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Abstract Background Asthma is one of the most common causes of chronic respiratory disease, and countries with low socioeconomic status have both a high prevalence of asthma and asthma‐related death. Objective In this study, we aimed to determine socioeconomic levels of asthmatic patients according to a national database and investigate the effects of social markers on disease control in our region. Methods This is an analysis of data from 2053 adult asthma patients from a multicentre chart study in Turkey. Socioeconomic status (SES) data were collected from questionnaires and this form was sent to the patients via e‐mail. Parameters related to social status and poor disease control were analyzed. Results Illiteracy (OR:2.687 [95% CI: 1.235–5.848]; p = 0.013) and lower household income (OR:1,76 [95% CI: 1.002–3.09]; p = 0.049) were found as independent risk factors for hospitalization in the multivariate logistic regression analysis. Therewithal, being aged between 40 and 60 (OR: 1.435 [95% CI: 1.074–1.917]; p = 0.015), illiteracy (OR: 2.188 [95% CI: 1.262–3.795]; p = 0.005) and being employed (OR: 1.466 [95% CI: 1.085–1.847]; p = 0.011) were considered as independent risk factors for systemic corticosteroid use at least 3 days within last 1 year. Conclusion As a result of our national database, education level, household income and working status briefly socioeconomic status have impacts on asthma control. Identification of social markers in asthma and better recognition of risk factors based on the population gives us clues to provide better asthma control in the future.

Case report: INTRODUCTION: Adrenal glands are one of the organs where malignancies frequently metastasize. However, primary malignancies of the adrenal glands are rare. Primary adrenal lymphomas (PAL) account for less than 1% of extranodal lymphomas. It is seen bilaterally in 75% of cases. The most common subtype is diffuse large B-cell lymphoma. CASE: A 57-year-old male patient with no known history of disease applied to an external center with complaints of weight loss (13 kg, more than 10% of body weight), tremors, loss of appetite and lower back pain. As a result of the evaluations made at an external center, thorax CT showed bilateral adrenal masses. PET CT was taken with the preliminary diagnosis of malignancy; In the right adrenal gland, approximately 11.6 × 8.1cm (SUVmax: 25.6) and in the left adrenal gland, approximately 10.1 × 7.2cm (SUVmax: 24.4) in size, heterogeneous dense hypermetabolic solid mass sections with necrotic areas were seen and left paraaortic (SUVmax: 11.7) lymph node with dimensions of 1.6 × 1.2 cm and a few mildly-intensely hypermetabolic lymph nodes were observed in the interaortocaval chain. Primary malignancy storage was evaluated in the foreground of dense hypermetabolic mass regions of heterogeneous structure defined in both adrenal glands. After pheochromocytoma was diagnosed, the patient was referred to our clinic after the tru-cut pathology performed on the mass lesions in the right adrenal gland revealed that the morphological and histochemical findings were consistent with diffuse large B-cell lymphoma.The patient's vital signs were stable upon admission. In the hemogram, Hgb: 9.7g/dL Hct: 31.2% MCV: 96 fL Platlet: 126.000 / mm3. In biochemistry, creatinine:1.83mg/dL urea:80 mg/dL Na:139 mmol/L K:4.36 mmol/L Ca:10.2mg/dL uric acid:9.4mg/dL LD:343U/L. There was no sign of adrenal insufficiency other than dehydration. The patient was started on hydration and allopurinol treatments. During follow-up, urea and creatinine levels decreased to normal limits. The patient's basal cortisol was 12.02 µg/dL and ACTH was 83.8ng/L. Low-dose (1µg) ACTH test was performed on the patient, for whom chemotherapy was planned for his primary disease, with the preliminary diagnosis of adrenal insufficiency. The patient's cortisol levels were detected as 8.23-10.35-8.93-9.75 µg/dL at 30-60-90 and 120 minutes, respectively, and hydrocortisone treatment was started with the diagnosis of adrenal insufficiency. During the follow-up of the patient, R-CHOP chemotherapy was started, and since the patient had prednisolone in the chemotherapy course, hydrocortisone was discontinued during chemotherapy and isolated prednisolone treatment was given. Central Nervous System involvement was detected in the cerebrospinal fluid during intrathecal (IT) chemotherapy (Mtx, Dexamethasone, Cytosine Arabinosine). Intrathecal therapy was initially administered 3 times a week and subsequently twice a week. Since no cells were detected in the cytocentrifuge, intrathecal chemotherapy was given 4 times. After 6 cycles of R-CHOP chemotherapy, the patient underwent Autologous peripheral stem cell transplantation because of high risk disease in December 2023. The patient, whose general condition is good during follow-up, is currently being followed in remission under replacement dose hydrocortisone treatment.

Aim:Abdominal obesity (AO) can affect some disease developments such as diabetes, cardiovascular diseases, or thyroid autoimmunity. To date, there is no data on the anthropometric parameters’ impact on the development of refractory chronic spontaneous urticaria (CSU). We evaluated the impact of AO on the course of the presence of refractory CSU and to determine the possible associated risk factors for having refractory CSU.Methods:This study was designed as a retrospective study and data was collected from January 2021 to April 2022. For determining AO, the waist-to-height ratio (WHtR) was used and calculated by the physicians, retrospectively. WHtR>0.5 was considered AO. Patients were divided into two groups [Group 1= refractory CSU (n=87) and Group 2= non-refractory CSU (n=83)]. Demographics, clinical characteristics of patients, and laboratory test findings were recorded from patients’ medical files, retrospectively.Results:A hundred and seventy CSU patients were included in the study. The mean age of the patients was 38.95±13.08 years. The number of patients accompanying angioedema was significantly higher in refractory CSU than in non-refractory CSU [65 (74.7%) vs 45 (54.2%), p=0.005]. Exacerbation of urticaria plaques with stress was more common in refractory CSU than in non-refractory CSU (p=0.030). WHtRs were similar in both groups. Baseline C-reactive protein (CRP) and blood neutrophil count were significantly higher in refractory CSU (p=0.008 and p=0.024, respectively).Conclusion:High baseline CRP levels, baseline blood neutrophil count, stress and angioedema accompanying CSU are the associated risk factors of refractory CSU in the Turkish population. Furthermore, AO may not have an impact on the development of antihistamine refractory CSU.

For archival pathogens, like pH1N1 Influenza A virus the causative agent of 1918/19 pandemic, only few whole genome sequences exist. Here, Patrono et al. provide one complete and two partial genomes from Germany and find variation in two sites in the nucleoprotein gene in pandemic samples compared to pre-pandemic samples, that are associated with resistance to host antiviral response, pointing at a possible viral adaptation to humans.

Background: In daily practice, atopic patients and those who have other drug allergies are referred to allergy clinics for evaluation of possible general anesthetic allergy despite the fact that it is not recommended in recent guidelines. Objective: The aim of this prospective study is to determine the negative predictive value of skin tests for common general anesthetic drugs prior to general anesthesia in atopic patients and in patients who had drug allergies by including the data of those who had previously tolerated or reacted to general anesthesia. Methods: A database program was constituted to collect the preoperative skin test data of patients referred to our clinic between 2013 and 2018. Demographic and clinical history, medications implemented during perioperative period, reactions, and results of skin tests performed with anesthetic drugs and latex were evaluated. Results: Four hundred fifty-nine out of the total 1167 patients referred fulfilled the inclusion criteria for further evaluation. Nearly 75% of the patients were female and mean age was 46.3 ± 14.3 years. History of hypersensitivity reactions (HRs) due to NSAIDs and/or antibiotics, radiocontrast agents, local anesthetics, and food were present in the 53.1%, 4.1%, 1.5%, and 2.0%, respectively. The negative predictive values of skin tests for general anesthetics were in the range of 80–100%. Only 4 patients (0,87%) experienced HRs during operation. Conclusion: These real-life data reveal high rates of negative predictive value of skin tests with general anesthetic drugs and a low reaction rate in atopic patients and in patients with allergy to other drugs.

Background: Mast cell-related symptoms might be influenced by mental health status in mastocytosis. In this study, we aimed to investigate the influence of mental health problems developed during the COVID-19 pandemic on the course of mastocytosis. Methods: Mental health status in 60 adult patients with mastocytosis was prospectively evaluated with the total Depression-Anxiety-Stress Scale (tDASS-21) and Fear of COVID-19 Scale (FCV–19S) in the lockdown period (LP) and the return to normal period (RTNP) during the pandemic. The disease course was assessed from emergency and outpatient medical reports, including Scoring Mastocytosis (SCORMA) index and serum baseline tryptase levels, by telephone interviews and clinical visits. Results: The mean FCV-19S and median tDASS-21 scores were significantly higher in LP than RTNP (p

Neuroblastoma is a devastating tumour in children. Here, the authors analyse multi-region patient samples using genomics and transcriptomics, revealing temporal and spatial heterogeneity and questioning the reliability of single-biopsy based diagnostics.

Among non-native copepods, the calanoid Pseudodiaptomus marinus Sato, 1913 is the species probably spreading at the fastest pace in European and neighbouring waters since its first record in the Adriatic Sea in 2007. In this contribution, we provide an update on the distribution of P. marinus in the Mediterranean and Black Seas, along the Atlantic coasts of Europe, in the English Channel and in the southern North Sea. Starting from a previous distribution overview, we include here original and recently (2019–2023) published data to show the novel introduction of this species in different geographical areas, and its secondary spreading in already colonised regions. The picture drawn in this work confirms the strong ability of P. marinus to settle in environments characterised by extremely diverse abiotic conditions, and to take advantage of different vectors of introduction. The data presented allow speculations on realistic future introductions of P. marinus and on the potential extension of its distribution range.

The electroencephalogram is a powerful tool for understanding the electrical activities of the brain. The automatic and accurate classification of extracranial and intracranial electroencephalogram signals are significant for the evaluation of epilepsy. Electroencephalogram signals contain significant characteristic information about epileptic brain waves. However, the electroencephalogram signals are easily disrupted by the artifacts polluting. This study proposed a clinical decision support system to extract significant epilepsy-related spectral features from the electroencephalogram signal. The artifact-free electroencephalogram signals features were obtained from the Kaiser window based on Finite Impulse Filter. The extracted features were modeled by the Artificial Neural Networks Back Propagation training algorithms which are Levenberg-Marquardt, Bayesian Regularization, and Scaled Conjugate Gradient. The algorithms' classification performances were compared by the accuracy rates. The experiment results show that compared with the Artificial Neural Networks Back Propagation training algorithms, the performance of the Levenberg-Marquardt is better from the point of accuracy rate which achieves a satisfying classification accuracy of 83.01% for extracranial and intracranial electroencephalogram signals.

Witze, ethnische Witze werden in dieser Arbeit nach der Eignung als Textsorte für den Fremdsprachenunterricht näher untersucht. Pragmatische Aspekte werden dazu in Betracht gezogen. Eingehend auf die Struktur und Flexibilität der Textsorte 'Witze' werden Beispiele für den FSU in verschiedenen Niveaustufen gegeben, wobei nach geeigneten Modellen für den DaF-Unterricht geforscht wird. Stereotype von der Kultur und dem Volk der zu erlernenden Fremdsprache sollen verbildlicht werden, um dem Lerner einen Einblick in die andere Fremdkultur zu geben und ein Feingefühl für das Neue zu entwickeln. Die Intention dieser Untersuchung ist, dass mögliche Übertragungsfehler beim Lernen von einer Sprache aus einer anderen Kultur als der Muttersprache vermieden wird und nicht nur Grammatische und Wortschatz bezogene Lehrstoffe, sondern auch historisch-kulturelle, politisch-gesellschaftliche Aspekte in humorvoller und Interesse erweckender Weise aufgegriffen und gut verständlich im DaF- Unterricht vermittelt werden.

Abstract Background The hydrophobic triterpenes, oleanolic and betulinic acid as well as the hydrophilic mistletoe lectins and viscotoxins possess anticancer properties. They do all occur in combination in European mistletoe (Viscum album L.). Commercial Viscum album L. extracts are aqueous, excluding the insoluble triterpenes. We have previously shown that mistletoe lectins and triterpene acids are effective against Ewing sarcoma in vitro, ex vivo and in vivo. Methods We recreated a total mistletoe effect (viscumTT) by combining an aqueous extract (viscum) and a triterpene extract (TT) solubilised with cyclodextrins and analysed the effects of viscumTT and the single extracts on TC-71 Ewing sarcoma cells in vitro by transcriptomic and proteomic profiling. Results Treatment with the extracts strongly impacted Ewing sarcoma cell gene and protein expression. Apoptosis-associated and stress-activated genes were upregulated, proteasomal protein abundance enhanced and ribosomal and spliceosomal proteins downregulated. The mechanism of action of viscum, TT and viscumTT in TC-71 and MHH-ES-1 cells suggests the involvement of the unfolded protein response. While viscum and viscumTT extract treatment indicate response to oxidative stress and activation of stress-mediated MAPK signalling, TT extract treatment suggests the involvement of TLR signalling and autophagy. Conclusions Since the combinatory extract viscumTT exerts highly effective pro-apoptotic effects on Ewing sarcoma cells in vitro, this phytopolychemotherapy could be a promising adjuvant therapeutic option for paediatric patients with Ewing sarcoma.

Bu çalışmada, hamsi balığından döner yapılması ve kalite özelliklerinin belirlenmesi amaçlanmıştır. Hamsi balığı dönerinde % 52.17 su, % 24.79 ham protein, % 18.62 ham yağ ve % 4.28 oranında ham kül saptanmıştır. Muhafaza süresinin sonunda hamsi döner örneklerinde doymuş yağ asitleri DYA içerisinde C16:0, tekli doymamış yağ asitleri TDYA içerisinde C18:1 n-9 ve çoklu doymamış yağ asitleri ÇDYA içerisinde ise C22:6 n-3’ün en yüksek orana sahip olduğu tespit edilmiştir. Genel olarak, hamsi dönerler örneklerinde ∑n6/∑n3 oranında ve DHA/EPA dekosahegzaenoik asit, C22:6 n-3/eikosapentaenoik asit, C20:5 n-3 oranında önemsiz bir değişim tespit edilmiştir P>0.05 . Depolama sonunda hamsi döner örneklerinde pH, tiyobarbitürik asit TBA , toplam uçucu bazik azot TVB-N ve trimetilamin azot TMA-N değerleri sırasıyla 6.25, 3.53 mg MDA kg-1, 34.03 mg 100 g-1 ve 5.25 mg 100 g-1 olarak saptanmıştır. Hamsi döner örneklerinde toplam mezofilik aerob bakteri TMAB ve toplam psikrofilik aerob bakteri TPAB sayısı depolama ile birlikte artarak muhafaza süresi sonunda sırasıyla 4.82 logkob g-1 ve 4.39 logkob g-1 değerlerine ulaşmıştır. Maya-küf ve koliforma ise rastlanılmamıştır. Duyusal analiz sonuçlarından panelistlerce hamsi dönerin beğenildiği anlaşılmaktadır. Bu çalışmada, hamsiden üretilen döner örneklerinin 63.günde bozulduğu belirlenmiştir

Multifractal denoising techniques capture interest in biomedicine, economy, and signal and image processing. Regarding stroke data there are subtle details not easily detectable by eye physicians. For the stroke subtypes diagnosis, details are important due to including hidden information concerning the possible existence of medical history, laboratory results, and treatment details. Recently, K-means and fuzzy C means (FCM) algorithms have been applied in literature with many datasets. We present efficient clustering algorithms to eliminate irregularities for a given set of stroke dataset using 2D multifractal denoising techniques (Bayesian (mBd), Nonlinear (mNold), and Pumping (mPumpD)). Contrary to previous methods, our method embraces the following assets: (a) not applying the reduction of the stroke datasets’ attributes, leading to an efficient clustering comparison of stroke subtypes with the resulting attributes; (b) detecting attributes that eliminate “insignificant” irregularities while keeping “meaningful” singularities; (c) yielding successful clustering accuracy performance for enhancing stroke data qualities. Therefore, our study is a comprehensive comparative study with stroke datasets obtained from 2D multifractal denoised techniques applied for K-means and FCM clustering algorithms. Having been done for the first time in literature, 2D mBd technique, as revealed by results, is the most successful feature descriptor in each stroke subtype dataset regarding the mentioned algorithms’ accuracy rates.

Some of the nutritional properties of Potamon potamios, captured from the Lake of Egirdir were investigated in relation to season and sex. In the laboratory, crab meat and crab shells were seperated. All crab meat and dried crab shell analyses were conducted separately. According to proximate composition analysis, there were no significant differences in the moisture, protein, fat and ash contents in terms of seasons. But there were significant (P

Abstract Background Right sided arcus aorta (RSAA) is a rare condition that is usually asymptomatic. Patients may present with exertional dyspnea and chronic cough. A recent article suggested that RSAA should be included in the differential diagnosis of asthma, especially in patients with intractable exertional dyspnea. We aimed to present the clinical, radiologic and spirometric features of thirteen patients with RSAA observed in four years at the Rize Education and Research Hospital and Samsun Chest Diseases and Thoracic Surgery Hospital. Methods The characteristics of patients with RSAA, including age, gender, symptoms, radiologic and spirometric findings, were retrospectively evaluated. Results A total of thirteen patients were diagnosed with RSAA. Their ages ranged from 17 to 86 years and the male to female ratio was 11:2. Seven of the patients (54%) were symptomatic. The most common symptoms were exertional dyspnea, dysphagia and chronic cough. Five patients had received treatment for asthma with bronchodilators. Spirometry showed intrathoracic tracheal obstruction in five patients. Conclusions The RSAA anomaly occurs more frequently than might be estimated from the number of patients who are detected. Patients with intractable exertional dyspnea and chronic cough should be evaluated for the RSAA anomaly by thoracic CT.

Objectives: This case series describes adults with aquaporin 4 immunoglobulin G-seropositive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD) who switched treatment from eculizumab to satralizumab., Methods: Case information for patients with AQP4-IgG+ NMOSD who received satralizumab for ≥6 months was obtained from US healthcare providers from April 2022 to January 2024. Patient characteristics, examination findings, diagnostic test results, treatment response, and adverse events were recorded., Results: Among the 5 patients (4 women and 1 man) included, ages ranged from 32 to 81 years and 4 patients self-identified as Black/African American and 1 as White. Time since confirmed NMOSD diagnosis ranged from 1 to 14 years. The reasons for initiating satralizumab were route of administration/patient preference (n=3) and inadequate disease control with eculizumab (n=2). The duration of satralizumab treatment was 10 to 31 months. All 5 patients were relapse-free with satralizumab, and adverse events they experienced were primarily asymptomatic laboratory abnormalities., Discussion: In this retrospective case series, satralizumab was effective and well tolerated in patients with NMOSD who switched from eculizumab due to route of administration/patient preference or inadequate disease control. These outcomes align with the long-term efficacy and safety outcomes with satralizumab in the phase 3 SAkura clinical trials., Competing Interests: HA: Consultant for Biogen, Genentech, Inc., Bristol Myers Squibb, Alexion, Horizon, Cycle Pharma, and Alpine Pharma. Receives research support from Novartis, Sanofi-Genzyme, Bristol Myers Squibb, Genentech, Inc., UCB, and the Guthy-Jackson Charitable Foundation. Served as an assistant editor for the Neurology Journal. Receives royalties from UpToDate. AS: Speaker for TG Therapeutics, Bristol Myers Squibb. BS: Served on advisory boards for Genentech, EMD Serono, and Horizon. Dr. Sengul has received personal compensation for serving on speakers bureaus for Biogen and EMD Serono and served on the steering committee for EMD Serono. RS: Received personal compensation as a consultant or speaker for Alexion, Biogen, Bristol Myers Squibb, EMD Serono, Genentech, Horizon, Novartis, Sanofi Genzyme, and TG Therapeutics. PG, RW, JC, and RP: Consultant for Genentech/Roche, Bristol Myers Squibb, Sanofi, Horizon, Alexion. Speakers bureau for Alexion, Horizon, Biogen, Bristol Myers Squibb, EMD Serono. The institution of Drs. Walch, Goulette, Cote, and Pace has received research support from Genentech/Roche, Sanofi, EMD Serono, and Novartis. Research support from TG Therapeutics. AO: Speaker or consultant for Alexion Pharmaceuticals, Amgen, Banner Life Sciences, BD Biosciences, Biogen, Biologix, Bristol Myers Squibb, Celgene, EMD Serono, Genentech, Inc., GW Pharma, Jazz Pharmaceuticals, Horizon Therapeutics, Novartis, Sandoz Pharmaceuticals, Sanofi/Genzyme, TG Therapeutics, and Viela Bio and honoraria from Medscape, WebMD, and MJH Life Sciences. LF and SG: Employees of Genentech, Inc., and shareholders in F. Hoffmann-La Roche Ltd., (Copyright © 2025 Abboud, Subei, Sengul, Shin, Goulette, Walch, Coté, Pace, Obeidat, Ferayorni and Gholizadeh.)

Introduction: We evaluated the dosimetric results of the identification of the left ventricle (LV) and left anterior descending artery (LAD) as organs at risk (OARs) in adjuvant radiotherapy (RT) after breast-conserving surgery (BCS)., Materials and Methods: Twenty-two patients who had previously received RT in our center were evaluated retrospectively. All patients had undergone BCS operation for left breast cancer. LV and LAD were contoured as OARs on the same simulation CTs for these patients whose treatment was previously completed in which LV and LAD were not defined as OARs. Complying with the initial plans, intensity-modulated RT plans with 7-9 fields were made on the computer. Planning target volume (PTV), homogeneity index (HI), conformity index (CI), monitor unit (MU) values, and doses of OARs were compared using the Wilcoxon signed-rank test (p < 0.05)., Results: There were no significant differences in PTV 50 (D 50% and D 98%), PTV 60 (D 2% and D 50%), HI, CI, and MU values when treatment plans and control plans were compared (p > 0.05). While it was possible to protect the heart, LAD, and LV better, LAD and LV were not contoured in the treatment plans, and they received higher doses compared to the control plans (p < 0.05). There was no significant difference in the other OARs., Conclusion: In conclusion, it is essential to define the lower anatomical regions of the heart as OARs. Otherwise, the doses taken by these regions are ignored and may be maintained less than possible. In our study, it was shown that LV and LAD doses were significantly reduced even in the same center and planning by the same team.

The aim of this study was to evaluate the maternal and foetal factors affect higher cell-free DNA (cfDNA) levels and to investigate a possible relationship between high cfDNA levels and adverse perinatal outcomes. From a total of 4594 women who underwent non-invasive prenatal testing from January 2016 to March 2018 in our hospital, 112 women had high levels of cfDNA, which was not appropriate for testing. Maternal characteristics and perinatal outcomes were compared between patients with high levels of cfDNA and normal levels of cfDNA. Patients with high levels of cfDNA had greater risks than patients with normal cfDNA levels of pregnancy complications but no statistically significant difference was found. Patients with high cfDNA levels had higher foetal death rates with a statistically significant difference (9.8% versus 1.8%, p  = .024). An increase in foetal death could be expected in patients with increased cfDNA levels; therefore, these patients should be carefully followed up during pregnancy.IMPACT STATEMENT What's already known about this topic? Most studies about cfDNA levels are focussed on the foetal fraction. There are new arguments about maternal health and cfDNA. It is known that autoimmune diseases as systemic lupus erythematosus (SLE) and maternal obesity increase cell turnover. There are also clinical studies suggesting a relationship between low molecular weight heparin therapy and the amount of cfDNA. What do the results of this study add? This is the first study evaluating the maternal and foetal biological factors affecting cfDNA concentrations and investigating the possible relationship between high cfDNA levels and adverse perinatal outcomes in patients with high levels of cfDNA compared to patients with normal levels of cfDNA. In the present study, it was found that an increase in foetal death could be expected in patients with higher cfDNA levels. What are the implications of these findings for clinical practice and/or further research? If potential effects and underlying causes of increased cfDNA could be explained, cfDNA might be used as a biomarker for adverse perinatal outcomes.

In external radiotherapy (RT), the use of flattening filter-free (FFF) radiation beams obtained by removing the flattening filter (FF) in standard linear accelerators is rapidly increasing, and the benefits of clinical use are the issue of research. Advanced treatment techniques have increased the interest in the operation of linear accelerators in FFF mode. The differences of the beams with non-uniform dose distribution created by removing FF compared to the beams with uniform dose distribution used as a standard were examined. These differences were compared in the treatment plans of lung patients who have different planning target volumes (PTV). Clinac IX linear accelerator units were used. Twenty patients with previously completed treatment were divided into two groups depending on the size of the target volume. All patients underwent two different intensity-modulated RT (IMRT) plans using FF and FFF beams. The Wilcoxon Signed-Rank test was used to compare two different techniques (Significance p < 0.05). There was no statistically significant difference between the two techniques when looking at the D2%(Gy), D98%(Gy), D50%(Gy), homogeneity (HI), and conformity index (CI) data for both groups. When the critical organ doses were evaluated, there was a statistically significant difference only in the V20(%) values of the lungs, but these differences were not very large. Monitor unit (MU) data were found to be lower in FF planning, and treatment time was lower in FFF planning. Except for shorter treatment times, and of the lungs V20(%) value, in standard fractionated RT of lung cancer, there was no significant difference between the use of FFF and FF techniques for large and small target volumes.

Aldose reductase (AR) inhibitors play a vital importance as a potential therapeutic and preventive medicine when it comes to hyperglycemia associated diabetic complications. Additionally, capsaicin is used as a food additive and a drug in a number of diverse clinical trials. The aim of this study is to determine the in vitro inhibition behavior of capsaicin on AR enzyme activity, which was obtained from different rat tissues (heart, kidney, liver, and brain). We showed that AR was inhibited by capsaicin in the micromolar range and noncompetitive manner in all of the tissues. K i values of capsaicin were found to be 8.87, 264, 535, and 597, respectively, in heart AR, kidney AR, liver AR, and brain AR. In conclusion, capsaicin may be an effective molecule when used in low concentrations to prevent diabetic complications associated with the polyol pathway., (© 2017 Wiley Periodicals, Inc.)

Background: In cases of congenital chest wall deformities, it is important to maintain the flexibility of the chest wall after rib cartilage resection. In this study, we aimed to determine the regeneration capability of cartilage and the effects of platelet-rich plasma (PRP) on the regeneration process., Methods: A total of 16 four-week-old New Zealand rabbits were used in this study. In the 4th-5th right costal cartilages, the perichondrial sheaths were dissected and costal cartilages were excised. Then, the perichondrial sheaths were closed with absorbable material in the sham group (n = 8), and this was done after replacing PRP in the PRP group (n = 8). The left costal cartilages of the animals were used as controls. The volumes of the costal cartilages and their perichondrial sheaths were estimated using Cavalieri's principle. In addition, the mean numerical densities of the chondroblasts and chondrocytes per square millimetre were estimated using unbiased counting frames., Results: In the PRP and sham groups, the volumes of the cartilages and perichondrial sheaths were higher than those of the control group (p < 0.05). The numerical densities of the chondroblasts and chondrocytes increased more in the PRP group than in the sham group (p < 0.05)., Conclusions: Applying PRP after resection may provide better healing and faster regeneration of cartilage.

Objective: Migraine is among the most common and debilitating neurological conditions. Familial hemiplegic migraine type 1 (FHM1), a monogenic migraine subtype, is caused by gain-of-function of voltage-gated CaV 2.1 calcium channels. FHM1 mice carry human pathogenic mutations in the α1A subunit of CaV 2.1 channels and are highly susceptible to cortical spreading depression (CSD), the electrophysiologic event underlying migraine aura. To date, however, the mechanism underlying increased CSD/migraine susceptibility remains unclear., Methods: We employed in vivo multiphoton microscopy of the genetically encoded Ca(2+)-indicator yellow cameleon to investigate synaptic morphology and [Ca(2+)]i in FHM1 mice. To study CSD-induced cerebral oligemia, we used in vivo laser speckle flowmetry and multimodal imaging. With electrophysiologic recordings, we investigated the effect of the CaV 2.1 gating modifier tert-butyl dihydroquinone on CSD in vivo., Results: FHM1 mutations elevate neuronal [Ca(2+)]i and alter synaptic morphology as a mechanism for enhanced CSD susceptibility that we were able to normalize with a CaV 2.1 gating modifier in hyperexcitable FHM1 mice. At the synaptic level, axonal boutons were larger, and dendritic spines were predominantly of the mushroom type, which both provide a structural correlate for enhanced neuronal excitability. Resting neuronal [Ca(2+)]i was elevated in FHM1, with loss of compartmentalization between synapses and neuronal shafts. The percentage of calcium-overloaded neurons was increased. Neuronal [Ca(2+)]i surge during CSD was faster and larger, and post-CSD oligemia and hemoglobin desaturation were more severe in FHM1 brains., Interpretation: Our findings provide a mechanism for enhanced CSD susceptibility in hemiplegic migraine. Abnormal synaptic Ca(2+) homeostasis and morphology may contribute to chronic neurodegenerative changes as well as enhanced vulnerability to ischemia in migraineurs., (© 2015 American Neurological Association.)

Background and Purpose: Migraine with aura is an established stroke risk factor, and excitatory mechanisms such as spreading depression (SD) are implicated in the pathogenesis of both migraine and stroke. Spontaneous SD waves originate within the peri-infarct tissue and exacerbate the metabolic mismatch during focal cerebral ischemia. Genetically enhanced SD susceptibility facilitates anoxic depolarizations and peri-infarct SDs and accelerates infarct growth, suggesting that susceptibility to SD is a critical determinant of vulnerability to ischemic injury. Because chronic treatment with migraine prophylactic drugs suppresses SD susceptibility, we tested whether migraine prophylaxis can also suppress ischemic depolarizations and improve stroke outcome., Methods: We measured the cortical susceptibility to SD and ischemic depolarizations, and determined tissue and neurological outcomes after middle cerebral artery occlusion in wild-type and familial hemiplegic migraine type 1 knock-in mice treated with vehicle, topiramate or lamotrigine daily for 7 weeks or as a single dose shortly before testing., Results: Chronic treatment with topiramate or lamotrigine reduced the susceptibility to KCl-induced or electric stimulation-induced SDs as well as ischemic depolarizations in both wild-type and familial hemiplegic migraine type 1 mutant mice. Consequently, both tissue and neurological outcomes were improved. Notably, treatment with a single dose of either drug was ineffective., Conclusions: These data underscore the importance of hyperexcitability as a mechanism for increased stroke risk in migraineurs, and suggest that migraine prophylaxis may not only prevent migraine attacks but also protect migraineurs against ischemic injury., (© 2014 American Heart Association, Inc.)

Objectives: To assess the increase in lung volume after Nuss surgery in patients with pectus excavatum (PE) by using stereological methods and to evaluate the correlation between the lung volume and spirometry findings., Methods: Twenty patients, treated for PE between 2008 and 2010, were evaluated prospectively. They underwent preoperative chest radiography, computed thorax tomography (CTT), and spirometry. Thereafter, the Haller index was calculated for each patient. In the third postoperative month, CTT and spirometry were repeated.Lung volumes and volume fractions were evaluated using CTT images, applying the Cavalieri principle for stereological methods. Then the correlation between the pre- and postoperative values of the lung volumes with spirometry findings was determined., Results: Volumes of the right and left lungs were calculated stereologically, using CTT images. Postoperative volume increase of ∼417.6 ± 747.6 mL was detected. The maximum volume increase was observed in the left lung. In the postoperative period, the total volume increase and the volume increase detected in the left lung were found to be statistically significant (p < 0.05).The preoperative correlation coefficients (r) for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow 25 to 75% were 0.67, 0.68, and 0.61, respectively; the postoperative r figures were 0.43, 0.42, and 0.35, respectively. Although there was a strong correlation between the preoperative lung volume and spirometry findings (p < 0.05), no correlation was observed between the postoperative lung volume and spirometry findings (p > 0.05)., Conclusions: Postoperative pulmonary volume increase occurs in patients with PE after Nuss surgery. However, postoperative spirometry findings may not reflect morphological improvement because pain restricts thoracic movements. Therefore, in patients with PE, quantitative evaluation of the results of surgical repair is possible using the CTT images through a combination of stereological methods., (Georg Thieme Verlag KG Stuttgart · New York.)

Background: Right-sided arcus aorta (RSAA) is a rare condition and usually asymptomatic. However, it may be symptomatic if it causes tracheal or esophageal compression., Methods: The authors evaluated clinical and radiological features of seven patients with RSAA who had the diagnosis between May 2006 and May 2009., Results: The authors found that the incidence of RSAA was 0.16% in patients who had applied to their clinic. The age of patients ranged from 17 to 55 years. The male to female ratio was 6/1. Four patients were symptomatic due to RSAA. Most common symptoms were dyspnea during exercise, which is similar to exercise-induced asthma and dysphagia. Two patients were misdiagnosed as asthma. The flow-volume curves on spirometry of the patients showed intrathoracic upper airway obstruction. Thorax magnetic resonance imaging (MRI) revealed marked narrowing of the tracheal air column due to external compression of RSAA in three patients., Conclusions: RSAA should be included in the differential diagnosis of asthma. Spirometry may help to suspect RSAA. Thorax computed tomography (CT) and/or MRI are the best imaging methods for the diagnosis of RSAA.

Tumor lysis syndrome is a potentially fatal complication of anti-cancer therapy that is usually seen in patients with bulky, rapidly proliferating, treatment-sensitive tumors such as hematological malignancies, but it rarely occurs in a variety of solid tumors such as colorectal carcinoma. Combination chemotherapy with infusional 5-fluorouracil/leucoverin and irinotecan has been recently accepted as the first treatment option for metastatic colorectal cancer. We present a case of tumor lysis syndrome in a patient with metastatic colon carcinoma that occurred 72 hrs after the initial course of a combination chemotherapy with irinotecan and 5-fluorouracil/leucoverin. Despite the immediate treatment with aggressive hydration by a sodium bicarbonate infusion, followed by forced diuresis and uricolytic therapy, he died of a sudden cardiac arrest complicated by acute renal failure. Our case indicates that administration of 5-fluorouracil/leucoverin and irinotecan for bulky tumors of colorectal origin with a rapid doubling time may induce an acute tumor lysis syndrome, which necessitates frequent laboratory monitoring and a close follow-up of the patient as well as prompt initiation of appropriate therapeutic measures.