OBJECTIVE: To investigate the decisive role of preoperative serum thrombopoietin levels in the discrimination of benign and malignant ovarian pathologies and its value in the evaluation of treatment response. METHODS: Fifty patients with diagnoses of adnexal masses (25 benign, 25 malignant) were included in the study. Blood samples were collected from all cases preoperatively. Age, menopausal status, adnexal mass size, preoperative CA-125 level, platelet count, the stage of the disease (FIGO stage), tumor grade, histologic subgroup, the residual tumor mass, ascites cytology, surgical procedures, and postoperative treatments were recorded for the malignant group. Response to treatment was evaluated based on the revised RECIST guideline. RESULTS: The preoperative serum thrombopoietin levels of the malignant cases (median, 98; range, 7 to 768) were significantly higher when compared with those of benign cases (median, 27; range, 13 to 131; p=0.004). The positive predictive value of CA-125 was found to be 79%, when it was used as a single marker; however it had risen to 85% when both CA-125 and thrombopoietin levels were used. There was no significant relationship between preoperative serum thrombopoietin levels and tumor grade, ascites cytology, presence of residual mass, and response to treatment. The preoperative serum thrombopoietin levels were significantly higher in stage III-IV cases and cases with serous histology. The post-treatment serum thrombopoietin levels in the malignant group were significantly lower as compared with the preoperative thrombopoietin levels. CONCLUSION: Thrombopoietin can play an additive role for prediction of ovarian cancer.
Ascites ; Discrimination (Psychology) ; Humans ; Neoplasm, Residual ; Ovarian Neoplasms ; Platelet Count ; Thrombopoietin ; Biomarkers, Tumor

Purpose: The aim of this study was to review patients with xanthogranulomatous cholecystitis (XGC). Methods: A total of 79 patients diagnosed with XGC were included in the study. The criteria for XGC in the pathology specimens were the presence of histiocytes, cholesterol deposits, lipids, and focal or widespread wall enlargement. Results: Patients were diagnosed with XGC, of which 52 (65.8%) were male and 27 (34.2%) were female, creating a male-to-female ratio of 2:1. The mean age was 65.8 ± 14.3 years (range, 36–97 years). The most common presenting symptom was abdominal pain (63.3%), and the least common presenting symptom was jaundice (8.9%). Of the total, 25 patients were found to have pathological conditions with the potential to obstruct the bile duct or to slow bile flow.A frozen section examination was performed on 20 patients due to suspicion of a tumor by intraoperative macroscopic examination. However, no malignancy was detected in the cases who underwent a frozen section examination. An increase in wall thickness of the gallbladder was observed in 81.6% (n = 31) of the patients on computed tomography scans and in 81.8% (n = 18) of the patients on magnetic resonance imaging scans in which possible tumor lesions were reported, but no tumor was detected. Conclusion It is difficult to diagnose XGC either preoperatively or intraoperatively, and further imaging methods are needed in the preoperative period other than ultrasonography. However, a definitive diagnosis depends exclusively on pathologic examination.

INTRODUCTIONThere has been a resurgence of interest in studies concerning the role of elements in the development and maintenance of the skeleton. The aim of the study was to assess the plasma and red blood concentrations of some elements in postmenopausal women with osteoporosis.

MATERIALS AND METHODSSeventy-seven postmenopausal women with osteoporosis aged 61 years (median interquartile range, 7.5; range, 46 to 74) and 61 age- and BMI-matched healthy postmenopausal women aged 60 years (median interquartile range, 8.0; range, 44 to 76) were included in the study. Element concentrations in plasma and red blood cells including magnesium (Mg), zinc, copper, manganese, and selenium were measured by atomic absorption spectrophotometry in both postmenopausal women with osteoporosis and healthy postmenopausal women.

RESULTSOnly statistically significant difference between the osteoporotic (51.51 [15.40] microg/mL) and healthy subjects (54.54 [15.42] microg/mL) was observed in red blood cell (RBC) magnesium concentration (Z=-2.07, P=0.039). However, no significant difference was found between patient and control groups, both in plasma and in red blood concentrations, for zinc, copper, manganese, and selenium.

CONCLUSIONMg levels in red blood cells are significantly lower in postmenopausal women with osteoporosis. It is concluded that Mg transport mechanism(s) into the cell could be affected in patients with osteoporosis.

Aged ; Bone Density ; Case-Control Studies ; Copper ; blood ; Female ; Humans ; Magnesium ; blood ; Manganese ; blood ; Middle Aged ; Osteoporosis, Postmenopausal ; blood ; physiopathology ; Risk Factors ; Selenium ; blood ; Turkey ; Zinc ; blood

The superior cerebellar artery is the most consistent branch of the basilar artery and arises near the bifurcation of the basilar artery. A bilateral origin of the superior cerebellar arteries from the posterior cerebral arteries has been rarely reported in the literature. Reporting variations in brain vessels is important for neurosurgeons to safely and confidently treat pathologies in this region. We report on a specimen with a bilateral origin to the superior cerebellar artery from the posterior cerebral artery and discuss the embryogenesis of this rare variation.
Arteries ; Basilar Artery ; Brain ; Embryonic Development ; Female ; Posterior Cerebral Artery ; Pregnancy

PURPOSE: Ankaferd Blood Stopper (ABS) is an herbal extract attained from 5 different plants. It has the therapeutic potential to be used for the management of external hemorrhage and controlling gastrointestinal bleedings. To date, the safety of ABS for intraperitoneal usage is not clear. In this study, we investigated the effectiveness and safety of using intraperitoneal ABS in an experimental peritoneal adhesion model. METHODS: Twenty-four male Wistar Albino rats were used in the study. The rats were randomly divided into 3 groups: saline, ABS, and control. On the 10th day, all rats were euthanized. The adhesions were evaluated by Nair's macroscopic adhesion classification, and pathologically evaluated with Zühlke's microscopic adhesion classification. RESULTS: macroscopic and microscopic comparison between the ABS and saline groups did not show any differences but both the ABS and saline groups were superior when compared to the control group. CONCLUSION: ABS was found equally effective with saline on the abdominal adhesions and to no effect on postoperative adhesion formation.
Animals ; Classification ; Hemorrhage ; Humans ; Male ; Peritoneum ; Rats

Background: The effects of housing conditions on animal physiology, behavior or stress are still debated. The aim of this study was to investigate the effects of three different housing systems, individually ventilated cages (IVC), classical small cages with floor surface area of 500 cm2 (CC500) and classical large cages with floor surface area of 800 cm2 (CC800) on body weight, sensory-motor performances, depression-like behavior, plasma corticosterone and brain oxidative stress parameters in C57BL/6 mice. The mice housed in one of the cages from birth to 6 months of age. Hang wire and adhesive removal tests were performed to evaluate somatosensory and motor performances. The extent of depression was determined by the forced swim test. Blood corticosterone levels were measured. In addition, brain malondialdehyde (MDA), total antioxidant status (TAS) and total oxidant status (TOS) levels were analyzed. Results: The depression-like behavior of the groups was similar. Although there were no significant differences in hang wire test among groups, CC500 group required longer durations in adhesive removal test. The body weight and plasma corticosterone levels of CC800 group were significantly higher than other groups. The oxidative stress parameters were highest in CC500 cage. Conclusions Our study showed that the least stressful housing condition was IVC cage systems. Interestingly, the number of mice in the classical cages had a significant effect on stress levels and sensory-motor performance.

BACKGROUND AND OBJECTIVES: Coronary collateral circulation (CCC) has been attributed as inborn bypass mechanisms supporting ischemic myocardium. Various factors have been postulated in CCC. Whole blood viscosity (WBV) has been an underappreciated entity despite close relationships between multiple cardiovascular diseases. WBV can be calculated with a validated equation from hematocrit and total plasma protein levels for a low and high shear rate. On the grounds, we aimed to evaluate the association between WBV and CCC in patients with chronic total occlusion. SUBJECTS AND METHODS: A total of 371 patients diagnosed as having at least one major, chronic total occluded coronary artery were included. 197 patients with good CCC (Rentrop 2 and 3) composed the patient group. The poor collateral group consisted of 174 patients (Rentrop grade 0 and 1). RESULTS: Patients with poor CCC had higher WBV values for a low-shear rate (LSR) (69.5±8.7 vs. 60.1±9.8, p<0.001) and high-shear rate (HSR) (17.0±2.0 vs. 16.4±1.8, p<0.001) than the good collateral group. Correlation analysis demonstrated a significant negative correlation between the grade of CCC and WBV for LSR (β=0.597, p<0.001) and HSR (β=0.494, p<0.001). WBV for LSR (β=0.476, p<0.001) and HSR (β=0.407, p<0.001) had a significant correlation with the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score. A multivariate analysis showed that the WBV for both shear rates were independent risk factors of poor CCC (WBV at LSR, OR: 1.362 CI 95%: 1.095-1.741 p<0.001 and WBV at HSR, 1.251 CI 95%: 1.180-1.347 p<0.001). CONCLUSION: WBV has been demonstrated as the overlooked predictor of poor coronary collateralization. WBV seemed to be associated with microvascular perfusion and angiogenesis process impairing CCC development.
Blood Viscosity* ; Cardiovascular Diseases ; Collateral Circulation* ; Coronary Vessels ; Hematocrit ; Humans ; Multivariate Analysis ; Myocardium ; Percutaneous Coronary Intervention ; Perfusion ; Plasma ; Risk Factors ; Taxus ; Thoracic Surgery

Different studies have demonstrated changes in chitotriosidase (ChT) activity and concentrations in multiple diseases. However, changes in ChT activity and concentrations have not been concurrently evaluated in patients with Familial Mediterranean Fever (FMF). In this study, we analyzed the changes in serum ChT activity and concentrations in patients with FMF. The study included a total of 80 patients with FMF and 80 healthy controls. ChT enzyme activity and concentrations were measured and then compared between the groups. ChT activity was measured by using fluorometric ELISA and ChT concentrations were measured by using colorimetric ELISA methods. The median ChT activity was 10.00 (6.00–15.00) nmol/mL/hr in the patients and 14.00 (6.25–20.75) nmol/mL/hr in the controls. There was a statistically significant difference in the ChT activity between the controls and patients (P = 0.027). The median ChT concentrations were 65.40 (46.20–84.92) pg/mL and 125.00 (75.72–143.95) pg/mL in the patients and controls, respectively (P < 0.001), which were expressed as median percentiles (25th–75th). Additionally, we found no correlation between C-reactive protein and ChT activity (P = 0.978, r = 0.003) and concentrations (P = 0.446, r = −0.87). Serum ChT enzyme activity and concentrations may not be considered as a biomarker in FMF patients taking colchicine. New studies are needed to evaluate the changes of enzyme activity and concentration in colchicine-negative patients.
C-Reactive Protein ; Colchicine ; Enzyme-Linked Immunosorbent Assay ; Familial Mediterranean Fever* ; Humans

PURPOSE: The purpose of this study is to evaluate the prognostic role of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) and the need for para-aortic lymphadectomy in patients with primary fallopian tube carcinoma (PFTC). MATERIALS AND METHODS: Ninety-one patients with a diagnosis of PFTC were identified through the gynecologic oncology service database of six academic centers. Clinicopathological, surgical, and complete blood count data were collected. RESULTS: In univariate analysis, advanced stage, suboptimal surgery, and NLR > 2.7 were significant prognostic factors for progression-free survival, whereas in multivariate analysis, only advanced stage and suboptimal surgery were significant. In addition, in univariate analysis, cancer antigen 125 > or = 35 U/mL, ascites, advanced stage, suboptimal surgery, NLR > 2.7, PLR > 233.3, platelet count > or =400,000 cells/mm3, staging type, and histological subtype were significant prognostic factors for overall survival (OS); however, in multivariate analysis, only advanced stage, suboptimal surgery, NLR > 2.7, and staging type were significant. Inclusion of pelvic and para-aortic lymphadenectomy in surgery showed significant association with longer OS, with a mean and median OS of 42.0 months and 35.5 months (range, 22 to 78 months), respectively, vs. 33.5 months and 27.5 months (range, 14 to 76 months), respectively, for patients who underwent surgery without para-aortic lymphadenectomy (hazard ratio, 3.1; 95% confidence interval, 1.4 to 5.7; p=0.002). CONCLUSION: NLR (in both univariate and multivariate analysis) and PLR (only in univariate analysis) were prognostic factors in PFTC. NLR and PLR are inexpensive and easy tests to perform. In addition, patients with PFTC who underwent bilateral pelvic and para-aortic lymphadenectomy had longer OS.
Ascites ; Blood Cell Count ; Blood Platelets* ; Diagnosis ; Disease-Free Survival ; Fallopian Tubes* ; Female ; Humans ; Lymph Node Excision* ; Lymphocytes* ; Multivariate Analysis ; Neutrophils* ; Platelet Count