Adenoid Cystic Carcinoma of the Scalp as a Cause of Recurrent Operations

Introduction: Primary cutaneous adenoid cystic carcinoma (PACC) is a rare slow-growing tumor. Presentation of the case: We report a 62 year-old woman presented with a nodular lesion on the scalp who had three operations before for recurring lesion at the same localization. In the operation, we detected a lesion which was adherent to thesubcutaneous tissue. The lesion was firm and gray-white colored, and invading the surrounding soft tissues. According to histopathological findings, the patient diagnosed with adenoid cystic carcinoma.  Conclusions: Primary cutaneous adenoid cystic carcinoma is a rare tumor that the etiology, origin, and treatment are still controversial. The metastases must be ruled out from other sites, especially from the salivary glands after the its pathological diagnosis

Comparison of efficacy of neural therapy and physical therapy in chronic low back pain

The aim of this prospective study was to evaluate the effects of neural therapy, and physical therapy on level of pain, disability, quality of life, and psychological status in patients with chronic low back pain. Patients admitted to the physical therapy and rehabilitation outpatient clinic with the complaint of low back pain of at least 3 months duration. Group 1 (n=27), physical therapy (PT, hotpack, ultrasound, TENS 15 sessions), group 2 (n=33), neural therapy (NT, 1:1 mixture of 20 mg/mL Lidocaine HCl (Jetokain simplex®) and saline for 5 sessions. For pain, Visual Analogue Scale (VAS), for disability Roland Morris Disability Questionnaire (RMDQ), for quality-of-life Nottingham-Health-Profile (NHP), for depression, and anxiety, Hospital Anxiety-Depression Scale (HADS) were used before and after the treatment. Mean age was 47.3±11.32 years, symptom time was 13.78±11.98 months. There were no differences for demographic variables between groups. Significant improvements were detected for VAS, RMDQ, NHP-Pain, NHP-Physical activity, HADS for both of two groups after treatment. In addition to these findings, significant improvements were found for NHP-Energy, NHP-Social isolation in NT group. The differences of pre- and post-treatment values of parameters were evaluated for each group. Although there were no differences for VAS, NHP-sleep, NHP-Emotional reaction, HADS between groups, RMDQ, NHP-Pain, NHP-Physical activity, NHP-Social isolation were higher in NT than PT before treatment, the improvements for these parameters were better in NT than PT. In conclusion both of NT and PT are effective on pain, function, quality of life, anxiety, and depression in patients with chronic low back pain

Strabismus in Retinopathy of Prematurity: Risk Factors and the Effect of Macular Ectopia

Objectives:This study aimed to examine factors associated with strabismus in patients with retinopathy of prematurity (ROP) and the relationship between strabismus and macular ectopia.Materials and Methods:Patients with ROP were divided into three groups: Group 1, patients with spontaneous regression (n=45); Group 2, patients who received laser treatment (n=70); and Group 3, patients who underwent surgical treatment (n=91). Rates of anisometropia, amblyopia, nystagmus, macular ectopia, and retinal pathologies were evaluated and their impacts on strabismus development were determined. Disc-to-fovea distance (DFD) was measured from color fundus photographs and the correlation of macular ectopia with severity of strabismus was evaluated.Results:A total of 206 patients were included. Rates of anisometropia, amblyopia, nystagmus, macular ectopia, retinal pathologies causing vision loss, and strabismus were higher in Group 3 (p=0.0001) and correlated with higher stages of ROP (p=0.0001). Macular ectopia (p=0.005), retinal pathologies (p=0.005), and amblyopia (p=0.012) had the strongest impact on strabismus development in ROP patients. DFD and strabismus severity were not significantly correlated (p=0.364). Mean visual acuity (VA) was significantly higher in orthophoric patients compared to those with esotropia and exotropia (p=0.027). Esotropic patients had lower VA compared to patients with exotropia, but this finding was not statistically significant (p=0.729).Conclusion:Presence of macular ectopia, retinal pathologies, and amblyopia were the most strongly correlated risk factors for strabismus development in ROP patients. DFD was not associated with severity of strabismus. Exotropia was mostly related to higher DFD and a possible relationship between esotropia and lower VA was observed

Regio- and stereo-chemical ring-opening reactions of the 2,3-epoxy alcohol derivative with nucleophiles: Explanation of the structures and C-2 selectivity supported by theoretical computations

The ring-opening reactions of (1aS,2S,6bR)-5-ethyl-2-hydroxyhexahydro-4H-oxireno[2,3-e]isoindole-4,6(5H)-dione were investigated under very mild and nonchelated conditions. C-2 selective ring-opening products were obtained with nucleophilic additions such as Cl-, Br- and N-3(-). The exact configuration of (3aS,4R,5R,6S,7aS)-5-chloro-2-ethyl-4,6-dihydroxyhexahydro-1H-isoindole-1,3(2H)-dione was determined by X-Ray diffraction analysis which was obtained from the reaction of epoxy alcohol with HCl . On the other hand, theoretical computations were carried out to explain the regioselectivity in the ring opening reaction of epoxy alcohols. The results showed that the ring-opening reaction of both epoxy alcohols proceeds in a kinetically controlled manner and regioselectivity occurs depending on the transition state. (c) 2022 Published by Elsevier B.V

Coenzyme Q10 supplementation modulates NFκB and Nrf2 pathways in exer-cise training

This study reports the effects of Q10, coenzyme Q10 or ubiqui-none, a component of the electron transport chain in mitochon-dria, on nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB), inhibitors of kappa B (IκB), nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and hemeoxygenase 1 (HO-1) in rats after chronic exercise training for 6 weeks. 8-week old male Wistar rats were assigned randomly to one of four treat-ments planned in a 2 x 2 factorial arrangement of two condition (sedentary vs. exercise training), and two coenzyme Q10 levels (0 and 300 mg/kg per day for 6 weeks). The expression levels of the target proteins were determined in the heart, liver and mus-cle, and biochemical parameters including creatinine, urea, glucose and lipid profile were investigated in plasma. When compared with sedentary group, significant decreases in heart, liver and muscle NFκB levels by 45%, 26% and 44% were observed in Q10 supplemented rats after exercise training, re-spectively, while the inhibitory protein IκB increased by 179%, 111% and 127% in heart, liver and muscle tissues. Q10 supple-mentation caused an increase in Nrf2 (167%, 165% and 90%) and HO-1 (107%, 156% and 114%) after exercise training in heart, liver and muscle tissues (p < 0.05). No significant change was observed in any of the parameters associated with protein, carbohydrate and lipid metabolism, except that exercise caused a decrease in plasma triglyceride, which was further decreased by Q10. In conclusion, these results suggest that Q10 modulates the expression of NFκB, IκB, Nrf2 and HO-1 in exercise training, indicating an anti-inflammatory effect of Q10 and emphasizes its role in antioxidant defense

CXXC5 as an unmethylated CpG dinucleotide binding protein contributes to estrogen-mediated cellular proliferation.

Evidence suggests that the CXXC type zinc finger (ZF-CXXC) protein 5 (CXXC5) is a critical regulator/integrator of various signaling pathways that include the estrogen (E2)-estrogen receptor α (ERα). Due to its ZF-CXXC domain, CXXC5 is considered to be a member of the ZF-CXXC family, which binds to unmethylated CpG dinucleotides of DNA and through enzymatic activities for DNA methylation and/or chromatin modifications generates a chromatin state critical for gene expressions. Structural/functional features of CXXC5 remain largely unknown. CXXC5, suggested as transcription and/or epigenetic factor, participates in cellular proliferation, differentiation, and death. To explore the role of CXXC5 in E2-ERα mediated cellular events, we verified by generating a recombinant protein that CXXC5 is indeed an unmethylated CpG binder. We uncovered that CXXC5, although lacks a transcription activation/repression function, participates in E2-driven cellular proliferation by modulating the expression of distinct and mutual genes also regulated by E2. Furthermore, we found that the overexpression of CXXC5, which correlates with mRNA and protein levels of ERα, associates with poor prognosis in ER-positive breast cancer patients. Thus, CXXC5 as an unmethylated CpG binder contributes to E2-mediated gene expressions that result in the regulation of cellular proliferation and may contribute to ER-positive breast cancer progression

Are functional assessment questionnaires related with hand function tests in patients with nerve injury at the level of wrist and in patients with tendon injury/fracture at the level of fingers?

Objective: We aimed to research the relationship between functional assessment questionnaires answered by patients and hand function tests in patients with injury on level of wrists or fingers. Materials and Methods: Demographic characteristics of 43 patients with nerve injury at the level of wrists (median/ulnar) (LW group) and patients with fracture or tendon injury at the level of fingers (LF group) were recorded. Functional level detected by examination was evaluated according to the Seddon classification in LW group, and according to Buck-Gramco scores in LF group. The Sollerman Hand Function Test (SHFT) was administered to all patients, and the Quick-DASH (Q-DASH) and Duruöz Hand Index (DHI) were completed by all patients. Hand grip strength was expressed as a percentage of that of the uninjured hand. Results: There was no difference in mean age and distribution of gender between the groups (p=0.429, p=0.229). Three (14.3%) patients had excellent, 10 (47.6%) good, 6 (28.6%) moderate, and 2 (9.5%) patients had poor results according to the Seddon classification in LW group. 1 (4.5%) patient had excellent, 9 (40.9%) good, 4 (18.2%) poor, and 8 (36.4%) patients had bad results according to the Buck-Gramko scores in LF group. In LW and LF groups, SHFT sores were 72.3±16.8, 76.1±5.6, Q-DASH 27.9±19.4, 19.6±15.2, DHI 19.3±21.2, 11.3±10.6, respectively and the injured hand grip strength was 65.4±29.9, 72.5±25.8. The SHFT significantly correlated with the Q-DASH and DHI in both LW and LF groups (p<0.05). The SHFT significantly correlated with the Seddon classification (r=0.449) and grip strength (r=0.585) in LW group. While there was no significant correlation between SHFT and Buck-Gramco, there was a significant correlation between SHFT and grip strength (r=0.463) in LF-group. Conclusion: It was observed that hand function tests had correlations with the functional-questionnaires answered by patients both in patients with nerve injury at the level of wrist and in patients with fracture/ tendon injury at the level of finger. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing

The presence of upper extremity problems and the effect on quality of life in breast cancer patients who undergone breast surgery and axillary dissection

Aim: The purpose of this study was to determine the prevalence of upper extremity problems in patients who had undergone breast cancer surgery, to compare the risk factors associated with these problems and to investigate their effects on quality of life. Materials and Methods: One hundred thirty-two patients who had undergone either modified radical mastectomy or breast conserving surgery (lumpectomy) were enrolled to the study. Lymphedema, shoulder pain and restriction of shoulder motion were considered as upper extremity problems. Type of surgery, body mass index (BMI), radiotherapy, chemotherapy, disease stage and dominant hand involvement were recorded. The World Health Organisation (WHO) Quality of Life-BREF-Turkish Version (WHOQOLBREF- TR) was used for the assessment of quality of life. Results: Shoulder pain was the most common symptom (45.5%), followed by lymphedema (34.8%) and shoulder motion restriction (22%). No significant relation was found between lymphedema and age, type of surgery, restriction of shoulder motion, pain and dominant hand involvement. Increased BMI, treatment with chemotherapy or radiotherapy, advanced-disease stage and lymph node involvement were associated with lymphedema (p< 0.05). It was seen that doing regular exercise had positive effect on lymphedema, pain and shoulder motion restriction reduction (p<0.05). Lymphedema, pain and shoulder motion restriction were related with physical and psychological subgroups of WHOQOL-BREF TR, whereas shoulder motion restriction was also associated with the environmental subgroup (p<0.05). When lymphedema, pain and shoulder motion restriction was searched for to determine which one was more effective on quality of life shoulder pain had negative effect in the physical and psychological subgroups; motion restriction had negative effect in the physical subgroup, whereas lymphedema did not affect the quality of life subgroups. Exercise also had positive contribution to environmental and psychological subgroups of quality of life (p<0.05). Conclusion: Arm problems are frequently encountered following breast surgery and affect the daily living of patients by decreasing their quality of life. The major aim in these patients must be taking preventive precautions and preserving the quality of life by minimizing complications with regular follow-up. Turk J Phys Med Re hab 2011;57:186-92. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing