A case of tracheobronchial amyloidosis presenting with acute myeloid leukemia

Localized tracheobronchial amyloidosis (TBA) is a rare form of pulmonary amyloidosis that is characterized by amyloidosis accumulation in the trachea and main bronchus submucosa. TBA is usually localized in the lung and is not associated with systemic amyloidosis. Although patients may be asymptomatic at first, they may develop dyspnea, recurrent cough, and hemoptysis attacks as the lesions narrow the tracheobronchial tree. Histochemical examination of biopsies taken with flexible bronchoscopy after thorax CT findings is usually used to make the diagnosis. There has never been a case reported in which TBA and acute myeloid leukemia (AML) coexisted. We report the first case of TBA in a patient diagnosed with AML

Shelf-life extension of traditional licorice root “sherbet” with a novel pulsed electric field processing

Pulsed electric field (PEF) processing of licorice root “sherbet” (LRS) by various electric field strengths (7.00, 15.50, and 24.10 kV/cm), treatment times (108, 432, and 756 µsec), and processing temperatures (6, 18, and 30°C) according to the Box–Behnken design were performed. The samples were analyzed for pH, titratable acidity, conductivity, turbidity, total reducing sugar, color (L*, a*, and b*), hue, chroma, total color difference, color intensity, color tone (yellow, red, and blue color tones), total antioxidant capacity, total phenolic substance content, and sensory properties. Results revealed that PEF processing did not adversely affect most of the physical, chemical, and sensory properties of LRS, with a maximum of 2.48, 4.04, 1.78, and 1.20 log reductions on the initial total mesophilic aerobic bacteria, total mold and yeast, Bacillus circulans, and Candida tropicalis. The response variable modeled for the PEF was found to be conductivity, with the optimum processing conditions of 6.90 kV/cm, 756.00 µs, and 7.48°C. After that, the samples were stored at 4°C and 22°C for shelf-life studies. Control samples at 4°C and 22°C were spoiled on the fifth and second days, whereas PEF-treated samples stored at 4°C began to deteriorate after the 40th day and the samples stored at 22°C after the 30th day, respectively. It was revealed that PEF is a suitable process to extend the shelf-life of licorice “sherbet” with preservation of physicochemical and sensory properties

Surgical Results in Temporal Lobe Epilepsies Due to Structural Lesions

Objective:Temporal lobe epilepsy (TLE) is the most common localization-related epilepsy syndrome in adults. The aim of this study was to determine the long-term efficacy of epilepsy surgery in patients with TLE with focal lesions and to evaluate the predictive factors for seizure-free status after surgery.Methods:Among 109 patients aged more than 17 years, 26 cases with a postoperative follow-up period of at least 2 years and who underwent anterior temporal lobectomy and lesionectomy were included in the study. Each patient was evaluated with a detailed history, video-electroencephalography (EEG), neuroimaging, and postsurgical outcomes according to Engel classification to predict postsurgical seizure freedom.Results:Patients with chronic TLE (n=26) associated with structural lesions were included in the study. According to Engel’s classification, the seizure freedom rate was found to be 92.3% in the first year and 80.8% in the second year after surgery. At the postoperative 2nd year, demographic parameters, disease duration before surgery, mean age of patients, presence of focus to bilateral tonic-clonic seizure, EEG, video EEG monitoring, clinical lateralization, scanning results, surgical technique, and histopathological diagnosis did not demonstrate a significant difference between the seizure-free (Engel’s class I) and non-seizure-free groups (Engel’s class II, III, IV) (p>0.05).Conclusion:Refractory epilepsy surgery for temporal lobe tumors often offers complete seizure freedom. Complete surgical excision of the epileptogenic region is of great importance for achieving seizure-freeness

Placenta accreta spectrum surgery with the Joel Cohen incision for abdominal access: a single-center experience

Objectives: Placenta accreta spectrum (PAS) is usually treated by hysterectomy performed through a midline incision. We hypothesize that PAS surgery can be performed through a Joel-Cohen incision with adequate sight and safety. Material and methods: The data on women having a hysterectomy due to PAS between 2013–2021 was collected retrospectively. Operation length, baby’s pre-delivery general anesthesia exposure time, transfusion rates, complication rates, postoperative admission to the intensive care unit (ICU), postoperative hospital stay, and neonatal outcomes were collected. In addition, the data investigated whether the operation was performed under emergent conditions and in the early (2013–2016) or late (2017–2021) years. Results: 161 patients met the inclusion criteria. The median gestational age at delivery was 34 weeks (27–39). The mean operation length was 150 minutes (75–420), and the anesthesia–to–delivery interval was 32 minutes (5–95). Twenty-three (14%) patients did not receive any blood product, 73 (45%) received less than three packs of erythrocyte, and only seven (4%) had a massive transfusion. Bladder injuries occurred in 24 (15%). Preoperative anemia, hypogastric artery ligation, transfusion, ICU admission, and maternal and neonatal complications were more frequent in emergent cases. Comparison between the early and late groups showed a decrease in the rate of anemia, maternal ICU admission, hypogastric artery ligation, and neonatal complications. In addition, infectious complications were relatively rare in all groups. Conclusions: The Joel-Cohen incision and bladder dissection before the baby's delivery reduce transfusion rates and avoid midline incision, which is prone to complications and unpleasant cosmetic appearance while performing a hysterectomy for PAS surgery

Recurrence is Unavoidable in Hand and Wrist Ganglion Cyst Surgery

INTRODUCTION: We aimed to evaluate surgical treatment results of hand and wrist ganglions those seen frequently in clinical practice. METHODS: Patients who were diagnosed with ganglion cysts clinically and radiologically in the hand and wrist region and treated with surgical excision between 2011 and 2014 were retrospectively analyzed. A total of 102 patients, 69 (67.6%) female and 33 (32.4%) male, who had a regular follow-up period of 12 months, had no additional injuries in the hand and wrist region, were included in the study. All cases were evaluated in terms of age, gender, region of ganglion cyst, treatment method and local recurrence. RESULTS: Mean age was 37.73+-9.5 (20-61) years. Local recurrence was seen in 5 (%83.3) patients whom have volar ganglion cyst and 1 (%16.7) in dorsal localized. There was no significant difference in treatment of localization of cysts (p>0.05). In addition, there was significant difference in presence of recurrence (p: 0.005; p<0.05). There was %20.8 local recurrence in volar cysts and it is higher than other localizations, this finding was statistically significant (p<0.05). There wasn't statistically significant difference in ratio of local recurrence (p>0.05). DISCUSSION AND CONCLUSION: The reason of high incidence in local recurrence in volar ganglion cysts can be insufficient excision of sac and pedicle of ganglion cyst because of anatomical relations in this region. It can be assumed that, if the surgeon has a high knowledge of anatomy of this area and develop his/her experience in this surgery local recurrence incidence can be decreased

Knowledge and Prejudice about HIV/AIDS among Physicians and Nurses at a University Hospital

INTRODUCTION: The prejudice of healthcare personnel may be reflected as an important problem in patient follow-up. This study aimed to evaluate knowledge and prejudice regarding HIV/AIDS among physicians and nurses working in a university hospital. METHODS: The sample size of this cross-sectional study was calculated as 191 by taking distance from confidence limit(s) to mean 1 and standard deviation 7 in two-sided 95% confidence interval. In Dicle University Hospitals, 6 nurses, 4 assistant physicians and 1 specialist physician/lecturer/teaching staff were invited by random sampling method from each of the 23 clinics. Total of 218 physicians and nurses were included. A questionnaire including demographic variables and 30 statements about HIV/AIDS was applied. The data obtained were analyzed using R-3.5.1 program. RESULTS: 33.5% of the participants stated that they were involved in the follow-up of a HIV-infected patient. The mean HIV knowledge score was 76.3+-13.7; higher in men(78.9+-13.5) and doctors(83.2+-11.1). The mean HIV prejudice score was 39.0+-21.2; higher in nurses(42.0+-22.3) and lower in participants with HIV-infected relatives/friends(23,6+-14,3). There was a weak negative correlation between HIV knowledge and prejudice scores. 40.6% of the participants stated that HIV/AIDS is not a curable disease. 52.5 percent stated that they would not prefer to follow HIV/AIDS patients. DISCUSSION AND CONCLUSION: Considering that the healthcare professionals working in Turkey, which is located in a high endemic area in terms of HIV/AIDS, will encounter this disease more, the results are worrying. Health personnel should be considered as a special group in all studies that will be done to reduce HIV/AIDS stigma

Süt Ve Daimi Dişlerde Kullanılan Dentin Adezivlerin Universal Özelliklerinin Mikrosızıntı Açısından Değerlendirilmesi

The evaluation of universal properties of dental adhesive systems in terms of microleakage in primary and permanent teeth. Hacettepe University Health Sciences Institute PhD Thesis in Pediatric Dentistry, Ankara, 2013.The aim of this in vitrostudy was to evaluate the effects of different types of adhesive systems on the microleakage of compomer restorations in Class V cavities. For that purpose; eighty persistant, non-carious primary molar teeth and eighty permanent molar teeth that were extracted for periodontal and ortodontics reasons were used in the study. Teeth divided randomly into two main groups as primary and permanent teeth groups. Then, both groups were divided into eight subgroups in order to form sixteen groups totaly. Standard Class V cavities were prepared at the cervical margin on the buccal surfaces of each tooth. The cavities were randomly assigned into eight groups of 10 teeth each, according to the type of adhesive system applied to the cavities:Group 1: Prime&Bond NT; Group 2: XP Bond; Group 3: Xeno V Bond; Group 4: Clearfil Protect Bond; Group 5: Clearfil S3 Bond; Group 6: G Bond; Group7: Acid etching + Prime&Bond NT; Group 8: Acid etching + XP Bond. All cavities were restored with a compomer, Dyract eXtra, according to manufacturer?s instructions. The compomer was applied in three increments, each being light-cured for 40 s. All restored teeth were placed in deionized water at 37°C for seven days and thermocycled (1000 times at 5°C to 55°C). After thermocycling, marginal leakage was evaluated using a conventional dye penetration method. New three samples were prepared and examined with a scanning electron microscope in order to evaluate dentin-adhesive interface. There were no significant differences among the gingival and occlusal margins of teeth in any of the groups, once all groups were assessed. In primary teeth lowest levels of microleakage were observed in groups 1,2,7 and 8 in which total-etch bonding agents (Prime&Bond NT, Acid+Prime&Bond NT, XP Bond, Acid+XP Bond) were used, regardless of acid etching. In permanent teeth lowest levels of microleakage were observed in groups in which both total-etch systems (Acid Prime&Bond NT, Acid+XP Bond) were applied after acid etching and in two-step self-etch system (Clearfil Protect Bond) grour. While there was no statistically significant difference in terms of gingival and occlusal scores between primary and permanent teeth in Clearfil S3 Bond, Prime&Bond NT, G Bond, XENO V Bond, Acid+XP Bond, XP Bond groups, the scores of permanent teeth was statistically significant lower than the scores of primary teeth in Clearfil Protect Bond and Acid+Prime&BondNTgroups. On the basis of these results, and within the limitations of this in vitro study,it may be concluded that, none of the adhesive systems tested were able to totally prevent the occurrence of microleakage on the occlusal and gingival margin of the class V compomer restorations.Süt ve daimi dişlerde kullanılan dentin adezivlerin universal özelliklerinin mikrosızıntı açısından değerlendirilmesi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Pedodonti Programı Doktora Tezi, Ankara, 2013. Bu çalışmanın amacı; in vitro şartlarda süt ve daimi dişlerde açılan sınıf V kavitelerin farklı adeziv sistemler kullanılarak kompomer ile restore edilmesini takiben meydana gelen mikrosızıntı miktarının incelenmesidir. Bu amaçla, çalışmada değişme zamanı gelen 80 adet persiste çürüksüz süt molar diş ve 80 adet ortodontik veya periodontal sebeple travmatize edilmeden çekilmiş 3. büyük azı diş kullanılmıştır. Dişler süt ve daimi olmak üzere 2 ana gruba ayrılmış, daha sonra süt ve daimi diş grubundaki dişler kendi içlerinde randomize olarak her grupta 10 diş olacak şekilde 8 gruba ayrılmıştır. Gruplarda kullanılan materyaller; Grup 1: Prime&Bond NT, Grup 2: XP Bond,Grup 3:Xeno V Bond,Grup 4: Clearfil Protect Bond, Grup 5: Clearfil S3 Bond, Grup:6 G Bond,Grup 7:Asit+Prime&Bond NT ve Grup 8:Asit+XP Bond?dur.Tüm dişlere sınıf V kavitelerin açılmasını takiben ilgili dentin adezivler üretici firma önerileri doğrultusunda uygulanmıştır. Dişlerin kompomer (Dyract eXtra) ile restorasyonları yapılmıştır. 37 0C?de 7 gün suda bekletildikten ve termal siklus uygulamasından sonra restorasyonlarda meydana gelen okluzal ve gingival mikrosızıntı boya penetrasyonu ile değerlendirilmiştir. Rezin-dentin ara yüzeyinin değerlendirilmesi amacıyla her grupta 3 yeni örnek hazırlanarak taramalı elektron mikroskopu ile incelenmiştir. Tüm gruplar değerlendirildiğinde, hiç bir grupta dişlerin gingival kenarlarında meydana gelen sızıntı değerleri ile okluzal kenarlarında meydana gelen sızıntı değerleri arasında istatistiksel olarak anlamlı bir fark gözlenmemiştir. Süt dişleri materyaller açısından değerlendirildiğinde asit uygulanmasından bağımsız olarak en düşük mikrosızıntı değerleri total-etch dentin adezivlerinkullanıldığı1,2,7 ve 8. gruplarda (Prime&Bond NT,Asit+Prime&Bond NT, XP Bond, Asit+XP Bond) gözlenmiştir. Daimi dişler materyaller açısından değerlendirildiğinde en düşük mikrosızıntı değerleri asit uygulaması sonrası uygulanan her iki dentin adeziv (Asit+Prime&Bond NT, Asit+XP Bond) ve iki aşamalı self-etch sistem (Clearfil Protect Bond) uygulanan gruplarda gözlenmiştir. Clearfil S3 Bond, Prime&Bond NT, G Bond, XENO V Bond, Asit+XP Bond, XP Bond gruplarında gingival ve okluzal skor yönünden daimi dişlerle süt dişleri arasında istatistiksel olarak anlamlı fark bulunmazken, Clearfil Protect Bond ve Asit+ NT gruplarında daimi dişlerin gingival skoru süt dişlerine göre istatistiksel olarak anlamlı düzeyde düşük bulunmuştur. Sonuç olarak bu çalışmanın metodolojik sınırlamaları dahilinde, değerlendirilen adeziv sistemlerin hiçbirisi kompomer ile restore edilen sınıf V kavitelerin gingival ve okluzal duvarlarında mikrosızıntıyı tamamen engelleyememiştir

P. pastoris ikili-promotör sistemleri tasarımı ve oluşturulması ile farmasötik protein üretimine katkısı.

Intracellular phenomena such as promoter strength, mRNA secondary structure, translation efficiency and codon preference, 5′-untranslated region processing, and protein turnover, have impacts directly on the expression of heterologous genes. Design of multi-promoter expression systems with constituent strong promoters and engineered promoter variants is a novel metabolic engineering strategy for increasing the promoter strength further, and tuning the expression for recombinant protein (r-protein) production with enhanced production and productivity in the yeast P. pastoris. Double-promoter expression systems (DPESs) carrying enhanced green fluorescent protein (eGFP) and red fluorescent protein (mApple) genes were designed and constructed for the synthesis of the heterologous model proteins mApple and eGFP in order to determine and justify the expression period of each promoter that can be either simultaneously, or by consecutively stimulating the changeover from one to another in a biphasic process or via successive-iterations in methanol-free v vi media, on glucose, glycerol or ethanol. A library of expression cassettes was designed with single naturally occurring promoters (NOPs) and novel-engineered promoter variants (NEPVs) having distinct regulatory properties: i) a NEPV of alcohol dehydrogenase1 gene (ADH1), ii) a NEPV of alcohol oxidase 1 gene (AOX1), and iii) PGAP; and P. pastoris DPESs have been constructed as separate expression cassettes. Novel P. pastoris strains were constructed with the DPESs and tested in the fed-batch phase of the fermentation of the carbon sources 2% (v/v) ethanol, excess glucose, and excess glycerol. P. pastoris DPESs having double expression cassettes each having a different antibiotic resistance gene were constructed, denoted by; i) pADH2-Cat8-L2::mApple and pGAP::eGFP, ii) pADH2-Cat8-L2::mApple and pmAOX1::eGFP, iii)pADH2-Cat8-L2::mApple and pADH2-Cat8-L2::mApple, iv) pGAP::eGFP andpGAP::eGFP v) pmAOX1::eGFP and pmAOX1::eGFP. The proteins mApple and eGFP were expressed in the novel P. pastoris strains constructed with: i) pADH2-Cat8-L2::mApple and pGAP::eGFP consecutively and also simultaneously; ii) pADH2-Cat8-L2::mApple and pmAOX1::eGFP bifunctionally and simultaneously; iii)pADH2-Cat8-L2::mApple and pADH2-Cat8-L2::mApple; iv) GAP::eGFP andpGAP::eGFP; v) pmAOX1::eGFP and pmAOX1::eGFP simultaneously as identical-twin promoters. PADH2-Cat8-L2+mAOX1DPES increased the production capacity on ethanol 2.1-fold compared to that with the single NEPVs PADH2-Cat8-L2 and PmAOX1, respectively. With PADH2-Cat8-L2+mAOX1, the expression increased to 1.3-fold on ethanol compared to that with identical-twin promoters. With simultaneously-operating PADH2-Cat8-L2+mAOX1 the expression was 1.6-fold higher than the consecutively-operating PADH2-Cat8-L2+GAP vii on ethanol. Strength of the DPESs were tested in fermentations for extracellular human growth hormone (rhGH) production. Secreted rhGH yields (YP/X, mg/gDW) by novel P. pastoris strains constructed with PADH2-Cat8-L2, PmAOX1, PGAP, PADH2-Cat8-L2+mAOX1, PADH2-Cat8-L2+GAP, and PADH2-Cat8-L2+ADH2-Cat8-L2 were as 2.95, 3.00, 0.13, 4.86, 3.73 and 4.21 mg/g at t = 48 h of the fermentations on ethanol, respectively.Thesis (M.S.) -- Graduate School of Natural and Applied Sciences. Chemical Engineering

Ingénierie de la surface des bulles pour la récolte des microalgues par flottation à l'aide d'une approche biophysique

La flottation assistée représente une technique de récolte prometteuse qui consiste à faire monter de l'air dispersé en microbulles à travers une suspension de microalgues. En conséquence, les cellules de microalgues se fixent aux bulles et sont transportées et accumulées à la surface, sans être endommagées. La flottation est donc une opération relativement rapide qui nécessite peu d'espace, a des coûts opérationnels modérés, et qui pourrait ainsi surmonter le goulot d'étranglement de la production réalisable de biocarburants à base de microalgues. Afin de rendre cette technique plus efficace pour la récolte des microalgues, la stratégie originale proposée repose sur la fonctionnalisation des bulles produites au cours du processus avec des composés adhésifs, permettant aux bulles de capturer efficacement les cellules au cours de leur ascension. Pour cela, il faut (i) développer des méthodes permettant de moduler la taille des bulles produites et leur interaction avec les cellules individuelles. Puis (ii) de déterminer quelles molécules sont présentes à la surface des microalgues afin d'identifier une molécule qui adhère à celles-ci. Pour le faire, nous avons d'abord analysé la composition de leur paroi en utilisant une combinaison de techniques telles que la chromatographie liquide et la spectroscopie photoélectronique à rayons X (XPS). Les informations obtenues à partir de ces analyses ont révélé la présence de molécules de type chitine telles que le chitosan à la surface des cellules. Puis, dans un deuxième temps, nous (iii) déterminons si la molécule identifiée permet effectivement l'adhésion aux cellules, pour cela au niveau moléculaire les interactions entre le chitosan et la paroi cellulaire ont été mesurées à l'aide AFM. Après avoir compris la base moléculaire de ces interactions, nous avons ensuite (iv) modifié chimiquement cette molécule pour la rendre amphiphile afin de fonctionnaliser la surface de la bulle. Nous avons ajouté un groupe hydrophobe au chitosane hydrophile par N-alkylation par amination réductrice. Enfin, nous évaluons la possibilité de fonctionnaliser la bulle et de moduler son interaction avec les cellules que nous avons dans une quatrième étape v) nous évaluons l'interaction entre les bulles fonctionnalisées et les cellules, et optimisons un processus efficace de flottation de bulles fonctionnalisées à l'échelle de la population de microalgues. Les résultats de ce projet, en proposant une nouvelle technique de récolte efficace, permettront d'exploiter tout le potentiel de la biomasse des microalgues pour la production de biocarburants de troisième génération et ainsi de limiter l'impact environnemental de l'activité humaine.Assisted flotation represents a promising harvesting technique that consists in air dispersed into microbubbles rising through a microalgae suspension. As a result, microalgae cells get attached to bubbles and are carried out and accumulated on the surface, without being damaged. Flotation is thus a relatively rapid operation that needs low space, has moderate operational costs, and that could thus overcome the bottleneck of feasible microalgal biofuel production. To make this technique more efficient for harvesting microalgae, the original proposed strategy relies on functionalizing the bubbles produced during the process with adhesive compounds, allowing bubbles to effectively capture the cells during their ascent. This requires (i) developing methods where microsize is produced bubble and their interaction with individual cells are modulated. Then (ii) determining which molecules are present on the surface of microalgae to identify a molecule that adheres to them. In order to identify which molecule could adhere to microalgae cells, we first analyzed the composition of their wall using a combination of techniques such as liquid chromatography and X-ray photoelectron spectroscopy (XPS). The information obtained from these analyses revealed the presence of chitin-like molecule such as chitosan on the cell surface. Then in a second step we (iii) determine whether the identified molecule effectively allows adherence to cells, for that at the molecular level the interactions between chitosan and the cell wall were measured using atomic force microscopy (AFM). After understanding the molecular basis of these interactions we then (iv) chemically modify this molecule to make it amphiphilic to functionalize the bubble surface. Basically, we added an hydrophobic group to hydrophilic chitosan through N-alkylation by reductive amination. Finally, we evaluate the possibility to functionalize the bubble and modulate its interaction with cells we have in a fourth step v) we evaluate the interaction between the functionalized bubbles and cells, and optimize an efficient functionalized bubble flotation process at microalgae population scale. The results of this project, by proposing a new efficient harvesting technique, will allow to exploit the full potential of microalgae biomass for the production of third generation biofuels and thus to limit the environmental impact of human activity