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Platelet-rich plasma decreases fibroblastic activity and woven bone formation with no significant immunohistochemical effect on long-bone healing: An experimental animal study with radiological outcomes
No full textPurpose: This study aimed to analyze the immunohistochemical effect of platelet-rich plasma (PRP) on healing of long-bone fractures in terms of bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF), the Ki-67 proliferation index, and radiological and histological analyses.
Methods: Sixteen adult rabbits, whose right femoral diaphysis was fractured and fixed with Kirschner wires, were randomly divided into two groups, control and PRP (groups A and B, respectively). PRP was given to group B at 1 week postoperatively, and all animals were euthanized after 12 weeks. Radiographic evaluations were performed periodically. Cortical callus formation, chondroid and woven bone area percentages, osteoblastic and fibroblastic activities, and mature bone formation were examined. The depths of BMP-2 and VEGF staining were measured. The Ki-67 proliferation index was also calculated.
Results: The mean radiological union score of group B was significantly higher than that of group A. There were also statistically significant differences between groups A and B in terms of cortical callus formation, woven bone area percentage, fibroblast proliferation, and mature bone formation. Group B had significantly more cortical callus and mature bone formation with less woven bone and fibroblast proliferation. Immunohistochemical analysis revealed no statistically significant difference between the groups in terms of BMP-2 and VEGF staining and the Ki-67 index.
Conclusions: PRP had no effect on BMP-2 or VEGF levels with no increase in the Ki-67 proliferation index, although its application had a positive effect on bone healing by increasing callus and mature bone formation with decreased woven bone and fibroblast proliferation
Clinical and genetic characterization of a Chanarin Dorfman Syndrome patient born to diseased parents
No full textBackground: Chanarin Dorfman Syndrome (CDS) is a rare autosomal recessive disorder characterized by ichthyosiform non-bullous erythroderma and variable involvement of the liver and the neuromuscular system. In CDS patients, the accumulation of neutral lipids inside cytoplasmic lipid droplets has been demonstrated in different tissues. To date, ninety families with this disease have been described worldwide; most of them are from Mediterranean countries.
Case presentation: In this report, we describe a consanguineous Turkish family with typical features of CDS. The parents are first cousins and are both diseased. At the age of eight, their child presented CDS with non-bullous congenital ichthyosiform erythroderma, hepatosteatosis, hepatomegaly and ectropion. Electromyographic examination is compatible with myopathy. A five-year-old cousin of the child is also affected by CDS. She was born to non-affected consanguineous parents. Mutation analysis of the ABHD5 gene revealed the previously reported mutation, N209X, which is the most frequent in Turkish patients. Lipid vacuoles, also known as Jordan's anomaly, are detectable in their leucocytes.
Conclusions: To the best of our knowledge, this is the first report of a CDS family in which both parents and their child are affected by CDS. To date, the child does not present a more severe clinical phenotype compared with those of his relatives or other CDS patients of the same age. These findings suggest that high levels of triacylglycerol accumulation, that may be supposed to be present in high amount inside the ooplasm, did not affect embryo development and foetal growth
A Novel Computer Vision-Based Advertisement System for Individual Marketing
No full textTo improve the performance of marketing efforts, marketers seek new ways of attracting customers. Individual marketing is an efficient way of communicating with individuals. Meeting the individual customers' expectations and needs is becoming increasingly important in modern marketing activities. Marketers have started to concentrate on specific customers' demands. The paradigm shift from the masses to individuals has required changes to firms' marketing strategies. In this paper, a new system called the Personalized Smart Billboard System (PSBS) is introduced, which personalizes promotional messages by developing customer profiles using customers' accessories and some of their facial features. Once any of these clues are detected, related advertisements are shown to the customers. The system was tested with various portrait photos with different visual appearances and promising results were obtained. We anticipate that this system will present a helpful means of establishing more effective communication between businesses and their customers
Possible Association of Papillophlebitis with Guillain-Barre Syndrome: Case Report
No full textIn this case report, we presented a patient with visual deterioration as a result of papillophlebitis in the right eye who was later diagnosed with Guillain-Barre syndrome (GBS). Upon systemic and laboratory work-up to determine the etiology of papillophlebitis, the diagnosis of GBS was made and treatment was initiated immediately. The ocular and systemic symptoms resolved quickly after starting intravenous immunoglobulin therapy. We present this case to emphasize the importance of etiological diagnosis in papillophlebitis and the unusual presentation of GBS
Benign Paroxysmal Positional Vertigo Diagnosed in a Patient with Idiopathic Cervical Dystonia
No full textIdiopathic cervical dystonia (CD) is a focal dystonia characterized by involuntary contraction of the muscles of the neck causing twisting movements and abnormal head and neck postures. Its etiology is unclear: however. intracerebral neuronal circuit pathologies are highly considered. On the contrary, benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo diagnosed. We present a patient with CD suffering from severe vertigo who was diagnosed with BPPV. This is a very unique case representing the co-occurrence of a rare central nervous system pathology and a peripheral inner ear disease. The cause and effect relation between two pathologies is under scope. We present a 55-year-old woman with CD attended our clinic with severe vertigo and nausea. Left posterior semicircular canal BPPV (PSCC BPPV) was diagnosed. Involuntary head and neck muscle contractions caused by CD appear to have contributed to the development of BPPV in this case. However, increased neuronal activities causing CD could also have led to BPPV in the vestibular nuclear level. Further investigations are essential. Peripheral vestibular pathologies and their association with CD are not clearly determined in the literature so far. To our knowledge, there are no other cases reported regarding this co-occurrence
A novel mutation of Dent's disease in an 11-year-old male with nephrolithiasis and nephrocalcinosis
No full textDent's disease is a rare X-linked recessive tubulopathy characterized by low molecular weight (LMW) proteinuria, hypercalciuria, nephrolcalcinosis or nephrolithiasis, proximal tubular dysfunction and renal failure in adulthood. Females are carriers and usually mildly affected. Progression to end-stage renal failure are at the 3rd-5th decades of life in 30-80% of affected males. In the absence of therapy targeting for the molecular defect, the current care of patients with Dent’s disease is supportive, focusing on the prevention of nephrolithiasis and nephrocalcinosis. We present an 11-year-old child with nephrocalcinosis and nephrolithiasis caused by a new mutation at CLCN5 gene. © 2018 Sociedad Argentina de Pediatria. All rights reserved
Retrospective Analysis of Patients with Synchronous Primary Breast and Thyroid Carcinoma
No full textObjective: Breast and thyroid cancers are commonly encountered malignancies. Increased risk of breast cancer in follow-up period of thyroid cancer or vice versa has been reported. However, they have some associations, synchronous presentation of these tumors is rare. We presented 12 patients diagnosed as breast and thyroid cancer and treated at the same time.
Materials and Methods: Mastectomy and thyroidectomy were performed in 19 patients at the same time. 7 patients were excluded because of benign thyroid pathology. Therefore 12 patients who had diagnosis of synchronous breast and thyroid cancer were included. Data regarding clinical, pathological, treatment and prognostic factors was retrospectively analyzed.
Results: Total thyroidectomy was performed in all patients. The mean age of patients was 54 years (min. 44-max. 70). Only one patient was male. Thyroid pathology was detected preoperatively by FDG PET-CT scan in 11 patients. Breast reconstruction was performed in three patients. The most commonly seen thyroid malignancy was papillary thyroid carcinoma. Postoperative complication rate was 33.3%. Adjuvant chemotherapy was given in 11 patients whereas one patient received adjuvant radiotherapy.
Conclusion: Although synchronous presentation of breast and thyroid cancer is rare, surgical treatment of both of these tumors can be safely performed at the same time. Association of these tumors should be evaluated by large scaled studies
Molecular Characterization of Drug Resistance in Hepatitis B Viruses Isolated from Patients with Chronical Infection in Turkey
No full textBackground: Hepatitis B virus (HBV) has a high mutation rate due to its unusual replication strategy leading to the production of a large number of virions with single and double mutations. The mutations, in turn, are associated with the development of drug resistance to nucleos(t)ide analogs (NUCs) in patients before and during NUCs therapy.
Objectives: The current study aimed at investigating the molecular characterization of HBV in Turkish patients with chronic hepatitis B (CHB) infection.
Methods: Polymerase chain reaction (PCR) amplification and direct sequencing procedures were used to analyze mutations. The detected drug resistance mutations were divided into the nucleos(t) ide analogs primary, partial, and compensatory resistance groups. The amino acid substitutions of hepatitis B surface antigen (HBsAg) were categorized into antiviral drug - associated potential vaccine-escape mutations (ADAPVEMs) and typical HBsAg amino acid substitutions, which included hepatitis B hyperimmunoglobulin (HBIg) - selected escape mutation, vaccine escape mutation, hepatitis B misdiagnosis, and immune - selected amino acid substitutions.
Results: The number of patients included in the study was 528 out of which 271 (51.3%) were treatment - naive and 351 (66.3%) were hepatitis B e antigen (HBeAg) - negative. Moreover, 325 (61.6%) were males with a mean age of 38 years (range: 18 - 69). Primary, partial, and compensatory resistance to NUCs was reported in 174 (32.9%) patients. Six different ADAPVEM motifs were determined in both treatment - naive and treatment - experienced patients, namely, sF161L/rtI169X, sE164D/rtV173L, sL172L/rtA181T, sL173F/rtA181V, sS195M/rtM204V, and sS196L/rtM204I. The prevalence of ADAPVEMs and typical HBsAg escape mutations was 5.3% (n = 28) and 34.8% (n = 184), respectively.
Conclusions: The analysis of drug resistance should constitute a fundamental part of the follow - up period of patients with CHB undergone treatment with NUCs. The surveillance of development of drug resistance mutations, while receiving treatment for hepatitis B is of paramount importance to monitor and control the emerging resistance
Stewart-Treves Syndrome: A Case Report and Review of Literature
No full textStewart-Treves syndrome (STS) is defined as angiosarcoma arising in the setting of chronic lymphedema. It is typically presented in breast cancer patients who underwent axillary dissection. A 79-year-old woman presented to our clinic with a wound that developed secondary to lymphedema. Pathologic examinations diagnosed the lesion as angiosarcoma. STS is a rare and deadly entity. It is hard to diagnose and has 10% mean survival rate for 5 years. We emphasize the importance of early diagnosis that can be a lifesaver
Does the primary route of spread have a prognostic significance in stage III non-serous epithelial ovarian cancer?
No full textBackground: The purpose of this retrospective study was to determine the prognosis of non-serous epithelial ovarian cancer (EOC) patients with exclusively retroperitoneal lymph node (LN) metastases, and to compare the prognosis of these women to that of patients who had abdominal peritoneal involvement.
Methods: A multicenter, retrospective department database review was performed to identify patients with stage III non-serous EOC at 7 gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. The patients were divided into three groups based on the initial sites of disease: 1) the retroperitoneal (RP) group included patients who had positive pelvic and / or para-aortic LNs only. 2) The intraperitoneal (IP) group included patients with > 2 cm IP dissemination outside of the pelvis. These patients all had a negative LN status, 3) The IP / RP group included patients with > 2 cm IP dissemination outside of the pelvis as well as positive LN status. Survival data were compared with regard to the groups.
Results: We identified 179 women with stage III non-serous EOC who were treated at 7 participating centers during the study period. The median age of the patients was 53 years, and the median duration of follow-up was 39 months. There were 35 (19.6%) patients in the RP group, 72 (40.2%) in the IP group and 72 (40.2%) in the IP/RP group. The 5-year disease-free survival (DFS) rates for the RP, the IP, and IP/ RP groups were 66.4%, 37.6%, and 25.5%, respectively (p = 0.002). The 5-year overall survival (OS) rate for the RP group was significantly longer when compared to those of the IP, and the IP/RP groups (74.4% vs. 54%, and 36%, respectively; p = 0.011). However, we were not able to define "RP only disease" as an independent prognostic factor for increased DFS or OS.
Conclusions: Primary non-serous EOC patients with node-positive-only disease seem to have better survival when compared to those with extra-pelvic peritoneal involvement