Serum progranulin levels are elevated in infertile women with obesity

Introduction: The aim of the present study was to investigate the changes in serum progranulin and sex hormone levels in infertile women with obesity. Material and methods: A total of 171 infertile women who had fertility desire were included in this cross-sectional study. The initial assessment included measurements of weight, height, waist circumference, and hip circumference to calculate body mass index (BMI) and waist/hip ratio. All participants were categorised into two groups in accordance with BMI as a control group ( < 30 kg/m2, n = 135) and a study group (≥ 30 kg/m2, n = 36). After anthropometric measurements, venous blood samples were taken for analyses of oestradiol and follicle stimulating hormone (FSH), luteinising hormone, total testosterone (TT), 17-hydroxyprogesterone, dehydroepiandrosterone sulphate, anti-Müllerian hormone, and progranulin. Results: The present study demonstrated that the overweight women had higher FSH levels (p < 0.01). Elevated TT levels were detected in obese women (p < 0.05). Progranulin concentrations were higher in the study group than in the control group (p < 0.05). Regression analysis demonstrated that there was a relationship between the serum progranulin concentrations and BMI (p < 0.05). Conclusions: Our findings support that the elevated progranulin levels are associated with obesity in infertile women. Therefore, infertile and obese patients may benefit if their serum progranulin levels decrease. Further studies are needed to elucidate this issue

Sectored DRAM: A Practical Energy-Efficient and High-Performance Fine-Grained DRAM Architecture

We propose Sectored DRAM, a new, low-overhead DRAM substrate that reduces wasted energy by enabling fine-grained DRAM data transfers and DRAM row activation. Sectored DRAM leverages two key ideas to enable fine-grained data transfers and row activation at low chip area cost. First, a cache block transfer between main memory and the memory controller happens in a fixed number of clock cycles where only a small portion of the cache block (a word) is transferred in each cycle. Sectored DRAM augments the memory controller and the DRAM chip to execute cache block transfers in a variable number of clock cycles based on the workload access pattern with minor modifications to the memory controller's and the DRAM chip's circuitry. Second, a large DRAM row, by design, is already partitioned into smaller independent physically isolated regions. Sectored DRAM provides the memory controller with the ability to activate each such region based on the workload access pattern via small modifications to the DRAM chip's array access circuitry. Activating smaller regions of a large row relaxes DRAM power delivery constraints and allows the memory controller to schedule DRAM accesses faster. Compared to a system with coarse-grained DRAM, Sectored DRAM reduces the DRAM energy consumption of highly-memory-intensive workloads by up to (on average) 33% (20%) while improving their performance by up to (on average) 36% (17%). Sectored DRAM's DRAM energy savings, combined with its system performance improvement, allows system-wide energy savings of up to 23%. Sectored DRAM's DRAM chip area overhead is 1.7% the area of a modern DDR4 chip. We hope and believe that Sectored DRAM's ideas and results will help to enable more efficient and high-performance memory systems. To this end, we open source Sectored DRAM at https://github.com/CMU-SAFARI/Sectored-DRAM.Comment: Extended version of paper that is to appear in ACM Transactions on Architecture and Code Optimization (ACM TACO

AMYAND HERNIA AND SURGERY: IS APPENDECTOMY NECESSARY? HOW SHOULD HERNIA REPAIR BE DONE?

Amaç: Amyand herni, kasık fıtığı kesesi içinde normal veya inflame appendiks vermiformisin bulunmasıdır. Amyand hernili olguların çoğunluğu erişkinler, geri kalan kısmı ise 0-1 yaş arası çocuklardır. Klinik olarak Amyand hernili hasta serimizi sunarak cerrahi tedavi protokolünü literatür eşliğinde tartışmayı amaçladık. Yöntemler: 1974 - 2010 yılları arasında Dışkapı Yıldırım Beyazıt Eğitim Araştırma Hastanesi genel cerrahi polikliniği ve acil servise kasıkta şişlik ve ağrı şikayeti ile başvuran ve inguinal herni tanısıyla operasyona alınan, fıtık kesesi içinde appendiks saptanarak apendektomi yapılan 15 hasta tedavi edilmiştir. Bulgular: On beş hastanın yaş ortalaması 40,36 ± 21,82 idi. Kadın /erkek oranı ¼ idi. Hastaların 14'ünde sağ inguinal bölgede, birinde situs inversus nedeniyle sol inguinal bölgede Amyand herni olgusu saptandı. On bir hasta elektif şartlarda opere olurken, 4 hasta irredükte inguinal herni nedeniyle ameliyata alındı. İntraoperatif 4 olguda akut apandisit hali saptandı. Hastaların tamamına apendektomi uygulanırken ve 3 hastaya mesh herniorafi, 12 hastaya da anatomik onarım yapıldı. Sonuç: Amyand herni tanısı genellikle intraoperatif olarak konur. Fıtık kesesi içinde inflame olmayan apendiks saptanmasında tedavi tartışmalıdır ama apandisit saptanan durumlarda apendektomi yapılmalıdır. Apandisit saptanması durumunda da fıtık onarım tipi tartışma konusudur. Genelde mesh herniorafi uygulanırken, peritonit hali mevcutsa anatomik onarım tercih edilmelidir Objective: Amyand hernia is determined as the presence of normal or inflamed appendix in the hernia sac. It is commonly encountered in adult patients or in children up to 1 year of age. We aimed to discuss the treatment protocol of Amyand hernia cases under the light of the literature. Methods: There were 15 patients included the study in 1974 - 2010. They were admitted to Dışkapı Yıldırım Beyazıt Teaching and Researsh Hospital for elective or incarcerated inguinal hernia repair and appendix was found incidentally in hernia sacs, so appendectomy operations were performed additional procedure to hernioraphy. Results: The mean age was 40.36 (std dev 21.823), female/male ratio was ¼. Fourteen patients had right, one had left inguinal hernia but also situs inversus. Eleven cases were operated in elective condition, four patients for incarcerated hernia. We found acute appendicitis findings intra operatively in four patients. Appendectomies were done for all of the patients. Hernia repairing were performed with mesh in 3 cases, but with anatomic repairing were done in 12 patients. Conclusion: Amyand hernia is generally diagnosed intra operatively. Operation in the presence of non-inflamed appendix in the sac is controversial but inflamed appendix undoubtedly should be operated. This time, in these cases mesh usage is controversial due to the risk of infection. Generally m

Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study

Background: The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes. Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January–December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien–Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141). Results: A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively. Conclusions: This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives

RATLARDA AKUT NEKROTİZAN PANKREATİT MODELİNDE CANDESARTAN’IN PANKREAS MİKRODOLASIM BOZUKLUKLARINA ETKİSİ

Amaç: Akut nekrotizan pankreatitte pankreatitin baslangıç döneminde etyopatogenezde mikrosirkülasyon bozuklukları son derece önemlidir. Mikrosirkülasyon bozukluklarının önlenmesinde bugüne kadar bir çok madde kullanılmıstır. Ancak bu maddelerin klinikte kullanımı sınırlıdır. Bu çalısmada bir AT-II reseptör antagonisti olan candesartan&#8217;ın pankreatik mikrodolasım üzerindeki etkinliginin ortaya konulması amaçlanmaktadır. Gereç ve Yöntem: Çalısma her grupta 10 rat olacak sekilde olusturuldu. Pankreatit ceruleinin intravenöz yolla, glycodeoxycholic asitin ise biliopankreatik kanala infüzyonları ile olusturuldu. 24. ve 48. saat tedavi gruplarına 6. ve 18. saatlerde candesartan verildi. 24. ve 48. saatte sakrifiye edilen ratlardan pankreatik doku kan akımı lazer doppler flowmeter ile ölçüldükten sonra, amilaz, myeloperoksidaz, IL-6 ve tümör nekroz faktör- için kan örnekleri, histopatolojik analiz, endotel hücre apoptozis degerlendirilmesi ve matriks metalloproteinaz-9 için pankreatik doku örnekleri alındı. Bulgular: Pankreatik doku mikrosirkülasyon düzeyleri candesartan verilen gruplarda daha yüksek idi (p<0.05). Myeloperoksidaz, IL-6 ve tümör nekroz faktör- düzeyleri candesartan verilen gruplarda daha düsük olarak bulundu (p<0.05). Pankreatik dokunun histopatolojik analizinde pankreatik dokudaki ödem ve inflamasyonda candesartan tedavisi ile azalma tespit edildi (p<0.05). Endotel hücre apoptozisinde candesartan tedavisi ile azalma tespit edildi ancak bu deger istatistiksel olarak anlamlı bulunmadı (p>0.05). Pankreatik dokudaki matriks metalloproteinaz-9 düzeylerinde ise candesartan tedavisi ile azalma tespit edildi (p<0.05). Sonuç: Akut nekrotizan pankreatitin erken döneminde kullanılan candesartan pankreatik doku mikrovasküler dolasımı üzerinde olumlu etkilere sahiptir.Aim: Microcirculatory disorders are important in the initial stages of the acute necrotizing pancreatitis. Various subtsances have been used in the prevention of microcirculatory disorders. Nevertheless the use of these substances the clinics are very limited. In the present study it is aimed to detect the effects of candesartan; a AT II antogonist; on pancreatic microcirculation. Materials and Methods: The rats were grouped into groups of ten in each. Pancreatitis was induced by cerulein intravenous injection concommitant with glycodeoxycholate infusion to biliopancreatic duct. Treatment groups recieved candesartan at 6. and 18. hours. The rats were sacrifced at 24th and 48th hours. Pancreatic perfusion was assesed via laser doppler flowmeter, blood was colected for amylase, myeloperxidase, IL-6 and tumor necrosis factor alpha. Tissue samples were collected for histopathologic analysis, endothelial cell apopthosis and matrix metalloproteinase-9 evaluation. Results: Tissue microcirculation was enhanced in candesartan group (p<0.05). Myeloperoxidase, IL-6 and TNF-alpha levels were lower in candesartan group (p<0.05). Endothelial cell apopthosis was reduced in candesartan but did not reach statisticly significance (p>0.05). Candesartan treatment reduced matrix metalloproteinase-9 levels in the tissue (p<0.05). Conclusion: Candesartan treatment in the early phase of necrotizing pancreatitis has beneficial effects on pancreatic microcirculation

The Relationship Between Core Stabilization and Balance in The Curling Athletes

Objective: The aim of this study is to the relationship between core stabilization and balance in the national curling athletes. Materials and Methods: 38 curling player, 19 men and 19 women, whose average of age was 19.67±2.90 were included in the study. İn the study, Body composition were measured to use TANİTA TBF 300 device. To Measure Core stabilization levels were used Sit-Up Test, Biering Sorenson Test and Sport-Specific Core Muscle Strength &amp; Stability Plank Test. Balance were measured with SPORKAT 4000 Dynamic and Static Balance Device.The analysis of acquired datas from study is doneusing SPSS (version 24) for Windows Statistical Programme.Independent t-test was used for the comparison of paired groups while Pearson correlation was used for the control of the association between variables. Significance for statistical datas was selected being p&lt;0.05. Results: Sit-up Test average were 44.31± 7.59 in men and 30.84±6.13- in women, Biering Sorenson Test average were 226.78±74.60 in men and 289.10±111.10 women, Sport-Spesific Core muscle strength &amp; stability plan test average 280.26±113.14 in men and 176.05±47.128 women. Dynamic Balance Test average were 7677.26±1467.12 in men and 5207.94±1436.02 in women. The Static balance average were definitely 7759±1554.98 in men and 5477.63±2004.06 in women. Conclusion: As a result of the study, it is found that there wasn’t a significant relation between back endurance and static, dynamic balance, that there was a significant relation between sit up and static, dynamic balance. There was significantly relation between plank time and dynamic balance. However between Plank time and Static balance was not significantly relation. Keywords: Balance; Body composition; Core; Curling</jats:p

Resection of synchronous ipsilateral giant bullae and bronchial carcinoid tumor

Synchronous bronchial carcinoid tumor and giant bullae are rare entities. In this article, we report a 62-year-old male presenting with dyspnea, cough and chest pain. No improvement was achieved with medical treatment. Examinations revealed right lower lobe endobronchial carcinoid tumor and upper lobe giant bullae. Simultaneous bullectomy and bronchotomy and carcinoid tumor resection through right thoracotomy, as well as postoperative tracheostomy were performed. The patient who had 2 lt/minute oxygen was discharged on the 16th postoperative day without any complication. Radiological, apprearance, clinical situation and pulmonary functions were improved and better quality of life was observed at six months after surgery. Forced expiratory volume in 1 second (FEV1) increased from 0.90 liter (29% predicted) to 1.13 liter (37% predicted). Patient continued to smoke and died due to cor pulmonale one year after discharge