Clinical presentations and diagnostic work-up in sarcoidosis: A series of Turkish cases (clinics and diagnosis of sarcoidosis)

Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favor multimodality diagnosis

Evaluation of ethanol and sulfur dioxide pad effects on quality parameters of stored table grapes

Postharvest loses of table grapes are mainly caused berry decay or desiccation of stem and pedicels. It can be slow down or stop these problems by generator pads containing metabisulfite salt, then packing of the fruits in polyethylene liners. Metabisulfite salts are the compounds which slow release SO2 by the humidity. However, high levels can result in fruit damage or some allergies on human health. Red globe grape variety that has increased growing trend recently, in Mediterranean region was used in this studies. Bunches were sorted after harvest and divided for three treatment as (a) Packed into 0.05 mm thickness plastic film (b) Forced air cooled, packed into 0.05 mm thickness plastic film and sodium metabisulfate paper pads were placed on top of the bunches (c) Bunches were dipped 35 % ethanol solutions + 2 % citric acid concentration for 1 min, packed into 0.05 mm thickness plastic film. After all these treatments bunches that packed into plastic film were arranged in carton boxes and stored at 0°C 85-90 % RH for 4 month. This study showed that Red Globe grape variety can be stored successfully up to 4 month

Effects of rootstocks on storage performance of nova mandarins

In this research, the effects of rootstocks on the storage performance of Nova mandarins grafted on Carrizo citrange, Troyer citrange, or sour orange grown in the ecological conditions of Dörtyol were studied. Fruits were harvested at optimum maturity and kept at 4 °C and 6 °C for 120 days. Changes in weight loss, incidence of fungal decay and physiological disorders, juice content, total soluble solids (TSS), percent fruit with green button, titratable acidity (TA), juice pH, vitamin C content, and rind color (L*, C*, h°) were monitored at 15-day intervals during storage to determine the effects of rootstock on postharvest quality of Nova mandarins. The fruit of Nova mandarin grafted on sour orange and Carrizo citrange had higher weight loss than Troyer citrange. Weight loss from Nova mandarins kept at 4 °C and 6 °C reached 7.71% and 12.21%, respectively, after 120 days of storage. Juice pH, incidence of fungal decay, and physiological disorders increased, while juice content, TA, vitamin C content, percent fruit with green button, and L*, C*, and h° values of rind color decreased in the Nova mandarin cultivar during cold storage. According to the data, the fruits of Nova mandarin grafted on Carrizo citrange, Troyer citrange, or sour orange were stored better at 4 °C than 6 °C. Fruit could be kept at 4 °C for 75 days and at 6 °C for 45 days without any quality deterioration. © TÜBİTAK.Mustafa Kemal Üniversitesi: 04 M 0105This work was based upon the research of a master’s thesis financially supported by the Mustafa Kemal University Research Foundation (Project No: 04 M 0105)

The investigation of immunomodulatory effects of adipose tissue mesenchymal stem cell educated macrophages on the CD4 T cells

Mesenchymal stem cells (MSCs) are strong immunomodulatory cells investigated in numerous clinical studies on fatal pathologies, such as graft versus host disease and autoimmune diseases; e.g., systemic lupus erythematosus, Crohn's disease, and ulcerative colitis. Macrophages are one of the critical cells linking the innate and adaptive immune system, and it has been shown that MSCs can differentiate between pro-inflammatory M1 phenotype and anti-inflammatory M2 phenotype of macrophages. However, it has not yet been fully clarified whether these differentiated macrophages are functional. In this study, we compared the immunomodulatory effects on the CD4 T cells of M1, M2a and M2c macrophages with the macrophages that directly and indirectly cultured with MSCs. We analyzed the changes in CD14, CD64, CD80, CD163 and CD200R expression to evaluate macrophage phenotypes, and the changes in CD4, IFN-g, IL-4, IL-17a and FoxP3 expression to evaluate T helper subsets using the FACS method. The changes in IL-1b, IL-4, IL-10, IL-12p70, IL-17a and IFN-g in the media supernatants were analyzed using the Luminex method. We also performed WST-1 and Caspase-3 ELISA analyses to observe the proliferation and apoptosis status of the T cells. MSCs were found to differentiate macrophages into a distinctive phenotype, which was close to the M2c phenotype, but was not considered as an M2c cell due to the low expression of CD163, a characteristic marker for M2c. While MEM-D, MEM-ID and MSCs showed similar inhibitory effects on the Th2 and Th17 cells, the most significant increase in Treg cell frequencies was seen in MEM-D cells. Macrophages can alter their phenotypes and functions according to the stimuli from the environment. The fact that macrophages educated with MSCs suppressed the production of all the cytokines we evaluated even after the removal of MSCs suggests that these cells may be differentiated by MSCs into a suppressive macrophage subgroup. However, the Treg cell activation caused by direct interactions between MSCs and macrophage cells may be the most prominent observation of this study compared to previous work. As a result, according to our data, the interactions between MSCs and macrophages may lead to differentiation of macrophage cells into an immunosuppressive phenotype, and these macrophages may suppress the T lymphocyte subgroups at least as effectively as MSCs. However, our data obtained from in vitro experiments should be supported by future in vivo studies. © 2019 Elsevier Gmb

Fracture history in osteoporosis: Risk factors and its effect on quality of life

Background: Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. Aims: The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Study Design: Cross-sectional study. Methods: We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo- 41 questionnaire was also used for evaluating quality of life. Results: The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial). When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Conclusion: Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done