Retrospektivna analiza graničnih tumora jajnika: ishodi u jednom centru

We wanted to discuss our experiences in the approach to borderline ovarian tumors, which constitute a group different from epithelial ovarian tumors with respect to their biological structure in line with retrospective information gathered from our cases. A total of 25 patients operated on for the indication of adnexal masses diagnosed as borderline ovarian tumors based on frozen section results were included in our study. Patient age, tumor diameter, tumor markers and surgeries performed were discussed in the light of the literature. Statistical analyses were performed using the SPSS software. The patient mean age was 43.84±11.34 years. The mass was localized in the right (n=13), left (n=11) or both (n=1) adnexal regions. The mean tumor diameter was 12.9±5.84 cm. Histopathologic examination established the diagnosis of serous borderline (n=14 patients) and mucinous borderline (n=11) ovarian tumors. Although the results of our study are consistent with current literature data, a greater number of current studies should be performed on borderline ovarian tumors, which are defined as a class of tumors different from epithelial ovarian tumors.Želja nam je opisati naša iskustva u pristupu graničnim tumorima jajnika kao skupini tumora koji se razlikuju od epitelnih tumora jajnika prema biološkoj strukturi, sukladno retrospektivnim podacima prikupljenim iz naših slučajeva. U istraživanje je bilo uključeno 25 bolesnica operiranih pod indikacijom adneksnih tvorevina dijagnosticiranih kao granični tumori jajnika na osnovi rezultata dobivenih iz zamrznutih uzoraka. Prikazani su sljedeći podaci bolesnica: dob, promjer tumora, tumorski biljezi i izvedeni operativni zahvati, u odnosu na literaturne podatke. Statistička analiza je provedena primjenom programa SPSS. Srednja dob bolesnica bila je 43,84±11,34 godine. Tumorska masa bila je smještena u desnoj (n=13) ili lijevoj (n=11) adneksnoj regiji, a kod jedne bolesnice u objema adneksnim regijama. Srednji promjer tumora bio je 12,9±5,84 cm. Histopatološkom analizom postavljena je dijagnoza seroznog graničnog (n=14) i mucinoznog graničnog (n=11) tumora jajnika. Iako su rezultati ovoga istraživanja sukladni literaturnim podacima, potrebno je provesti veći broj studija graničnih tumora jajnika, koji se definiraju kao vrsta tumora različita od epitelnih tumora jajnika

Magnetic resonance imaging study of corpus callosum abnormalities in patients with different subtypes of schizophrenia

Background. Reductions in the size of the corpus callosum (CC) have been described for schizophrenia patients, but little is known about the possible regional differences in schizophrenia subtypes (paranoid, disorganised, undifferentiated, residual).  Methods. We recruited 58 chronically schizophrenic patients with different subtypes, and 31 age-and-gender matched healthy controls. The callosum was extracted from a midsagittal slice from T1 weighted magnetic resonance images, and areas of the total CC, its five subregions, CC length and total brain volume were compared between schizophrenia subtypes and controls. Five subregions were approximately matched to fibre pathways from cortical regions.  Results. Schizophrenia patients had reduced CC total area and length when compared with controls. Disorganised and undifferentiated schizophrenics had a smaller prefrontal area, while there was no significant difference for the paranoid and residual groups. The premotor/supplementary motor area was smaller in all schizophrenia subtypes. The motor area was smaller only in the disorganised group. A smaller sensory area was found in all subtypes except the residual group. Parietal, temporal and occipital areas were smaller in the paranoid and undifferentiated groups. Total brain volume was smaller in all schizophrenia subtypes compared with controls, but did not reach statistical significance.  Conclusion. These findings suggest that the heterogeneity of symptoms may lead to the different CC morphological characteristics in schizophrenia subtypes

FLT3 mutations in Early T-Cell Precursor ALL characterize a stem cell like leukemia and imply the clinical use of tyrosine kinase inhibitors

Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) has been identified as high-risk subgroup of acute T-lymphoblastic leukemia (T-ALL) with a high rate of FLT3-mutations in adults. To unravel the underlying pathomechanisms and the clinical course we assessed molecular alterations and clinical characteristics in a large cohort of ETP-ALL (n = 68) in comparison to non-ETP T-ALL adult patients. Interestingly, we found a high rate of FLT3-mutations in ETP-ALL samples (n = 24, 35%). Furthermore, FLT3 mutated ETP-ALL was characterized by a specific immunophenotype (CD2+/CD5-/CD13+/CD33-), a distinct gene expression pattern (aberrant expression of IGFBP7, WT1, GATA3) and mutational status (absence of NOTCH1 mutations and a low frequency, 21%, of clonal TCR rearrangements). The observed low GATA3 expression and high WT1 expression in combination with lack of NOTCH1 mutations and a low rate of TCR rearrangements point to a leukemic transformation at the pluripotent prothymocyte stage in FLT3 mutated ETP-ALL. The clinical outcome in ETP-ALL patients was poor, but encouraging in those patients with allogeneic stem cell transplantation (3-year OS: 74%). To further explore the efficacy of targeted therapies, we demonstrate that T-ALL cell lines transfected with FLT3 expression constructs were particularly sensitive to tyrosine kinase inhibitors. In conclusion, FLT3 mutated ETP-ALL defines a molecular distinct stem cell like leukemic subtype. These data warrant clinical studies with the implementation of FLT3 inhibitors in addition to early allogeneic stem cell transplantation for this high risk subgroup

Combined metabolic activators improve cognitive functions in Alzheimer’s disease patients: a randomised, double-blinded, placebo-controlled phase-II trial

Background: Alzheimer’s disease (AD) is associated with metabolic abnormalities linked to critical elements of neurodegeneration. We recently administered\ua0combined metabolic activators (CMA) to the AD rat model and observed that CMA improves the AD-associated histological parameters in the animals. CMA promotes mitochondrial fatty acid uptake from the cytosol, facilitates fatty acid oxidation in the mitochondria, and alleviates oxidative stress. Methods: Here, we designed a randomised, double-blinded, placebo-controlled phase-II clinical trial and studied the effect of CMA administration on the global metabolism of AD patients. One-dose CMA included 12.35\ua0g L-serine (61.75%), 1\ua0g nicotinamide riboside (5%), 2.55\ua0g\ua0N-acetyl-L-cysteine (12.75%), and 3.73\ua0g L-carnitine tartrate (18.65%). AD patients received one dose of CMA or placebo daily during the first 28\ua0days and twice daily between day 28 and day 84. The primary endpoint was the difference in the cognitive function and daily living activity scores between the placebo and the treatment arms. The secondary aim of this study was to evaluate the safety and tolerability of CMA. A comprehensive plasma metabolome and proteome analysis was also performed to evaluate the efficacy of the CMA in AD patients. Results: We showed a significant decrease of AD Assessment Scale-cognitive subscale (ADAS-Cog) score on day 84 vs day 0 (P = 0.00001, 29% improvement) in the CMA group. Moreover, there was a significant decline (P = 0.0073) in ADAS-Cog scores (improvement of cognitive functions) in the\ua0CMA compared to the placebo group in patients with higher ADAS-Cog scores. Improved cognitive functions in AD patients were supported by the relevant alterations in the hippocampal volumes and cortical thickness based on imaging analysis. Moreover, the plasma levels of proteins and metabolites associated with NAD + and glutathione metabolism were significantly improved after CMA treatment. Conclusion: Our results indicate that treatment of AD patients with CMA can lead to enhanced cognitive functions and improved clinical parameters associated with phenomics, metabolomics, proteomics and imaging analysis. Trial registration\ua0ClinicalTrials.gov NCT04044131 Registered 17 July 2019, https://clinicaltrials.gov/ct2/show/NCT04044131

Die Regulation von ERG durch microRNAs und die Rolle der microRNAs in der distinkten ETP-ALL Subgruppe der T-ALL

Acute leukemias are a complex heterogeneous group of disorders that differ with regard to biology, clinical course, and prognosis. Over the past years the knowledge of these hematological malignancies has increased, which has resulted in a classification based on morphology, immunophenotype, molecular and clinical features. Aberrant expression of genes in acute leukemia, such as the ETS transcription factor ERG, involved in normal hematopoiesis, has been shown to be independent risk factor predicting inferior outcome in T-ALL and CN-AML. The underlying biology of the oncogenic properties of ERG and its expression regulation remain unknown. Thus, we examined the regulation of ERG by miRNAs, and showed that miR-196a and miR-196b downregulated ERG expression on mRNA level. High expression of these miRNAs was associated with NPM1 mutations in AML, and with an immature phenotype, and myeloid markers in T-ALL. Thus, these results implicate a potential role for miR-196a and miR- 196b in acute leukemia. Recently, a new subgroup of T-ALL, termed ETP-ALL, was identified and was shown to be associated with stem cell and myeloid characteristics and poor prognosis in pediatric T-ALL, which makes this subgroup of biological and clinical relevance. Therefore, we assessed molecular alterations as well as the clinical outcome in a large cohort of adult ETP-ALL in comparison to non-ETP T-ALL patients. High rates of FLT3 mutations were observed in ETP-ALL. Interestingly, FLT3 mutated ETP-ALL was identified as a molecular distinct leukemic subgroup characterized by a specific immunophenotype, a distinct gene expression pattern (aberrant expression of IGFBP7, WT1, GATA3) and mutational status (lack of NOTCH1 mutations and low frequency of clonal TCR rearrangements). With respect to clinical course of these high-risk patients, ETP-ALL patients undergoing allogeneic stem cell transplantation showed an encouraging overall survival. To further explore and underscore the efficacy of targeted therapies, we demonstrate that T-ALL cell lines transfected with FLT3-ITD expression constructs were particularly sensitive to tyrosine kinase inhibitors. In conclusion, ETP-ALL with FLT3 mutations defines a molecular distinct stem cell like leukemic subtype. These data warrant the implementation of a specific treatment with FLT3 inhibitors in addition to early allogeneic stem cell transplantation for this high-risk subgroup. Apart from the genetic alterations of molecular markers, miRNAs, which are post-transcriptional regulators of genes, have been proposed to have crucial impact on the pathogenesis of acute leukemia. In this study, we further investigated the global expression of miRNAs in ETP-ALL. The miRNA profiling revealed miR-221 and miR-222 as the most upregulated and six miRNAs (miR-151-3p, miR-19a, miR- 20b, miR-342-3p, miR-363, miR-576-3p) as downregulated in ETP-ALL compared to non-ETP T-ALL. The expression of miR-221, miR-222, miR-19a, miR-363 was validated in a larger cohort of T-ALL patient samples. ETS1, downregulated in ETP-ALL, was identified as direct target of miR-222. Furthermore, in our in vitro studies miR-222 significantly inhibited proliferation, and caused cell cycle arrest and apoptosis in leukemic cells, implicating a role for miR-222 in the leukemogenesis by altering expression of the proto-oncogene ETS1 in acute leukemia. In conclusion, aberrantly expressed miRNAs, with a functional role in acute leukemia was identified. These findings may serve as useful resource for future studies and aid in development of novel therapeutic targets to improve the treatment of leukemia patients.Akute Leukämien stellen sehr heterogene Erkrankungen dar. In den letzten Jahren ist es möglich geworden akute Leukämien basierend auf morphologischen, immunologischen, molekularbiologische und zytogenetische Eigenschaften besser zu klassifizieren. Dies ermöglicht eine Therapieoptimierung von Leukämie Patienten. Es konnte gezeigt werden, dass die aberrante Expression von Genen als molekulare Prognosemarker dienen können und diese erklären teilweise auch die zugrundeliegende pathogenetischen Mechanismen von akuten Leukämien. Für den ETS Transkriptionsfaktor ERG, der an der Regulation der linienspezifischen Differenzierung von hämatopoetischen Progenitorzellen beteiligt ist, wurde gezeigt, dass er mit einer ungünstigen Prognose in CN-AML und T-ALL assoziiert ist und einen neuen molekularen Risikofaktor für Leukämie Patienten darstellt. Untersuchungen zur Expressionregulation von ERG konnten zeigen, dass ERG teilweise durch epigenetische Mechanismen reguliert ist. In der vorliegenden Arbeit ist die Regulation von ERG durch microRNAs untersucht worden. Die Überexpression von miR-196a und miR-196b führte zu einer Herunterregulation der ERG mRNA Expression in leukämischen Zellen. Eine erhöhte Expression der beiden miRNAs war mit NPM1 Mutationen in der AML, mit einem unreifen Immunophänotyp und der Expression von myeloischen Oberflächenmarkers in T-ALL assoziiert. Zusammfassend kann somit festgestellt werden, dass miR-196a und miR-196b eine mögliche funktionelle Rolle in der Pathogenese der akuten Leukämie darstellt. Weiterhin war die molekulargenetische Charakterisierung einer ETP-ALL Subgruppe der T-ALL durchgeführt. Die ETP-ALL ist eine neue Subgruppe, die sich durch eine spezifische Genexpressionssignatur, einem unreifen Immunophänotyp und durch die Expression von myeloischen Antigenen und/oder Stamzellmarkern auszeichnet. Innerhalb der pädiatrischen T-ALL ist die ETP-ALL mit einer ungünstigen Prognose assoziiert. Deswegen ist die ETP- ALL biologisch wie klinisch von besonderem Interesse. Hier konnte gezeigt werden, dass die ETP-ALL eine hohe Frequenz von FLT3 Mutationen besitzt. Interessanterweise konnte die FLT3 mutierte ETP-ALL als eine molekulargenetisch sehr distinkte ETP-ALL Subgruppe identifiziert werden, die sich durch eine spezifischen Imunophänotyp, Genexpressionsmuster (aberrante Expression von IGFBP7, WT1, GATA3) und Mutationsstatus (eine niedrige Frequenz von NOTCH1 Mutationen und TCR Rearrangement) auszeichnet. Darüber hinaus zeigten ETP-ALL Patienten einen Überlebensvorteil durch eine konsolidierende allogene Stammzelltransplantation im Vergleich zu Patienten die eine alleinige konsolidierende Chemotherapie erhalten haben. Weiterhin wurde die Wirksamkeit von Tyrosinkinase Inhibitioren in der T-ALL geprüft und es konnte gezeigt werden, dass FLT3-transformierten T-ALL Zelllinien eine hohe Sensitivität gegenüber Tyrosinkinase Inhibitoren besitzen. Diese Daten bestätigen die Einführung von spezifischen Behandlungsansätzen mit FLT3 Inhibitoren zusätzlich zur frühen allogenen Stammzelltransplantation für diese Risikogruppe. Darüber hinaus wurde die differentielle Expression von miRNAs in der ETP-ALL untersucht. Die miRNA Expressionsprofile zeigten eine erhöhte Expression von miR-221 und miR-222 und eine verminderte Expression von 6 weiteren miRNAs (miR-151-3p, miR-19a, miR-20b, miR-342-3p, miR-363, miR-576-3p) im Vergleich zur typischen T-ALL. Die Expression von miR-221, miR-222, miR-19a und miR-363 konnte in einer großen Kohorte von T-ALL Patienten validiert werden. Das Gen ETS1, welches in der ETP-ALL niedrig exprimiert ist, konnte als miR-222 Target identifiziert werden. Für die miR-222 konnte weiterhin eine Rolle in der Proliferationshemmung von leukämischen Zellen gezeigt werden; zum Einen durch die Inhibition der S-phase im Zellzyklus und zum Anderen durch die induktion von Apoptose. Zusammenfassend unterstreichen diese Daten, dass die Deregulation von miRNAs eine funktionelle Rolle in der akuten Leukämie spielt und können als Basis für die Entwicklung von miRNA-basierten Therapiestrategien dienen, um die Therapie von Leukämie Patienten zu verbessern

Comparison of ultrasound-guided genicular block vs. intrathecal morphine for postoperative analgesia in patients undergoing knee arthroplasty: A randomised prospective study

Aim:  Total knee arthroplasty (TKA) is a major orthopedic surgical procedure often necessitating effective postoperative analgesia. This study aimed to compare the analgesic efficacy of ultrasound-guided genicular block (GB) and intrathecal morphine (ITM) in patients undergoing THA under spinal anesthesia.Method: A prospective, randomized, single-blind study was conducted at Ordu University Training and Research Hospital from October 1, 2022, to April 1, 2023. Eligible patients aged 18 to 90 undergoing knee surgery with spinal anesthesia were randomized into two groups: Group ITM received intrathecal morphine, while Group GB underwent ultrasound-guided triple genicular block. Pain scores, rescue opioid consumption, time to initial mobilization, and Modified Bromage Scale (MBS) scores were assessed at five time points (0, 2, 6, 12, and 24 hours) within the first 24 hours post-surgery.Results: At the 24-hour mark, cumulative tramadol consumption was significantly lower in Group ITM compared to Group GB (35.45±54.84 vs. 63.37±37.7 mg, respectively, p = 0.028). Group ITM also exhibited statistically lower Numeric Rating Scale (NRS) scores at 12 hours (p = 0.005) but had similar scores at other time points. Additionally, time to first ambulation and MBS scores were consistent across all intervals (p < 0.05).Conclusions: In patients undergoing knee arthroplasty with spinal anesthesia, those receiving ultrasound-guided genicular blocks demonstrated higher opioid consumption over a 24-hour period compared to those receiving intrathecal morphine. However, regarding postoperative pain scores, both groups exhibited similar outcomes. These findings provide valuable insights into the selection of postoperative analgesic modalities for TKA patients

Evaluation of the effect of anemia on the birth weight of the baby during pregnancy

The aim of this study is to evaluate the impact of anemia on quality of life of mothers with without anemia on birth weight of the babies during pregnancy. The socio-demographic characteristics and complete blood counts of the patients who admitted to the pregnancy outpatient clinic were included in the study and data obtained from the files registered in the automation system. Evaluation of the data was performed by using software SPSS version 22. The mean Hb value was 11.650 ± 1.4 g / dL. Anemia was determined in 34 pregnant women (48.6%). In periodic follow up visits the mean weight of babies was 3325 g in the group without anemia and 2950 g in the group with anemia, the difference was statistically significant (p [Med-Science 2018; 7(3.000): 511-4

Exploring Online Payment System Adoption Factors in the Age of COVID-19&mdash;Evidence from the Turkish Banking Industry

Turkey&rsquo;s e-commerce market is rapidly expanding, and the country is ranked first in the world in monthly mobile purchases. The purpose of this study is to determine the factors that influence the adoption of online payments systems among the customers of a Turkish bank during the COVID-19 pandemic. The research model extends the technology acceptance model (TAM) by further examining the impact of 11 factors on attitude, behavioral intention and actual usage. The results suggest a strong influence of these factors on attitude and behavioral intention. Relative advantage, perceived trust, perceived usefulness, personal innovativeness, perceived integrity, perceived ease of use, health and epidemic effects, income, private sector employment and self-employment all have a positive effect on actual online payment system usage. However, perceived risk and age have a negative impact on the actual online payment system usage

Effect of various enzymatic treatments on the mechanical properties of coir fiber/poly(lactic acid) biocomposites

###EgeUn###The effects of enzymatic treatments on the properties of coir fiber-reinforced poly(lactic acid) (PLA) were not found in the literature. Accordingly, the effects of various enzymatic treatments on the mechanical performance of the coir fiber-reinforced PLA composites were investigated in the current study. Four different enzymes, namely lipase, lactase, pectinase, and cellulase, were used. The mechanical properties of the composites were determined by the tensile, flexural, impact tests, and dynamic mechanical analysis. According to the test results, the use of enzyme treated coir fibers affected the mechanical properties except for the flexural properties with different extents depending upon their type. The tensile strength increased with the treatments of lipase and lactase, while the treatments with pectinase and cellulase had no remarkable effect. The impact strength was improved with enzymatic treatments except for pectinase. All enzymatic treatments improved the elastic modulus below the glass transition temperature. In brief, enzymatic treatments improved the interfacial adhesion between coir fiber and PLA via the waxes and fatty acids removal and/or the increment in surface roughness.Erciyes University Scientific Research UnitErciyes University [BAP-FYL-2017-7635]The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported by Erciyes University Scientific Research Unit under grant no. BAP-FYL-2017-7635

An assessment on the use of infrascanner for the diagnosis of the brain hemotoma by using support vector machine

Diagnosis of the brain hematoma injuries is critical for patients and requires exhaustive processes. For this reason, the practical methods may be attractive for medical applications to reduce time and cost. The purpose of this study is to discuss the applicability of the InfraScanner for the diagnosis of the brain hematoma and to determine the most important factors affecting the positive brain hematoma cases by support vector machine approach. For the purpose of the study, the data of 92 adult and 161 pediatric patients (253 in total) with traumatic brain injury were collected and assessed. The analyses applied in this study gave encouraging results about the use of near Infrared Scanner (NIRS) on practical diagnosis of brain hematoma. When making a comparison between the adult and pediatric patients, it is obvious that the use of NIRS exhibited better results in pediatric patients than adult patients