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In Vitro Anti-Aging Potential Evaluation of Maclura pomifera (Rafin.) Schneider 80\% Methanol Extract with Quantitative HPTLC Analysis
Objectives: Maclura pomifera (Rafin.) Schneider is a widespread species all around the world, which is also frequently cultured for ornamental purposes. Previous studies revealed that M. pomifera fruits are rich in prenylated isoflavonoids, exhibit noteworthy biological activities, and have probable benefits, particularly, when applied topically. Considering that phenolic compounds are important sources in the development of anti -aging cosmetic products, this study investigated the anti-aging potential of M. pomifera 80\% methanolic extract (MPM) by evaluating antioxidant and extracellular matrix degrading enzymes inhibiting activity. Materials and Methods: For this study, the inhibitory potential of 80\% MPM against different enzymes associated with the aging process was evaluated. Given the unequivocal role of oxidative stress in aging, in vitro antioxidant tests were employed as well. Moreover, osajin was determined as the major bioactive isoflavonoid of the sample by high performance thin layer chromatography analysis. Results: Results of the mechanistically different antioxidant assays exhibited notable antioxidant potential of the extract. Inhibition potential of MPM against hyaluronidase, collagenase, and elastase enzymes, which are directly linked to acceleration of the aging process, was investigated and results revealed that MPM inhibited the aforementioned enzymes explicitly. MPM had notable phenolic and flavonoid content113.92 +/- 2.26 mg gallic acid equivalent/g and 66.41 +/- 0.74 mg QE/g, respectively. When total antioxidant capacity assays were considered, it is possible to suggest that MPM is a promising anti-aging agent.Conclusion: As a result, this study discloses that extracts of fruits of M. pomifera have significant anti-aging potential and may be used for this purpose.4AUG400-4071
Correlation of anatomical involvement patterns of insular gliomas with subnetworks of the limbic system
OBJECTIVE Gliomas frequently involve the insula both primarily and secondarily by invasion. Despite the high connectivity of the human insula, gliomas do not spread randomly to or from the insula but follow stereotypical anatomical involvement patterns. In the majority of cases, these patterns correspond to the intrinsic connectivity of the limbic system, except for tumors with aggressive biology. On the basis of these observations, the authors hypothesized that these different involvement patterns may be correlated with distinct outcomes and analyzed these correlations in an institutional cohort. METHODS Fifty-nine patients who had undergone surgery for insular diffuse gliomas and had complete demographic, pre- and postoperative imaging, pathology, molecular genetics, and clinical follow-up data were included in the analysis (median age 37 years, range 21-71 years, M/F ratio 1.68). Patients with gliomatosis and those with only minor involvement of the insula were excluded. The presence of T2-hyperintense tumor infiltration was evaluated in 12 anatomical structures. Hierarchical biclustering was used to identify co-involved structures, and the findings were correlated with established functional anatomy knowledge. Overall survival was evaluated using Kaplan-Meier and Cox proportional hazards regression analysis (17 parameters). RESULTS The tumors involved the anterior insula (98.3\%), posterior insula (67.8\%), temporal operculum (47.5\%), amygdala (42.4\%), frontal operculum (40.7\%), temporal pole (39\%), parolfactory area (35.6\%), hypothalamus (23.7\%), hippocampus (16.9\%), thalamus (6.8\%), striatum (5.1\%), and cingulate gyrus (3.4\%). A mean 4.2 +/- 2.6 structures were involved. On the basis of hierarchical biclustering, 7 involvement patterns were identified and correlated with cortical functional anatomy (pure insular {[}11.9\%], olfactocentric {[}15.3\%], olfactoopercular {[}33.9\%], operculoinsular {[}15.3\%], striatoinsular {[}3.4\%], translimbic {[}11.9\%], and multifocal {[}8.5\%] patterns). Cox regression identified hippocampal involvement (p = 0.006) and postoperative tumor volume (p = 0.027) as significant negative independent prognosticators of overall survival and extent of resection (p = 0.015) as a significant positive independent prognosticator. CONCLUSIONS The study findings indicate that insular gliomas primarily involve the olfactocentric limbic girdle and that involvement in the hippocampocentric limbic girdle is associated with a worse prognosis.2FEB323-33413
Immune modulation as a consequence of SARS-CoV-2 infection
Erroneous immune responses in COVID-19 could have detrimental effects, which makes investigation of immune network underlying COVID-19 pathogenesis a requisite. This study aimed to investigate COVID-19 related alterations within the frame of innate and adaptive immunity. Thirty-four patients clinically diagnosed with mild, moderate and severe COVID-19 disease were enrolled in this study. Decreased ILC1 and increased ILC2 subsets were detected in mild and moderate patients compared to healthy controls. NK cell subsets and cytotoxic capacity of NK cells were decreased in severe patients. Moreover, CD3(+) T cells were reduced in severe patients and a negative correlation was found between CD3(+) T cells and D-dimer levels. Likewise, moderate and severe patients showed diminished CD3(+)CD8(+) T cells. Unlike T and NK cells, plasmablast and plasma cells were elevated in patients and IgG and IgA levels were particularly increased in severe patients. Severe patients also showed elevated serum levels of pro-inflammatory cytokines such as TNF-alpha, IL-6 and IL-8, reduced intracellular IFN-gamma and increased intracellular IL-10 levels. Our findings emphasize that SARS-CoV-2 infection significantly alters immune responses and innate and acquired immunity are differentially modulated in line with the clinical severity of the disease. Elevation of IL-10 levels in NK cells and reduction of CD3(+) and CD8(+) T cells in severe patients might be considered as a protective response against the harmful effect of cytokine storm seen in COVID-19.AUG 301
Graft and Patient Survival in Kidney Transplant Recipients Over the Age of Sixty-Five
Introduction: Elderly patients have increased morbidity and mortality compared to younger patients due to existing comorbid diseases and chronic immunosuppression. Therefore, the option of kidney transplantation for renal replacement therapy in elderly patients is still being controversial. Our aim in this study was to evaluate graft function, graft and patient survival, and associated factors in kidney transplant recipients over 65 years of age, at 11 years of follow-up. Methods: The study included 53 patients aged 65-76 years, out of a total of 1319 patients who underwent live kidney transplantation in the Organ Transplant Center of Acibadem International Hospital between October 2010 and July 2021. Demographic characteristics and creatinine values were recorded. Graft survival rates and patient survival rates at one, three, and five years were analyzed. Results: Fifty-three patients, 14 female, 39 male, aged 65-76 years were included in the study. The follow-up period of the patients was 7-125 months. During the follow-up, 20 patients died. Graft loss occurred in two of 20 patients who died, and 18 patients died with working grafts. Graft loss developed in two of the 33 surviving patients. In the whole group, one-, three-, and five-year patient survival rates were 94\%, 81\%, and 76\%, respectively. Conclusion: These results emphasize that kidney transplantation is a viable treatment option in elderly patients who have been well evaluated before kidney transplantation.1JAN 31
The effect of onlay cortical fibula strut grafts on biomechanical features of Vancouver type B1 periprosthetic femoral fractures
Objective: This study aimed to investigate biomechanically the effects of onlay fibula grafts on Vancouver Type B1 Periprosthetic Femoral Fractures (PPFs). Methods: Vancouver Type B1 PFF models were created in 25 fourth-generation synthetic femurs and fixed with locking plates using bicortical, unicortical screws, and cables. While no graft was used in group 1, onlay fibula grafts were placed anteriorly in group 2 and medially in group 3. In group 4, the cortical strut allograft was placed on the medial femoral cortex, and a locking compression plate (LCP) was applied to the lateral femoral cortex. In group 5, the strut allograft was placed over the anterior cortex of the femur and fixed with the same technique as in group 4. All models were then subjected to rotational and axial cyclical stiffness tests and load to failure to measure and compare the mechanical strengths of the constructs. Results: The mean stiffness values of group 4 with medial allograft, before and after cyclical loading, were higher than all other groups, under both rotational and axial forces. The mean stiffness values of fibula autografts (groups 2 and 3) were similar to that of anterior allografts (group 5) in each test except that the mean initial axial stiffness of group 5 was higher than group 2. Failure loads were also not different between the groups. Conclusion: Although the rigidity of Vancouver type B1 periprosthetic femur fractures is highest if allografts are placed medially, fibula autografts can also provide similar fixation strengths to allografts if locking plates with unicortical and bicortical screws and cables are used.3MAY166-1725
Relationship between serum sialic acid levels and prolidase activity with airflow obstruction in patients with COPD
Our aim in this study was to evaluate the prognostic significance of sialic acid (SA) and prolidase activity and to evaluate the association between airflow obstruction severity and these parameters in chronic obstructive pulmonary disease (COPD) patients. Ninety-four patients (84 M, 10 F) and 34 healthy subjects (19 M, 15 F) were included into the study. COPD staging was performed to COPD patients according to new global initiative for chronic obstructive lung disease criteria which includes pulmonary function tests, symptoms and hospitalizationCOPD patients were divided into 4 subgroups as group A (n = 25), group B (n = 19), group C (n = 20), and group D (n = 28). SA and C-reactive protein levels were significantly higher than the control group in all COPD groups. SA levels were significantly higher in group B patients than the control and group A. Prolidase activity was significantly lower than control group in total COPD groups (P < .05). There was a weak negative correlation between SA and forced vital capacity (r = -0.217, P = .038) and forced expiratory volume in 1 second (FEV1) (r = -0.210, P = .045), whereas weak positive correlation was present between SA and Creactive protein (r = 0.247, P = .018) in all patient groups. There was weak positive correlation between prolidase and FEV1 (r = 0.222, P = .033) and FEV1/forced vital capacity (r = 0.230, P = .027). Our study shows that systemic inflammation, prolidase activity, and SA levels in stable COPD patients are associated with airflow obstruction severity. In addition to the prolidase activitySA levels might be associated with inflammation.11MAR 1810
Zinc protoporphyrin levels in COVID-19 are indicative of iron deficiency and potential predictor of disease severity
Background Coronavirus disease (COVID-19) has a severe impact on all aspects of patient care. Among the numerous biomarkers of potential validity for diagnostic and clinical management of COVID-19 are biomarkers at the interface of iron metabolism and inflammation. Methods The follow-up study included 54 hospitalized patients with laboratory-confirmed COVID-19 with a moderate and severe/critical form of the disease. Iron deficiency specific biomarkers such as iron, ferritin, transferrin receptor, hepcidin, and zinc protoporphyrin (ZnPP) as well as relevant markers of inflammation were evaluated twice: in the first five days when the patient was admitted to the hospital and during five to 15 daysand their validity to diagnose iron deficiency was further assessed. The regression and Receiver Operating Characteristics (ROC) analyses were performed to evaluate the prognosis and determine the probability for predicting the severity of the disease in the first five days of COVID-19. Results Based on hemoglobin values, anemia was observed in 21 of 54 patients. Of all iron deficiency anemia-related markers, only ZnPP was significantly elevated (P<0.001) in the anemic group. When patients were grouped according to the severity of disease, slight differences in hemoglobin or other anemia-related parameters could be observed. However, the levels of ZnPP were significantly increased in the severely ill group of patients. The ratio of ZnPP to lymphocyte count (ZnPP/L) had a discrimination power stronger than the neutrophil to lymphocyte count ratio (N/L) to determine disease severity. Additionally, only two markers were independently associated with the severity of COVID-19 in logistic regression analysisD-dimer (OR (5.606)(95\% CI 1.019-30.867)) and ZnPP/L ratio (OR (74.313) (95\% CI 1.081-5108.103)). Conclusions For the first time ZnPP in COVID-19 patients were reported in this study. Among all iron-related markers tested, ZnPP was the only one that was associated with anemia as based on hemoglobin. The increase in ZnPP might indicate that the underlying cause of anemia in COVID-19 patients is not only due to the inflammation but also of nutritional origin. Additionally, the ZnPP/L ratio might be a valid prognostic marker for the severity of COVID-19.2FEB 31
Effects of Normal Morphology Sperm Count on Fertilization Time in Infertile Couples with Teratospermic Males: An Evaluation with an Embryoscope
Objective: Incubation of the embryo is the vital step in assisted reproductive techniques. Embryoscope systems are incubators that keep the embryo stable and allow for continuous observation without opening the lid. Therefore, the embryo is not displaced and goes through a temperature or air change. The primary aim of this study was to explore the effects of normal morphology sperm count on two pronucleus formation time following intracytoplasmic sperm injection in infertile couples with teratospermic males. The secondary aim was clinical pregnancy. Materials and Methods: Sixty-seven couples undergoing in vitro fertilization were included in this retrospective cohort study. First, intracytoplasmic sperm injection was performed to metaphase II-oocytes. Then, the embryos were placed in an embryoscope (a time-lapse system) for observation. The time that embryos demonstrated two pronuclei were recorded. Demographic and reproductive data were obtained and analyzed. Results: A statistically significant weak correlation was detected between sperm morphology the two pronucleus formation times (r=0.295, p=0.017). Severely decreased normal sperm count was significantly associated with pregnancy with less decreased normal sperm count (p>0.024). Moreover, decreased two pronucleus formation time was significantly associated with pregnancy. Conclusion: A statistically significant, albeit weak, correlation was detected between sperm morphology with two pronucleus formation time. Furthermore, having a lower normal sperm count was related to a higher pregnancy rate than having a higher normal sperm count. Lastly, reduced two pronucleus formation time was significantly associated with pregnancy.2JUN76-81
Is Endometrial Receptivity Assay (ERA) Useful in Patients with Repeated Implantation Failure Undergoing Single, Autologous Euploid Embryo Transfer?
Background: Our aim in this study was to evaluate whether endometrial receptivity assay (ERA) test improves single, autologous euploid frozen-thawed embryo transfer (FET) outcomes in patients with repeated implantation failure. Methods: This was a retrospective cohort study which was conducted in a University affiliated private hospital. The study included 135 patients with repeated implantation failure who underwent single, autologous euploid ERA adjusted and non-adjusted FET. Patients were stratified into three groups, patients with receptive endometrium based on the ERA test, patients with non-receptive endometrium based on the ERA test and patients who did not receive the ERA test (control group). The three groups were compared in terms of FET outcomes. Results: Of 135 patients, 73 had the ERA test results available and 62 did not have the ERA test. Of 73 patients, 28 had non-receptive endometrium and 45 had receptive endometrium. The three groups are all the same in terms of age, body mass index, type of infertility, duration of infertility, number of previously embryo transfers and infertility causes (p > 0.05). Live birth rates were 46\%, 50\% and 51\% for receptive, nonreceptive and control groups, respectively (p > 0.05). Implantation and clinical pregnancy rates were similar between the groups, as well. Conclusions: Adjusting the embryo transfer day according to the ERA test results seems to improve FET outcomes in patients with repeated implantation failure.9SEP4
Evaluation of video head impulse test during vertiginous attack in vestibular migraine
Objective. The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack. Materials and methods. Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group. Results. The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixa-tion saccades were found in 52.3\% of VM patients and in 10.2\% of healthy individuals. Conclusions. When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed dur-ing the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.3JUN281-2864