Objectives: Premature ovarian failure (POF) rat models are essential for elucidating the hormonal and ovarian molecular mechanisms of human POF diseases and developing new therapeutic agents. This study aimed to compare the applicability of chronic immobilization stress (CIS) as a POF model with that of cisplatin and to examine the impact of AP39, a mitochondrial protective agent, on ovarian function in rats treated with cisplatin and CIS. Methods: Sixty Sprague–Dawley female rats were divided equally into six groups (10 per group): Control, Cisplatin, AP39, Cisplatin + AP39, CIS, and CIS + AP39. Ovarian dysfunction was induced with cisplatin (3 mg/kg) or CIS. Forced swim test, hormone concentrations, estrous cyclicity, histopathology, follicle counts, and molecular alterations in the ovary and mitochondria were analyzed. Results: In the CIS and cisplatin groups, mitochondrial biogenesis, egg quality, hormonal profile, estrous cycle, and folliculogenesis significantly declined. Nonetheless, most of the parameters with undesirable results did not normalize after AP39 administration. Conclusions The cisplatin- and CIS-treated rats exhibited unshared deteriorated hormonal pathways and similarly disrupted gene expression patterns. Our current CIS model did not meet the human POF criteria, which include decreased estradiol levels, despite having advantages in terms of ease of modeling and reproducibility and demonstrating pathological changes similar to those observed in human POF. Therefore, rather than using this model as an POF model, using it as a representation of stress-induced ovarian dysfunction would be more appropriate.

Background: Unicondylar knee arthroplasty (UKA) is an effective procedure, which reduces pain, increases range of motion, and improves function. UKA could be performed simultaneously or in staged sessions. This study aimed to compare bilateral cementless UKA performed simultaneously and in staged sessions in terms of complications, hemoglobin levels, transfusions, and functional outcomes. Methods: Patients undergoing bilateral UKA for symptomatic medial compartment osteoarthritis were retrospectively analyzed. Of the 73 patients who met the inclusion criteria, 40 underwent surgery simultaneously and 33 underwent surgery in separate sessions. Operative time, length of hospital stay, change in hemoglobin, need for blood transfusion, complications, and functional outcomes were assessed. Results: There was no statistically significant difference between the two groups in demographic data. Simultaneously operated patients had a significantly shorter hospital stay and shorter operative time. Statistically significant improvements in clinical scores were noted in both groups. The degree of improvement in functional scores did not differ between the groups. There was no difference between the two groups in terms of complication rates, but the number of periprosthetic tibial fractures was higher in the simultaneous group. Conclusions Simultaneous bilateral cementless UKA was more advantageous in terms of cumulative hospital stay and total operation time with similar clinical results when compared to a staged procedure. While the overall complication rate was similar, the rate of periprosthetic fractures was 5% in the simultaneous group.

OBJECTIVE: The purpose of this study was to investigate the prognostic value of lymph node ratio (LNR) in women with stage IIIC endometrioid endometrial cancer (EC). METHODS: A multicenter, retrospective department database review was performed to identify patients with stage IIIC pure endometrioid EC at 6 gynecologic oncology centers in Turkey. A total of 207 women were included. LNR, defined as the percentage of positive lymph nodes (LNs) to total nodes recovered, was stratified into 2 groups: LNR1 (≤0.15), and LNR2 (>0.15). Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. RESULTS: One hundred and one (48.8%) were classified as stage IIIC1 and 106 (51.2%) as stage IIIC2. The median age at diagnosis was 58 (range, 30–82) and the median duration of follow-up was 40 months (range, 1–228 months). There were 167 (80.7%) women with LNR ≤0.15, and 40 (19.3%) women with LNR >0.15. The 5-year progression-free survival (PFS) rates for LNR ≤0.15 and LNR >0.15 were 76.1%, and 58.5%, respectively (p=0.045). An increased LNR was associated with a decrease in 5-year overall survival (OS) from 87.0% for LNR ≤0.15 to 62.3% for LNR >0.15 (p=0.005). LNR >0.15 was found to be an independent prognostic factor for both PFS (hazard ratio [HR]=2.05; 95% confidence interval [CI]=1.07–3.93; p=0.03) and OS (HR=3.35; 95% CI=1.57–7.19; p=0.002). CONCLUSION: LNR seems to be an independent prognostic factor for decreased PFS and OS in stage IIIC pure endometrioid EC.
Carcinoma, Endometrioid ; Diagnosis ; Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methods ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Turkey

BACKGROUND: Ideal positioning and best coverage of the tibial base plate are essential in total knee arthroplasty. There are 2 types of tibial base plates: symmetric and asymmetric. The superiority of one to the other is still controversial. The aim of this study was to compare symmetric and asymmetric tibial base plates for total knee arthroplasty in terms of rotational alignment and coverage. METHODS: The study was conducted on a total of 80 cadaveric tibial bones. Two surgeons were asked to place 20 symmetric (group 1) and 20 asymmetric (group 2) tibial base plates taking care to ensure the best coverage that they were able to determine. Afterwards, the rotational errors and coverage were assessed with reference to the posterior tibial margin and posterior condylar axis on the three-dimensional computed tomography (3D CT) scan. In the second part of the study, the surgeons were asked to place 20 symmetric (group 3) and 20 asymmetric (group 4) base plates taking care to ensure the best rotational alignment. The rotational errors and the areas uncovered or overstuffed after the application were measured on the 3D CT scan. RESULTS: On the comparison of rotational errors, while there was no significant difference between group 1 and group 2 in terms of coverage (p = 0.624), the mean external rotation error was significantly greater in group 2 (p = 0.034). On the comparison of coverage, while there was no significant difference between group 3 and group 4 in terms of rotation (p = 0.36), the mean ratios of the uncovered tibial surface to the total tibial surface (p = 0.041) and also the overstuffed area to the total base plate surface (p = 0.029) were significantly greater in group 4. CONCLUSIONS: The determination of correct size and rotation of the tibial component is essential for favorable outcomes of total knee arthroplasty. In this study, the symmetric tibial base plate design was more effective than the asymmetric design in providing the ideal tibial rotation and coverage.
Arthroplasty ; Arthroplasty, Replacement, Knee* ; Cadaver ; Knee ; Prosthesis Implantation ; Surgeons ; Tomography, X-Ray Computed

PURPOSE: Lipid peroxidation and consequent reactive oxygen species in the setting of oxidative stress have crucial roles in liver regeneration, which may adversely affect the regeneration itself and lead to liver failure. The aim of the current study is to investigate whether omega-3 fatty acid supplementation inhibits oxidative stress in an experimental model of liver regeneration. METHODS: Forty rats were allocated to four groups. Rats in group A received a sham operation. Rats in group B were subjected to right portal vein ligation (RPVL) and saline infusion. Rats in groups C and D were subjected to RPVL and total parenteral nutrition (TPN) with an all-in-one admixture containing a soybean oil based lipid emulsion. Rats in group D were additionally supplemented with omega-3 fatty acid infusion. Oxidative stresses in the blood and liver were measured by glutathione, superoxide dismutase, catalase, glutathione peroxidase, malondialdehyde, and nitric oxide. RESULTS: Omega-3 supplementation to the TPN solution significantly corrected alterations in the blood and tissue concentrations of oxidants and anti-oxidants during regeneration (P < 0.05). CONCLUSION: Omega-3 fatty acid supplementation to the TPN solution revealed promising results in removal of oxidative stress that emerges during liver regeneration.

Cystic echinococcosis (CE) caused by Echinococcus granulosus is a major public health problem worldwide, including Turkey. The aim of the current study was to identify the strains and to estimate the potential risk factors of E. granulosus in operated pediatric cases in eastern Turkey. Ten pediatric patients (7 boys and 3 girls) living in rural areas, with ages ranging from 3 to 15 years old and various clinical histories, were included in this study. Eight patients had only liver hydatid cyst, while 1 patient had liver and lung hydatid cyst and the other liver, lung, and spleen, together. There were 2 ruptured liver cysts. After surgery, during follow-up, no increase was observed in hemagglutination levels, there were no mortalities, and there was no evidence of recurrence at 2 years post operation in all patients. Molecular analysis was performed on hydatid cyst samples obtained from the 10 pediatric cases. According to mt-12S rRNA PCR results, all cases were found to be G1/G3 cluster of E. granulosus sensu stricto.
Adolescent ; Animals ; Child ; Child, Preschool ; Echinococcosis/parasitology/*surgery ; Echinococcosis, Hepatic/parasitology/surgery ; Echinococcosis, Pulmonary/parasitology/surgery ; Echinococcus granulosus/genetics/*isolation & purification ; Female ; Humans ; Male ; Turkey

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

OBJECTIVE: The aim of this study was to compare clinicopathologic characteristics, surgery outcomes and survival outcomes of patients with stage III and IV mucinous epithelial ovarian cancer (mEOC) and serous epithelial ovarian carcinoma (sEOC). METHODS: Patients who had surgery for advanced stage (III or IV) mEOC were evaluated retrospectively and defined as the study group. Women with sEOC who were matched for age and stage of disease were randomly chosen from the database and defined as the control group. The baseline disease characteristics of patients and platinum-based chemotherapy efficacy (response rate, progression-free survival and overall survival [OS]) were compared. RESULTS: A total of 138 women were included in the study: 50 women in the mEOC group and 88 in the sEOC group. Patients in the mEOC group had significantly less grade 3 tumors and CA-125 levels and higher rate of para-aortic and pelvic lymph node metastasis. Patients in the mEOC group had significantly less platinum sensitive disease (57.9% vs. 70.8%; p=0.03) and had significantly poorer OS outcome when compared to the sEOC group (p=0.001). The risk of death for mEOC patients was significantly higher than for sEOC patients (hazard ratio, 2.14; 95% confidence interval, 1.34 to 3.42). CONCLUSION: Advanced stage mEOC patients have more platinum resistance disease and poorer survival outcome when compared to advanced stage sEOC. Therefore, novel chemotherapy strategies are warranted to improve survival outcome in patients with mEOC.
Case-Control Studies ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes ; Mucins ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Platinum ; Retrospective Studies

A 39-year-old female patient presented to our hospital with epigastric pain lasting for two months. Laboratory results showed impaired glucose tolerance. Ultrasonography of the patient showed a hypoechoic, diffusely enlarged pancreas. CT revealed a large pancreas, with multiple calcifications. On MRI, a diffusely enlarged pancreas was seen hypointense on both T1- and T2-weighted images with heterogeneous enhancement after gadolinium administration. A biopsy of the pancreas revealed primary amyloidosis of islet cells. Decreased signal on T1-weighted images without inflammation findings on CT and MRI were clues for the diagnosis.
Adult ; Amyloidosis/*diagnosis ; Contrast Media/diagnostic use ; Diagnosis, Differential ; *Diagnostic Imaging ; Female ; Glucose Tolerance Test ; Humans ; Islets of Langerhans/*pathology ; Pancreatic Diseases/*diagnosis

No abstract available.
Catheters ; Constriction, Pathologic ; Crohn Disease