TWIST1 Gene expression as a biomarker for predicting primary doxorubicin resistance in breast cancer

Doxorubicin is one of the most commonly used chemotherapeutic agents for adjuvant chemotherapy of breast cancer. In the studies focused on finding biomarkers to predict the response of the patients and tumors to the drugs used, the Twist transcription factor has been suggested as a candidate biomarker for predicting chemo-resistance of breast tumors. In this study, we aimed to investigate the relationship between TWIST transcription factor expression and the effectiveness of doxorubicin treatment on directly taken primary tumor samples from chemotherapy-naive breast cancer patients. Twenty-six primary breast tumor samples taken from 26 different breast cancer patients were included in this study. Adenosine triphosphate tumor chemo-sensitivity assay (ATP-TCA) has been used to determine tumor response to doxorubicin and real-time reverse-transcription polymerase chain reaction (RT-PCR) was used for analyzing the TWIST1 gene expression of tumors. There was a significant difference in TWIST gene expression between responder and non responder tumors (p <0.05). The TWIST gene expression of the drug-resistant group was higher than the responsive group. This difference was not dependent on the histopathological features of tumors. In conclusion, compatible with earlier studies that have been performed with cell lines, the current study supports the role of higher TWIST gene expression as a biomarker for predicting the response of breast tumors to chemo-therapeutic agent doxorubicin

Effects of intraperitoneal glycerol and flax oil administration on colonic anastomosis healing.

Effects of Intraperitoneal glycerol and flax oil on colonic anastomosis healing process was studied. Thirty female Wistar albino rats were divided into three groups. Each rat underwent segmental colonic resection with single-layer anastomosis. In group-1, the anastomotic line was covered with 9%NaCl, in group-2 with glycerol, and in group-3 with flax oil. The rats were sacrificed on postoperative day 10. Anastomosis burst pressures, tissue hydoxyproline levels and anastomosis histopathological characteristics were evaluated. We observed no statistical differences among all groups in mean bursting pressures (p=0.767). The mean hydroxyprolin level of group 1 was statistically lower than group 2 and 3 (p=0.0001) but no difference between them 3 (p=0.436). Histopathologic evaluation results were not statistically different in all groups. The p values were 0.664 for inflammation, 0.638 for neovascularization, 0.381 for fibroblast ingrowth, and 0.295 for collagen deposition. Glycerol and flax oil are not harmful to the colonic anastomosis healing process. On the contrary, they increase mean tissue levels of hydroxyproline, which is directly related to anastostomotic healing. These liquids securely applicable for colonic anastomosis performed peritoneal cavities

Comparison of physical examination findings and evaluation of pain between two groups of chronic low back pain patients with and without psychiatric disorders

Bu çalışmada kronik bel ağrısı nedeniyle bel okuluna alınan ve istanbul Tıp Fakültesi Liyezon Psikiyatri Birimi tarafından da değerlendirilen hastalardan psikiyatrik tanı alanlar ile psikiyatrik tanı almayanlarda fizik muayene bulguları, ağrı ve ağrı şiddeti değerleri karşılaştırmıştır ve psikiyatrik tanıların dağılımı belirlenmiştir. Çalışmaya mekanik kaynaklı kronik bel ağrısı olan 68 hasta alınmıştır. Hastalar Bel Okulu uygulama grubu tarafından ağrı (yok, hafif, orta, şiddetli, dayanılmaz), ağrı şiddeti (VAS), lomber schober (cm), düz bacak kaldırma testi (DBKT), el-yer mesafesi (cm) yönünden, Liyezon-Psikiyatri Birimi tarafından da psikiyatri muayeneleri (DSM Ill-Rtanı ölçütleri) yapılarak değerlendirilmişlerdir. Hastaların % 80.9'unun psikiyatrik tanı aldığı, % 19.1'inin ise psikiyatrik tanı almadığı belirlenmiştir. Psikiyatrik tanı alanların % 27.3'ünde fiziksel hastalığa eşlik eden anksiyeteli uyum güçlüğü, % 18.2'sinde distimik bozukluğu, % 14.5'inde yaygınlaşmış anksiyete bozukluk görülmüştür. Psikiyatrik tanı alan hastalar ile tanı almayan hastalar arasında fizik muayene bulguları açısından anlamlı bir fark olmamasına rağmen, psikiyatrik tanı alan hastalarda tanı almayanlara göre ağrı ve ağrı şiddetinin anlamlı şekilde daha fazla olduğu saptanmıştır(p<0.001). Anksiyete ve depresyona ait semptomlar sıklıkla ağrı şeklinde algılanabilirler ve genellikle kronik ağrılı tablonun major komponentleridirler. Çalışmamızda da anksiyetesi ve depresyonu olan hastalarda ağrı yakınmasının daha fazla olduğu görülmüştür, Bu nedenle kronik bel ağrılı hastaların tedavisi için Liyezon-Psikiyatri birimi ile iş birliği yapılmasının yararlı olduğu kanısındayız.COMPARISON OF PHYSICAL EXAMINATION FINDINGS AND EVALUATION OF PAIN BETWEEN TWO GROUPS OF CHRONIC LOW BACK PAIN PATIENTS WITH AND WITHOUT PSYCHIATRIC DISORDERS. This is a comperative study in chronic low back pain patients (CLBP) who had Back School training and evaluates physical findings, pain and pain intensity between two groups with and without additive psychiatric disorder diagnosed in the Department of Liason Psychiatry of Istanbul Medical Faculty. 68 patients with CLBP of mechanical origin were enrolled in the study and evaluated for pain by verbal reports of none, mild, moderate, intense and unbearable pain. Pain intensity was evaluated by VAS, lumbar flexibility by Schober, straight leg rasising test (SLRT), and finger tip to floor distance. All patients were also examined by the Liaison Psychiatry Department and evaluated by the DSM Ill-R diagnostic criteria. 80.9 % of our patients were diagnosed as having a psychiatric disorder while 19.1 % had no psychiatric disorder while 19.1 % had no psychiatric disorder. Compliance difficulty with anxiety was diagnosed in 27.3 % dysthymic disorder in 18,2 % and generalized anxiety disorder in 14.5 %. No significant difference in physical findings was found between two groups while there was significant difference in verbal pain report and pain intensity between those with and without psychiatric diagnosis (p&lt;0.001). It is well known that symptoms of anxiety and depression can often be perceived as pain so that depression and anxiety are usually major components of the clinical picture of chronic pain. This study shows a higher pain intensity and verbal reporting of pain in patients with anxiety and depression. We believe a mutual approach of Liaison Psychiatry and Physical Medicine and Rehabilitation teams in the rehabilitation of CLBP patients can be very beneficial

Factor IX gene mutations in turkish haemophiliacs

Hemofili B hastalığının nedeni, kanın temel fonksiyonları arasında bulunan koagülasyon mekanizmasında etkin olan faktör IX’un konjenital eksikliği veya disfonksiyonel olmasıdır. Faktör IX’u kodlayan gen, X kromozomunun q27.1 bandında lokalize olup, 34 kilobaz (kb) uzunluğunda ve 8 ekzon ile 7 introndan oluşmaktadır. Hem genotipik hem de fenotipik olarak oldukça heterojen bir yapıda olan hemofili B hastalığının şiddeti, gendeki mutasyonun lokalizasyonu ve yapısıyla yakından ilgilidir. Bu çalışmadaki temel amaç, yüksek heterojenite gösteren faktör IX geninde, hızlı, efektif ve kesin sonuç veren otomatik kapiller jel elektroforezi ile DNA baz dizileme yöntemini kullanarak, kesin moleküler tanıya gidilmesi, yöntemin avantajlarının belirlenmesi ve Türk popülasyonundaki mutasyon profilinin ortaya çıkartılmasına yönelik çalışmalara ışık tutmasıdır. Yapılan çalışmada, klinik olarak tanısı konmuş 13 hemofili B hastasında, otomatik kapiller jel elektroforezi yöntemi ile DNA dizi analizi yapılarak mutasyonlar taranmış ve 2’si yeni olmak üzere 11 farklı mutasyon tanımlanmıştır. Tespit edilen mutasyonlar en çok ( %33 ) 8. ekzon bölgesinde gözlenmiştir. Ayrıca, faktör IX geninin CpG’den zengin bölgelerinde mutasyonların daha çok ( %36 ) oldu- ğu görülmüş ve missens mutasyonların faktör IX geninde hastalığa en fazla ( %46 ) neden olan mutasyon tipi oldu- ğu, literatürle de uyum gösteren bir şekilde ortaya konmuştur. Sonuç olarak, kapiller DNA dizi analizi yönteminin, faktör IX geni mutasyonlarının tanımlanmasında hızlı ve etkili bir yaklaşım olduğunu ve bu çalışmanın sonuçlarının, Türk popülasyonunun faktör IX geni mutasyon profilinin belirlenmesi ile ilgili başka çalışmalara da ışık tutacağını düşünmekteyiz.Hemophilia B is an X linked coagulopathy due to deficiency of clotting factor IX. The gene for factor IX is situated on the long arm of the X chromosome at band Xq27.1, and spans 34kb. It consists of eight exons and seven introns. The clinical and molecular basis of hemophilia B is heterogeneous and the clinical severity is related to the location and type of genetic mutation. The main purpose of this study was to perform molecular diagnosis of hemophilia B disease by DNA sequence analyses of the promoter, poly A and coding regions of the factor IX gene. To evaluate the efficiency of this technique in the diagnosis of factor IX gene mutations and light up further studies that aim to obtain mutation profile of the factor IX gene spesific to Turkish population. By this aim, blood samples from thirteen clinically diagnosed hemophilia B patients were analysed by the automatic capiller gel electrophoresis technique. At least one mutation was identified in the patients, except one case with mild hemophilia B. Of 11 identified molecular abnormalities, two were new mutations according to “Hemophilia B mutation bank” data of the recognised mutations. The most frequently seen mutations (33%) were localised at the exon 8 of the factor IX gene. The frequency of mutations was higher in the CpG rich regions of the gene and missense mutations was regarded as the most common type of mutations causing severe hemophilia B and this conclusion was in accordance with the literature. In conclusion, we suggested that capiller DNA sequencing is a fast and efficient approach to identify mutations in the factor IX gene and the results of this study will light up further studies in obtaining the factor IX gene mutation profile of the Turkish population