600 pre-clinical trials for treatment of LC. We sequenced KRAS and investigated expression of NQO1 and five clinically relevant proteins (DNMT1, DNMT3a, ERK1/2, c-MET, and survivin) in 108 patients with non-small cell lung carcinoma (NSCLC). NQO1, ERK1/2, DNMT1, and DNMT3a but not c-MET and survivin expression was significantly more frequent in patients with KRAS mutations than those without, suggesting the following: (1) oxidative stress may play an important role in the pathogenesis, worse prognosis, and resistance to treatment reported in NSCLC patients with KRAS mutations, (2) selecting patients based on their KRAS mutational status for future clinical trials may increase success rate, and (3) since oxidation of nucleotides also specifically induces transversion mutations, the high rate of KRAS transversions in lung cancer patients may partly be due to the increased oxidative stress in addition to the known carcinogens in cigarette smoke.

Lung cancer (LC) and colorectal cancer (CRC) are the first and second deadliest types of cancer worldwide. EGFR-based therapy has been used in the treatment of these cancers with variable success. Presence of mutations in the KRAS driver oncogene, possibly induced by environmental factors such as carcinogens in diet and cigarette smoke, may confer worse prognosis and resistance to treatment for reasons not fully understood. Data on possible associations between KRAS mutational status and clinical and metabolic parameters, which may help in clinical management, as well as in identifying risk factors for developing these cancers, are limited in the current literature. We sequenced the KRAS gene and investigated the associations of variations in 108 patients with non-small cell lung carcinoma (NSCLC), the most common form of LC, and in 116 patients with CRC. All of the mutations originated from the guanosine nucleotide and over half of all transversions in NSCLC and CRC were c.34 G>T and c.35 G>T, respectively. c.35 G>A was the most frequent type of transition in both cancers. Excluding smoking, the clinical and metabolic parameters in patients carrying mutant and wild type KRAS were similar except that the CRC patients with transversion mutations were 8.6 years younger than those carrying the transitions (P < 0.01). Dyslipidemia, hypertension, family cancer history, and age of diagnosis older than 60 years were more frequent in NSCLC than CRC (P ≤ 0.04). These results suggest that most of the clinical and metabolic parameters investigated in this study are probably not associated with the more aggressive phenotype and differences in response to EGFR-based treatment previously reported in patients with KRAS mutations. However, the increased rates of abnormal metabolic parameters in patients with NSCLC in comparison to CRC indicate that these parameters may be more important in the management of NSCLC. CRC patients carrying transition mutations are older than those carrying transversions, suggesting that age may determine the type of KRAS mutation in CRC patients.

The objective of this retrospective study was to investigate the incidence and clinical implications of multinucleation in blastomeres biopsied from cleavage-stage embryos obtained from patients undergoing preimplantation genetic screening (PGS) for aneuploidies or preimplantation genetic diagnosis (PGD) for translocations or single-gene defects (SGD). A total of 3515 embryos were obtained from 306 couples in 380 PGD or PGS cycles. Incidence of multinucleation, chromosomal complement in multinucleated (MN) and sibling embryos and the characteristics of MN embryos resulting in healthy births were investigated. Of all cycles, 41.3% involved at least one MN embryo. There were more uniformly diploid than uniformly haploid nuclei (22.0% versus 7.9%, P0.01). The most common form of abnormality was chaotic chromosomal complement (39.9%, 147/368). Transfer of embryos that had MN blastomeres free of the genetic abnormalities tested resulted in three healthy deliveries. It is concluded that, although the majority of MN blastomeres are chromosomally abnormal, healthy births are possible after transfer of embryos containing these blastomeres subjected to genetic analysis. As far as is known, this is the first report of healthy births after transfer of embryos with MN blastomeres tested for translocations or SGD in PGD cycles. Preimplantation genetic diagnosis (PGD) is an established method for selecting genetically healthy embryos for transfer. A blastomere sampled from the developing embryo is subjected to genetic analysis. Some of these blastomeres may contain multiple nuclei, complicating the genetic diagnosis. We investigated clinical implications of multinucleation in PGD cycles. Our results indicate that majority of the multinucleated blastomeres, and consequently embryos, are genetically abnormal. However, healthy births are possible after transfer of multinucleated embryos that are free of the genetic abnormalities screened.

WOS: 000348562100013 PubMed: 25008822 Aims: To investigate plasmid-mediated quinolone resistance in clinical isolates of Pseudomonas aeruginosa with the polymerase chain reaction (PCR). The plasmid-mediated quinolone resistance genes have been identified in many bacteria within the Enterobactericeae family, they have not been detected in P. aeruginosa isolates. Subjects and Methods: Identification of the isolates and testing of antibiotic susceptibility was performed in Vitek2 Compact (Biomeriux, France) and Phoinex (BD, USA) automated systems. Screening for the qnrA, qnrB, qnrS, qnrC, aac (6')-Ib-cr and qepA genes was carried out by PCR amplification and aac (6')-Ib-cr DNA sequencing. Results: The qnr and the qepA genes were not detected in any of P. aeruginosa isolates. The aac (6')-Ib gene was detected in six of the isolates and positive isolates for aac (6')-Ib were sequenced for detection of the aac (6')-Ib-cr variant but aac (6')-Ib-cr was not detected in any isolates. Conclusions: Plasmid-mediated quinolone resistance genes have so far not been identified in P. aeruginosa isolates. However, qnrB have detected in P. florescens and P. putida isolates. This is the first study conducted on the qnrA, qnrB, qnrS and qnrC genes as well as the qepA and aac (6')-Ib-cr genes in P. aeruginosa clinical isolates. Scientific Research Project Office of Ondokuz Mayis University, Samsun, TurkeyOndokuz Mayis University [PYO.1904.04.10.018] This study supported with project no. PYO.1904.04.10.018 by Scientific Research Project Office of Ondokuz Mayis University, Samsun, Turkey.

Background: Surgical excision constitutes an important part of the treatment of local advanced malignant melanoma. Due to the high recurrence risk, adjuvant high-dose interferon therapy is still the only therapy used in stage IIB and III high-risk melanoma patients. Methods: One hundred two high-risk malignant melanoma patients who received high-dose interferon-α-2b therapy were evaluated retrospectively. The clinicopathological features, survival times, and prognostic factors of the patients were determined. Results: The median disease-free and overall survival times were 25.2 and 60.8 months, respectively. Our findings revealed that male gender, advanced disease stage, lymph node involvement, lymphatic invasion, the presence of ulceration, and a high Clark level were significant negative prognostic factors. Conclusion: In light of the favorable survival results obtained in this study, high-dose interferon treatment as adjuvant therapy for high-risk melanoma is still an efficient treatment and its possible side effects can be prevented by taking the necessary precautions.

WOS: 000324527900001, PubMed ID: 24013617, Aim Diastolic dysfunction (DD) is common in hemodialysis (HD) patients. Because diabetes mellitus (DM) and hypertension (HT) are also common in this patient group, the exact reason for DD in HD patients is not clear. The present study evaluated left ventricular (LV) diastolic function in HD patients without DM and HT. Methods Fifty patients on HD and 34 age-matched and sex-matched healthy control individuals were enrolled. Echocardiography was performed in all participants. LV systolic and diastolic functions were evaluated by B-mode echocardiography, pulsed wave, and tissue Doppler imaging. The HD patients were divided into two groups according to the presence or absence of left ventricular hypertrophy (LVH) in echocardiography. Results LV dimensions and systolic function were within normal limits and similar between groups. However, the HD patients had significantly worse diastolic function (E/A: 0.78 +/- 0.26 vs. 1.19 +/- 0.28, P < 0.001, e '/a ' septal: 0.77 +/- 0.36 vs. 1.04 +/- 0.21, P < 0.001) and increased filling pressure (E/e ': 8.55 +/- 3.2 vs. 5.79 +/- 1.93, P < 0.001). Thirty-one (62%) patients had LVH, whereas 19 (38%) patients did not have LVH. LV systolic and diastolic functions were similar in HD patients with and without LVH. Seventeen (55%) hypertrophies were concentric and 14 (45%) were eccentric. Diastolic functions were similar in patients with either concentric or eccentric hypertrophy. Conclusion Diastolic function is impaired in HD patients even in the absence of diseases that can cause DD such as HT and DM.

Intoxication caused by propafenone is very rare, and there is no case reported before propafenone and captopril intoxication together. There are few case reports in the literature about intoxication with more than 6 g of propafenone. We present the clinical manifestation and successfully treatment of 9 g of propafenone and 1 g captopril intoxication in an 18-year-old female. An 18-year-old female was brought to the emergency department approximately half an hour after she committed suicide with 30 propafenone tablets, 300 mg each, and 20 captopril tablets, 50 mg each. Her fist electrocardiography (ECG) shows a chaotic ventricular rhythm with a prolonged QRS complex. After fluid and sodium bicarbonate infusion and permanent pacemaker implantation, sinus rhythm was achieved. This case, to our knowledge, is the first in that it describes the successful recovery of a patient who ingested extensively large doses of propafenone (9 g) and captopril (1 g), both of which are known to have severe cardiac side effects.

The aim of the research was to determine the incidence, significance, and anatomy of spermatic cord and round ligament lipomas. Between 2000 and 2010 we evaluated 969 consecutive patients with 1,070 indirect inguinal hernias, who underwent open repair. A total of 22 lipomas of the spermatic cord or round ligament were identified and resected in 22 patients. No neoplastic changes confirmed in histopathologic examinations of the specimens were reported. Lipomas of the cord and round ligament occur with a considerable incidence. We believe that even if there is no peritoneal sac, the herniation of extraperitoneal fat through the inguinal canal should be counted as an inguinal hernia, and it requires adequate treatment.

Lynch syndrome, caused by germline mutations in the mismatch repair genes, is associated with increased cancer risk. Here using a large whole-genome sequencing data bank, cancer registry and colorectal tumour bank we determine the prevalence of Lynch syndrome, associated cancer risks and pathogenicity of several variants in the Icelandic population. We use colorectal cancer samples from 1,182 patients diagnosed between 2000–2009. One-hundred and thirty-two (11.2%) tumours are mismatch repair deficient per immunohistochemistry. Twenty-one (1.8%) have Lynch syndrome while 106 (9.0%) have somatic hypermethylation or mutations in the mismatch repair genes. The population prevalence of Lynch syndrome is 0.442%. We discover a translocation disrupting MLH1 and three mutations in MSH6 and PMS2 that increase endometrial, colorectal, brain and ovarian cancer risk. We find thirteen mismatch repair variants of uncertain significance that are not associated with cancer risk. We find that founder mutations in MSH6 and PMS2 prevail in Iceland unlike most other populations., This study was funded by the Ohio State University (OSU) Comprehensive Cancer Center P30 CA16058 grant (shared resource), the OSU R01-67941 grant, the OSU Colorectal Cancer Research fund, the Obrine-Weaver Fund, the Pelotonia Fellowship Award and deCODE genetics.

Sig, Ali Korhan/0000-0003-2907-257X; Akbal, Ahmet Ugur/0000-0002-0627-5326 WOS: 000389886500001 PubMed: 27982061 The aim of this multicenter study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for detection of multidrug resistant tuberculosis (MDR-TB). This study was performed in 11 centers in two phases. A total of 156 isolates were tested for INH and RIF resistance. In the phase I, 106 clinical isolates were tested in the Center 1-7. In the phase 2, 156 clinical isolates were tested in the center 1-6, center 8-11. Eighty six of 156 tested isolates were the same in phase I. Agreements were 96.2-96.8% for INH and 98.1-98.7% for RIF in the phase I-II, respectively. Mean time to obtain the results in the phase I was 14.3 +/- 5.4 days. In the phase II, mean time to obtain the results was 11.6 +/- 3.5 days. Test results were obtained within 14days for 62.3% (66/106) of isolates in the phase I and 81.4% (127/156) of isolates in the phase II. In conclusion, CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of MDR-TB isolates. In addition, it could be adapted for drug susceptibility testing with all drugs both in developed and developing countries.

Çok ilaca dirençli tüberküloz (ÇİD-TB), en az izoniazid (INH) ve rifampisine (RIF) direnç olarak tanımlanır ve etkili tüberküloz kontrol programlarının uygulanmasını zorlaştırmaktadır. ÇİD-TB'nin hızlı tespiti, hastalığın yayılımını azaltmak açısından önemlidir. Nitrat redüktaz testi (NRT), ÇİD-TB'nin hızlı tespiti için kullanılabilen kolorimetrik duyarlılık test yöntemlerinden biri olup, Mycobacterium tuberculosis'in nitratı nitrite indirgemesi yeteneğine dayalıdır. Bu çalışmada, ÇİD-TB'nin hızlı tespitinde NRT'nin performansının değerlendirilmesi amaçlanmıştır. Çalışmaya, Türkiye'de dokuz farklı merkezde aynı sistemle (BD MGITTM TBc Identifi cation Test, ABD) tanımlanmış toplam 237 M.tuberculosis kompleks (MTC) izolatı alınmıştır. Suşlar referans yöntem (Bactec MGITTM 960, BD, ABD) ve NRT ile elde edilen INH ve RIF duyarlılıkları açısından karşılaştırılmıştır. Merkezler arasında uyumun sağlanması için, antibiyotikli ve antibiyotiksiz (üreme kontrolü) Löwenstein-Jensen (LJ) besiyerleri ile Griess ayıracı solüsyonları tek bir merkezde Multidrug-resistant tuberculosis (MDR-TB) is defi ned as resistance to at least isoniazid (INH) and rifampicin (RIF), and it complicates the implementation of tuberculosis control programmes. The rapid detection of MDR-TB is crucial to reduce the transmission of disease. The nitrate reductase assay (NRA) is one of the colorimetric susceptibility test methods for rapid detection of MDR-TB and based on the ability of reduction of nitrate to nitrite by Mycobacterium tuberculosis. The aim of this study was to evaluate the performance of the NRA for the rapid detection of MDR-TB. A total of 237 M.tuberculosis complex (MTC) isolates that were identifi ed by the same method (BD MGITTM TBc Identifi cation Test, USA) from nine different medical centers in Turkey were included in the study. The susceptibility results of the isolates against INH and RIF obtained by reference test (Bactec MGITTM 960, BD, USA) were then compared with NRA. In order to ensure consistency between centers, Löwenstein-Jensen (LJ) medium with antibiotics and without antibiotics (growth control) and Griess reagent solution were prepared in a single center (Ondokuz Mayıs University School of Medicine, Medical Microbiology Department) and sent to all participant centers with the standardized test procedure. After the inoculation of bacteria into the test tubes, the tubes were incubated at 37°C, and after seven days of incubation, 500 ?l Griess reagent was added to the LJ medium without antibiotics. If a color change was observed, an equal volume of Griess reagent was added to test LJ media with antibiotics. When a color change was observed in LJ media with antibiotics, it was considered that the isolate was resistant to tested antibiotics. Among 237 MTC isolates, 16 were resistant only to INH and nine were resistant only to RIF; 93 isolates (39.2%) were resistant (MDR) and 119 isolates (50.2%) were susceptible to both of the drugs determined with the reference susceptibility test. In the study, fi ve INH-resistant isolates determined with reference method were found susceptible with NRT and eight INH-susceptible isolates determined with reference method were found resistant with NRT. In contrast, one RIF-resistant isolate determined with reference method was found susceptible with NRT and three RIF-susceptible determined isolates were found resistant with NRT. Accordingly, the concordance rate between the reference method and NRA were estimated as 94.5% for INH and 98.3% for RIF. The sensitivity, specifi city, positive and negative predictive values of NRA were detected as 95.4%, 93.7%, 92.8% and 96% for INH, and 99%, 97.8%, 97.1% and 99.2% for RIF, respectively. The results of the 111 isolates were obtained on the seventh day, while the rest of the results were obtained between 10-14 days. In conclusion, the data of this multicenter study showed that NRA is a reliable, relatively inexpensive and practical method to perform for the rapid detection of MDR-TB

Akbal, Ahmet Ugur/0000-0002-0627-5326 WOS: 000380112500006 PubMed: 27304025 In this study we evaluated the crystal violet decolorization assay (CVDA) for detection of minimum inhibitory concentration (MIC) of antituberculosis drugs. 53 isolates were tested in this study and 13 of them were multidrug resistant (MDR) isolates. The antibiotics concentrations were 2-0.06 mg/L for isoniazid (INH) and rifampicin (RIF) and were 16-0.25 mg/L for streptomycin (STM) and ethambutol (EMB). Crystal violet (CV-25 mg/L) was added into the microwells on the seventh day of incubation and incubation was continued until decolorization. Decolorization of CV was the predictor of bacterial growth. Overall agreements for four drugs were detected as 98.1%, and the average time was detected as 9.5 +/- 0.89 day after inoculation. One isolate for INH and two isolates for STM were determined resistant in the reference method, but susceptible by the CVDA. One isolate was susceptible to EMB by the reference method, but resistant by the CVDA. All results were concordant for RIF. This study shows that CVDA is a rapid, reliable and suitable for determination of MIC values of Mycobacterium tuberculosis. And it can be used easily especially in countries with limited-sources.

The purpose of the present study was to investigate the articular eminence inclination and height according to age and gender in patients with temporomandibular joint (TMJ) dysfunction and healthy controls using cone beam CT (CBCT).The measurements were performed on CBCT records of 52 TMJ dysfunction patients (11 males and 41 females) and 41 control patients (17 males and 24 females). The eminence inclination and height were measured on the CBCT images.The eminence inclination and height values were higher in males than in females in both TMJ dysfunction patient and control groups; however, these differences were not statistically significant (p0.05). While no statistically significant differences were found in the eminence inclination and height values between the age groups (p0.05) in the TMJ dysfunction patient group, there were statistically significant differences in the control group. The eminence inclination was highest between the ages of 21 and 30 years and showed a decrease after the age of 30 years. Additionally, the eminence inclinations of the control patients were statistically higher than those of the TMJ dysfunction patients.There were no statistically significant differences in eminence inclination and height according to gender. The eminence inclination reaches its highest value between the ages of 21 and 30 years and shows a decrease after the age of 31 years in healthy patients. The eminence inclination was steeper in healthy control patients than in patients with TMJ dysfunction.

To evaluate preimplantation genetic diagnosis (PGD) efficiency in thawed human embryos vitrified without biopsy.In this retrospective clinical study, 21 PGD cycles were carried out using fresh and vitrified-thawed embryos collected from 21 patients.One hundred and ninety-nine embryos from patients with aneuploidy, single gene defects, or chromosomal translocations were vitrified at the cleavage stages; 93.5% of the embryos survived the vitrification procedure. Conclusive FISH results were obtained in 98.4% of the fresh and 99% of the frozen-thawed embryos screened for aneuploidy or chromosomal translocations. Conclusive PCR test results were obtained in 100% of the fresh and 93.9% of the frozen-thawed embryos screened for single gene defects. The overall clinical pregnancy rate per cycle was 57.1%. To date, 13 healthy children have been born.Reliable genetic diagnosis can be performed in thawed human embryos vitrified without biopsy. However, further research is required to support this conclusion.

Conventional diagnostic nuclear medicine applications have been continuously increasing in most nuclear medicine departments in Turkey, but to our knowledge no one has studied the doses to technologists who perform nuclear medicine procedures. Most nuclear medicine laboratories do not have separate control rooms for technologists, who are quite close to the patient during data acquisition. Technologists must therefore stay behind lead shields while performing their task if they are to reduce the radiation dose received. The aim of this study was to determine external radiation doses to technologists during nuclear medicine procedures with and without a lead shield. Another aim was to investigate the occupational annual external radiation doses to Turkish technologists. Methods: This study used a Geiger-Muller detector to measure dose rates to technologists at various distances from patients (0.25, 0.50, 1, and 2 m and behind a lead shield) and determined the average time spent by technologists at these distances. Deep-dose equivalents to technologists were obtained. The following conventional nuclear medicine procedures were considered: thyroid scintigraphy performed using 99mTc pertechnetate, whole-body bone scanning performed using 99mTc-methylene diphosphonate, myocardial perfusion scanning performed using 99mTc-methoxyisobutyl isonitrile, and 201Tl (thallous chloride) and renal scanning performed using 99mTc-dimercaptosuccinic acid. Results: The measured deep-dose equivalent to technologists per procedure was within the range of 0.13 ± 0.05 to 0.43 ± 0.17 μSv using a lead shield and 0.21 ± 0.07 to 1.01 ± 0.46 μSv without a lead shield. Also, the annual individual dose to a technologist performing only a particular scintigraphic procedure throughout a year was estimated. Conclusion: For a total of 95 clinical cases (71 patients), effective external radiation doses to technologists were found to be within the permissible levels. This study showed that a 2-mm lead shield markedly reduced the external dose to technologists. The doses to technologists varied significantly for different diagnostic applications. Consequently, the estimated annual dose to a technologist performing only a particular scintigraphic procedure is very different from one type of procedure to another. The results of this study should help in determining the rotation time of technologists in different procedures and differences in their individual techniques.

33rd Turkish Microbiology Congress -- OCT 21-25, 2008 -- Bodrum, TURKEY WOS: 000286205500027 PubMed: 20717673 In this study, the effects of 1-(1-naphtylmethyl)-piperazine (NMP), an efflux pump inhibitor, on antimicrobial drug susceptibilities of 42 clinical Acinetobacter baumannii isolates were investigated by the disc diffusion method. The inhibition zone diameters of antibiotic discs were tested in the presence and absence of NMP and then these zone diameters were compared. Presence of NMP restored ciprofloxacin susceptibility in 15 intermediate and 2 resistant isolates. One ciprofloxacin resistant isolate became intermediate in the presence of NMP. One isolate resistant to gentamicin became intermediate with NMP. Interestingly, one isolate susceptible to meropenem became resistant in the presence of NMP. Although NMP increased the inhibition zone diameters of some of the tested antibiotics against the resistant isolates, the increase was not enough to restore susceptibility. In conclusion, the presence of NMP increases the zone diameters of ciprofloxacin and levofloxacin. Intermediate strains become susceptible but the resistant isolates do not.

To evaluate the influence of 1.1% amino acid dialysis solutions on nutritional parameters in incident continuous ambulatory peritoneal dialysis (CAPD) patients.The effect of daily use of 1.1% amino acid solution was studied retrospectively in 32 incident CAPD patients (14 women and 18 men, mean age 54 +/- 13 years) who began CAPD at our tertiary university hospital between July 2005 and February 2009 (amino acid solution (AAS) group). Serum total protein, albumin, and creatinine were assessed for all patients prior to dialysis and at the end of the study period. Thirty-two control patients (12 women and 20 men, mean age 52 +/- 14 years) who started peritoneal dialysis with a standard CAPD program were also investigated and grouped as the dextrose solution (DS) group.Baseline serum albumin levels were significantly lower in the AAS group compared to the DS group (3.4 +/- 0.4 g/dL vs. 3.7 +/- 0.5 g/dL, p = 0.011). At the end of the 12-month follow-up period, mean serum albumin levels had decreased from 3.4 to 3.3 g/dL in the AAS group (p = 0.218) and increased from 3.7 to 3.8 g/dL in the DS group (p = 0.360). Overall, no significant changes were observed in serum total protein, creatinine, or albumin in either group.Amino acid solutions conferred no demonstrable benefit on biochemical parameters in incident CAPD patients. The effects of AAS may be different when added to the CAPD regimen of patients undergoing prior CAPD treatment.

Leblebicioglu, Hakan/0000-0002-6033-8543; WOS: 000278289200009 PubMed: 20134373 Objective: Neopterin (NT) is a compound of low molecule-based pteridine. It is secreted by macrophages as a response to the stimulation of cytokines such as interferon-gamma, interferon-1 beta, tumor necrosis factor alpha or bacteria compounds such as lipopolysaccharides. Procalcitonin (PCT) levels may increase in the course of bacterial, parasitic, and fungal infections. Therefore, it can be used for the differential diagnosis of the infection, especially in cases of serious inflammation. In this study, the role of NT, and PCT in sepsis as a prognostic factor, and the relationship between the two parameters are examined. Methods: From November 1, 2005 through December 31, 2005, fifty patients with sepsis admitted to the Department of the Infectious Diseases and Clinical Microbiology and/or Department of An-aesthesiology and Reanimation were enrolled in the study. Patients were divided in two subgroups according to their survival: group I (n = 23) nonsurviving patients and group II (n = 27) surviving patients. Results: Serum NT levels have been found to be increased in group I (median: 15 ng/mL, range: 2-69) when compared to group II (median: 5 ng/ mL, range: 2-130). The difference was statistically significant (P = 0.03). Other laboratory parameters and PCT levels (group I median: 0.13; group II median: 0.08; P < 0.05) were not different between the two groups. Conclusions: NT was found to be a prognostic factor in patients with sepsis.

WOS: 000272359300008, PubMed ID: 19669399, Atrial fibrillation (AF) is the most frequently encountered chronic arrhythmia associated with significant morbidity. It is generally encountered in the elderly, and will presumably become more prevalent in the future due to the increasing proportion of the elderly in the population. Major studies on AF have demonstrated no significant difference between rhythm and rate control in terms of mortality. However, young population with new-onset or lone AF, or patients in whom the maintenance of sinus rhythm is a must (due to recurrent thromboembolic events etc.) still gives rise to significant concerns related to the obligatory long-term prophylaxis. The long-term administration of the currently available conventional agents (amiodarone, dofetilide, sotalol, propafenone,flecainide etc.) is considered as a 'double edged sword' due to the presence of life-threatening adverse effects including pro-arrhythmia and organ toxicity associated with these agents. Several molecules are being developed for the management of AF. However, only a few novel agents confer promising results with respect to safety and efficacy issues in the major studies. Dronedarone is an amiodarone analogue without iodine moiety in its structure, and is similar to amiodarone with regard to its structural and electrophysiological properties. Dronedarone is largely denuded of the potentially life-threatening adverse effects of anti-arrhythmics. Major clinical studies have demonstrated both rhythm and rate-controlling efficacy of dronedarone compared to placebo without any serious adverse effects in patients with AF. However, the ANDROMEDA trial, a large scale study including patients hospitalized for symptomatic congestive heart failure (with severely depressed left ventricular systolic functions) was prematurely terminated due to the increased mortality in the dronedarone arm compared to placebo indicating a lack of safety in this group of patients. Conversely, the recently published ATHENA study (including more than 4,600 high risk patients, but excluding those with severe heart failure) demonstrated a significant reduction in cardiovascular hospitalizations and cardiovascular mortality with dronedarone compared to placebo. In contrast, the DIONYSOS study, comparing dronedarone with amiodarone, demonstrated better safety, but lower efficacy of dronedarone for the maintenance of sinus rhythm in patients with AF. Further clinical trials (including head to head comparison with other conventional anti-arrhythmics) are still required to determine the place of dronedarone in the management of AF. The present review focuses on basic and clinical aspects of dronedarone, a novel agent for the management of AF.

Objectives: The purpose of the present study is to determine the nature of the complaints that bring patients to our clinic and to what degree these complaints affect their quality of life (QoL). We also aimed to determine any associations between gender, education or harmful habits and each patient?s oral health-related quality of life (OHQoL). Methods: A total of 1090 patients, consisting of 651 females (59.7 %) and 439 males (40.3 %), were included in this study. Of these patients, 220 constituted healthy controls. Two patient-centered outcome measures, the 14 item OHIP-14 and the 16 item OHQoL-UK measures were used. Results: Most of the patients presented with toothache and caries (50.1 %), 11.2 % had suffered tooth loss and had denture needs, 9.2 % had periodontal problems, 1.8 % had temporomandibular joint (TMJ) disorders, 3.8 % had buried third molars, 2.4 % had orthodontic and aesthetic disorders, 1.3 % had suffered injury due to trauma, and 20.2 % came only for control checkups. OHQoL was best in the control group and the worst in patients who had suffered trauma. In addition, we noted correlations between gender, education and harmful habits, and that of the patient?s oral health-related quality of life. Conclusion: According to our results, OHQoL is associated with the oral complaints of patients. Furthermore, OHQoL may not only be associated with the oral health status of patients, but factors such as gender, education and harmful habits may also play a role.

Objective: To investigate the psychometric properties of the Rivermead Motor Assessment by Rasch analysis and conventional statistics to improve its clinical utility. Methods: A total of 107 patients after stroke were evaluated using the Rivermead Motor Assessment and Functional Independence Measure (FIM TM ). Scaling properties were assessed using Mokken scaling, internal construct validity using Rasch analysis, reliability using Cronbach’s alpha and intra-class correlation coefficients, external construct validity through convergent validity with FIM TM , and responsiveness using the effect size and standardized response mean. Results: Cronbach’s alpha and intra-class correlation coefficients for 3 sections of the Rivermead Motor Assessment were between 0.88 and 0.95. Mokken scaling showed appropriate Guttman patterns, but the hierarchical ordering of the items differed from that of the original. After removing 4 items of gross function, 1 of leg-trunk, and 4 of arm, all sections met Rasch model expectations. External construct validity was confirmed. Mean values of effect size and standardized response were 0.38–0.51 and 0.60–0.89, respectively. Conclusion: The Rivermead Motor Assessment has been shown to be reliable and responsive. Guttman scaling is apparent, but not as originally defined. After removing some items, the scale satisfies the most stringent Rasch measurement criteria and can produce interval scaling for the assessment of motor function in stroke.

Objective: Recurrent aphthous stomatitis (RAS) is the most common oral ulcerative condition affecting 5–25% of the general population. The aim of this study was to evaluate the oxidative stress parameters in saliva of patients with RAS and to investigate the relationship among these parameters in either group. Materials and Methods: The study involved 50 patients with RAS of whom 24 were male and 26 were female, and 25 healthy controls of whom 13 were male and 12 were female. Results: There was no statistically significant difference in the salivary total antioxidant capacity, total oxidant status, oxidative stress index levels, and myeloperoxidase activity between patients with RAS and those in the control group. Conclusions: The results show that reactive oxygen species may not play a role in the etiology of RAS.

Beta(2)-microglobulin (beta(2)-M) amyloidosis is an important cause of morbidity in patients on dialysis. In this cross-sectional study, we evaluated supraspinatus tendon thickness (as a measure of shoulder involvement from beta(2)-M amyloidosis) in patients who are on hemodialysis (HD) compared with those on continuous ambulatory peritoneal dialysis (CAPD). In 27 patients on HD who were treated with high-flux dialyzers, 31 patients on CAPD, and 31 healthy volunteers, we performed bilateral shoulder magnetic resonance imaging and measured the supraspinatus tendon thickness using electronic calipers. There were no statistically significant differences in age or dialysis duration between the HD and CAPD patients. Each patient was asked about the presence or absence of shoulder pain. The supraspinatus tendon thickness in HD patients (mean thickness 6.6 +/- 1.3 mm, range 3.20-8.80 mm, N = 53) and CAPD patients (6.8 +/- 0.9 mm, range 4.9-8.8 mm, N = 61) was not significantly different (P = 0.289); however, the mean thickness in either group was higher than in the healthy controls (5.5 +/- 0.6 mm, range 4.3-6.8 mm, N = 61) (HD patients vs. controls: P = 0.000; CAPD patients vs. controls: P = 0.000). Patients with shoulder pain had higher mean supraspinatus tendon thickness measurements than patients without shoulder pain (P = 0.042). The thickness of supraspinatus tendons is not significantly different between patients on CAPD and HD. An association exists between shoulder pain and mean supraspinatus tendon thickness. This hidden complication of ESRD should be further studied in larger populations of dialysis patients.

11th International Congress on Neuromuscular Diseases -- JUL 02-07, 2006 -- Istanbul, TURKEY WOS: 000253722800019 PubMed: 18279025 Although hypothyroid myopathy is seen frequently and the relationship with autoimmune hypothyroidism and myasthenia gravis is well known, specific forms of hypothyroid myopathy such as Hoffman's syndrome (HS) are rarely described. Here we describe a 40-year-old patient with Hashimoto thyroiditis showing symptoms and signs of two discrete forms of hypothyroid myopathy (HS and myasthenic syndrome) together. To our knowledge this is the first reported case with features of both of these syndromes. We discuss the diagnosis, speculate whether this patient may represent a unique form of hypothyroid myopathy, and report the 6-month follow-up of the patient both clinically and electrophysiologically.

WOS: 000251425300006, PubMed ID: 17952581, Background Levosimendan is a relatively new cardiac inotropic agent with calcium sensitizing activity. This study was conducted to investigate the effects of levosimendan (L) and dobutamine (D) on renal function in patients hospitalized with decompensated heart failure (HF). Method The present study included 88 consecutive patients hospitalized with acutely decompensated HF (New York Heart Association (NYHA) Class 3-4) requiring inotropic therapy. Patients were randomized 2:1 to either L or D for intravenous inotropic support. Diuretic therapy was kept constant during infusions. Renal function values, including serum creatinine (CR), blood urea nitrogen, 24-h urinary output levels and calculated glomerular filtration rate (GFR) were measured just prior to and 24 h after the infusions in all patients, and 48 and 72 h after the infusions in every second patient in both groups. The pre and post-infusion values of renal function and left ventricular ejection fraction (LVEF) were evaluated. Results LVEF increased significantly in both groups. Those in L showed a significant improvement in calculated GFR after 24 h, whereas those in D showed no significant change (median in change in L:+15.3%, median change in D: -1.33%). Furthermore, in the L group a significant improvement was observed in calculated GFR after 72 h compared to baseline levels, whereas in D no significant change (median change in L:+45.45%, median change in D: +0.09%) was seen. Both agents improved 24-h urinary output. Conclusion Levosimendan seems to provide beneficial effects in terms of improvement in renal function compared to dobutamine in patients with heart failure who require inotropic therapy.