Adnexal Torsion in the Third Trimester of Pregnancy: A Challenging Diagnosis

The incidence of adnexal torsion (AT) is reported 1 in 10000 births. AT is emergency condition in pregnancy, while the risk of late diagnosis is increased, in third trimester. Since it has been described as a severe complication after controlled ovarian hyper-stimulation for in vitro fertilization (IVF), it is more common in IVF pregnancies. This condition mainly occurs in the first trimester; it is rare during the late third trimester. Herein, we report a case of a 26-year-old woman, gravida 1, singleton pregnancy in the 30th week of gestation was presented to emergency department with 24-hour history of a stabbing pain because of AT. Removal of adnexa performed by laparotomy. The patient had labour pain and cervical dilatation at the 36th week of gestation and a healthy girl weighing 2,200 g was born by emergency caesarean section due to breech presentation

Konwencjonalna i płynna cytologia – badania porównawcze

Objectives: The aim of our study is the comparison of the results of conventional smear (CC) technique and liquidbased cytology (LBC) technique used as cervical cancer screening methods. Material and methods: The results of 47954 patients submitted to smear screening in our gynecology clinic between January 2008 and December 2014 have been studied. The smear results have been divided into two groups CC and LBC according to the technique used. Results: When considering the distribution within CC group, the results were as follows: intraepithelial cell abnormalities 2,0% (n=619), insufficient sample for analysis 2,1% (n=660), Atypical squamous cells of undetermined significance (ASC-US) 1.8% (n=554), Low grade squamous intraepithelial lesion (LGSIL) 0.1% (n=35), High grade squamous intraepithelial lesion (HGSIL) 0.1% (n=16), Atypical squamous cells – cannot exclude HGSIL (ASC-H) 0.029% (n=9), Atypical glandular cells- not other wise specified (AGC-NOS) 0.012% (n=4), squamous carcinoma 0.003% (n=1). When considering the distribution in LBC group, the results were as follows: intraepithelial cell abnormalities2.1% (n=357), insufficient sample for analysis 0.9% (n=144), ASC-US 1.8% (n=296), LGSIL 0.2% (n=38), HGSIL 0.1% (n=8), ASC-H 0.1% (n=10), AGC-NOS 0.017% (n=3), squamous carcinoma 0.011% (n=2). Conclusions: Although the rates of epithelial cell abnormalities are similar for both tests, LSIL results are more frequently observed in LBC technique. In LBC technique, the number of insufficient sample for analysis is quite low compared to CC group and thus constitutes an advantage.  Cel pracy: Celem badania było porównanie wyników konwencjonalnej (CC) i płynnej cytologii (LBC) stosowanej w skriningu raka szyjki macicy. Materiał i metoda: Przeanalizowano wyniki od 47954 pacjentek objętych cytologicznym badaniem skriningowym w naszym oddziale ginekologicznym w okresie od stycznia 2008 do grudnia 2014. Wyniki cytologiczne podzielono na dwie grupy CC i LBC w zależności od techniki pobierania. Wyniki: W grupie CC wyniki przedstawiały się nastepująco: nieprawidłowości komórek śródnabłonkowych 2,0% (n=619), nieodpowiednia próbka do analizy 2,1% (n=660), ASC-US 1.8% (n=554), LGSIL 0.1% (n=35), HGSIL 0.1% (n=16), ASC-H 0.029% (n=9), AGC-NOS 0.012% (n=4), rak płaskonabłonkowy 0.003% (n=1). W grupie LBC wyniki przedstawiały się następująco: nieprawidłowości komórek śródnabłonkowych 2.1% (n=357), nieodpowiednia próbka do analizy 0.9% (n=144), ASC-US 1.8% (n=296), LGSIL 0.2% (n=38), HGSIL 0.1% (n=8), ASC-H 0.1% (n=10), AGC-NOS 0.017% (n=3), rak płaskonabłonkowy 0.011% (n=2). Wnioski: Chociaż odsetek nieprawidłowości komórek śródnabłonkowych jest podobny dla obu testów, wyniki LSIL są częściej obserwowane w technice LBC. W metodzie LBC liczba próbek nieodpowiednich do analizy jest dość niska w porównaniu do grupy CC, stąd jest to jej niewątpliwa zaleta.

Reconsidering the Relationship between Oil Prices and Industrial Production: Testing for Cointegration in some of the OECD Countries

This paper investigates the effects of crude oil prices on the industrial production for some of the OECD countries. According to it, the empirical results sign that there is statistical meaningful short term causality from crude oil price to industrial production in all countries except France. In France however, causality is from industrial production to oil price in short run. The error correction mechanism is run for US. The causality is from oil price to industrial production in long run for US. These results show us that oil prices do affect industrial production index. Another interesting finding that, similar results were observed for oil exporting and importing countries such as Saudi Arabia and Iran as well. This situation is important that firm sensitivity towards oil price shows a similarity among the countries

P.C.N. and Arena Meet Hotel

This paper deals with the analysis of a hotel facility to determine opportunity for improvements using the Process Chain Network (P.C.N.) in combination with the Arena simulation software. The information presented is based on the authors’ personal experiences as guests at hotels, and presented in a final project assignment in the MBA Production and Operations Management course

Carvacrol alleviates acrylamide-induced hepatotoxicity in rats: an experimental insights

Aim: This study aimed to investigate the protective effects of carvacrol (CRV) on rat liver against acrylamide (AA)-induced hepatotoxicity. Materials and Methods: A total of 30 Wistar Albino rats were used in the study. Rats were divided into 4 groups: Control (n:6), CRV (n:8, 50 mg/kg/ day carvacrol, i.p), AA (n:8, 40 mg/kg/day acrylamide, gavage) and AA+CRV (n:8, 40 mg/kg/day acrylamide, gavage + 50 mg/kg/day carvacrol i.p). At the end of the 15-day study period, the rats, whose blood samples were taken under anesthesia, were euthanized and necropsied. Liver function tests were examined from serums. At the same time for histological analysis, scoring, and hematoxylin-eosin staining, liver tissues were preserved in 10% formaldehyde solution. Results: In microscopic examination, it was determined that AA causes hydropic/vacuolar degeneration, fatty changes, necrosis/apoptosis, bile duct proliferation, hepatic cord dissociation, congestion, megalocytosis and mononuclear cell infiltration. Parallelly, AA raised the levels of ALP, AST, and ALT. The inclusion of CRV to the diet improved histological structure and liver function tests considerably. These results show that CRV has a hepatoprotective effect by reducing AA-induced liver damage. Conclusion: This study showed that CRV attenuated AA-induced liver injury. It is considered that its preventive effect against liver damage is due to its antioxidant properties. However, more research is needed to determine the specific mechanism at the molecular level and offer therapeutic management suggestions

Effect of monoamine oxidase B A644G variant on nicotine dependence and/or schizophrenia risk

Objectives: Schizophrenia (Sch) is a severe and chronic mental illness. Smoking prevalence is higher in patients with Sch than general population. We aimed to investigate the effects of MAOB gene A644G variant on nicotine dependence (ND) and Sch+ND risk in Turkish population and to evaluate by bioinformatic analysis. Methods: Present study included 161 individuals with ND, 223 patients with Sch+ND, and 96 non-smoker controls. MAOB A644G variant was analyzed using PCR-RFLP method. As the MAOB gene is located on the X chromosome, each gender was analysed separately. Results: The total distributions of AA, AG and GG genotypes of MAOB gene A644G were 44.7%, 22.4% and 32.9% in the ND group, 45.3%, 25.1% and 29.6% in the Sch+ND group and, 44.8, 22.9% and 32.3% in non-smoker controls. No significant differences were observed between groups for the MAOB A644G genotype and allele frequencies when female group compared to male group (p > 0.05). Examination of disease associations of SNPs from each miRNA gene region in GWAS databases yielded results for aging, bipolar disorder, autoimmune, and neurological diseases. Discussion: Our results indicate that the MAOB gene A644G variant is not associated with ND and/or Sch susceptibility in the Turkish population

Canonical Wnt signaling is antagonized by noncanonical Wnt5a in hepatocellular carcinoma cells

<p>Abstract</p> <p>Background</p> <p>β-catenin mutations that constitutively activate the canonical Wnt signaling have been observed in a subset of hepatocellular carcinomas (HCCs). These mutations are associated with chromosomal stability, low histological grade, low tumor invasion and better patient survival. We hypothesized that canonical Wnt signaling is selectively activated in well-differentiated, but repressed in poorly differentiated HCCs. To this aim, we characterized differentiation status of HCC cell lines and compared their expression status of Wnt pathway genes, and explored their activity of canonical Wnt signaling.</p> <p>Results</p> <p>We classified human HCC cell lines into "well-differentiated" and "poorly differentiated" subtypes, based on the expression of hepatocyte lineage, epithelial and mesenchymal markers. Poorly differentiated cell lines lost epithelial and hepatocyte lineage markers, and overexpressed mesenchymal markers. Also, they were highly motile and invasive. We compared the expression of 45 Wnt pathway genes between two subtypes. TCF1 and TCF4 factors, and LRP5 and LRP6 co-receptors were ubiquitously expressed. Likewise, six Frizzled receptors, and canonical Wnt3 ligand were expressed in both subtypes. In contrast, canonical ligand Wnt8b and noncanonical ligands Wnt4, Wnt5a, Wnt5b and Wnt7b were expressed selectively in well- and poorly differentiated cell lines, respectively. Canonical Wnt signaling activity, as tested by a TCF reporter assay was detected in 80% of well-differentiated, contrary to 14% of poorly differentiated cell lines. TCF activity generated by ectopic mutant β-catenin was weak in poorly differentiated SNU449 cell line, suggesting a repressive mechanism. We tested Wnt5a as a candidate antagonist. It strongly inhibited canonical Wnt signaling that is activated by mutant β-catenin in HCC cell lines.</p> <p>Conclusion</p> <p>Differential expression of Wnt ligands in HCC cells is associated with selective activation of canonical Wnt signaling in well-differentiated, and its repression in poorly differentiated cell lines. One potential mechanism of repression involved Wnt5a, acting as an antagonist of canonical Wnt signaling. Our observations support the hypothesis that Wnt pathway is selectively activated or repressed depending on differentiation status of HCC cells. We propose that canonical and noncanonical Wnt pathways have complementary roles in HCC, where the canonical signaling contributes to tumor initiation, and noncanonical signaling to tumor progression.</p

Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis

Rarely, leukocytoclastic vasculitis can result from ischemic colitis, inflammatory bowel disease, and cryoglobulinemia. There is no established standard for the treatment of leukocytoclastic vasculitis associated with gastroenterologic diseases. This paper presents three cases of leukoytoclastic vasculitis, each of which is associated with a different gastroenterologic condition: ischemic colitis, Crohn’s disease, and chronic hepatitis C. Each condition went into remission by treatment of leukocytoclastic vasculitis, regardless of the underlying disease

Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

Study DesignRetrospective.PurposeThis study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia.Overview of LiteratureMany women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.MethodsWe examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).ResultsFifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.ConclusionsAge, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results

The Ability to Generate Senescent Progeny as a Mechanism Underlying Breast Cancer Cell Heterogeneity

Background Breast cancer is a remarkably heterogeneous disease. Luminal, basal-like, "normal-like", and ERBB2+ subgroups were identified and were shown to have different prognoses. The mechanisms underlying this heterogeneity are poorly understood. In our study, we explored the role of cellular differentiation and senescence as a potential cause of heterogeneity. Methodology/Principal Findings A panel of breast cancer cell lines, isogenic clones, and breast tumors were used. Based on their ability to generate senescent progeny under low-density clonogenic conditions, we classified breast cancer cell lines as senescent cell progenitor (SCP) and immortal cell progenitor (ICP) subtypes. All SCP cell lines expressed estrogen receptor (ER). Loss of ER expression combined with the accumulation of p21Cip1 correlated with senescence in these cell lines. p21Cip1 knockdown, estrogen-mediated ER activation or ectopic ER overexpression protected cells against senescence. In contrast, tamoxifen triggered a robust senescence response. As ER expression has been linked to luminal differentiation, we compared the differentiation status of SCP and ICP cell lines using stem/progenitor, luminal, and myoepithelial markers. The SCP cells produced CD24+ or ER+ luminal-like and ASMA+ myoepithelial-like progeny, in addition to CD44+ stem/progenitor-like cells. In contrast, ICP cell lines acted as differentiation-defective stem/progenitor cells. Some ICP cell lines generated only CD44+/CD24-/ER-/ASMA- progenitor/stem-like cells, and others also produced CD24+/ER- luminal-like, but not ASMA+ myoepithelial-like cells. Furthermore, gene expression profiles clustered SCP cell lines with luminal A and "normal-like" tumors, and ICP cell lines with luminal B and basal-like tumors. The ICP cells displayed higher tumorigenicity in immunodeficient mice. Conclusions/Significance Luminal A and "normal-like" breast cancer cell lines were able to generate luminal-like and myoepithelial-like progeny undergoing senescence arrest. In contrast, luminal B/basal-like cell lines acted as stem/progenitor cells with defective differentiation capacities. Our findings suggest that the malignancy of breast tumors is directly correlated with stem/progenitor phenotypes and poor differentiation potential. © 2010 Mumcuoglu et al