Paraoxonase 1 activity and survival in sepsis patients

Background: Sepsis is a state of augmented oxidative stress and diminished antioxidant capacity. High den- sity lipoprotein (HDL) particles were shown to possess antioxidant and anti-inflammatory properties, as well as Paraoxonase 1 (PON1), which is an enzyme that is also protective against HDL oxidation. Previous stud- ies suggested a possible role of decreased PON1 activ- ity or HDL levels in sepsis patients. Aims: The present study was designed to test a hypoth- esis that higher PON1 activity and HDL-cholesterol levels could predict a better survival in sepsis patients. Study Design: Observational study. Methods: Venous blood samples were collected from sepsis patients for HDL-cholesterol levels, PON1 ac- tivity and cytokine assays (TNF-α and IL-6) and Acute Physiologic and Chronic Health Evaluation II (APACHE II) scores were calculated in order to weight patients’ disease severity on the day of sepsis diagnosis. Patients were followed-up until the 28th day for any cause intra- hospital mortality. Data were statistically analyzed for effects of study parameters on patients’ survival. Results: In total, 85 patients with sepsis were included in the study. The mean age was 65.2±17.9 years and 48 were male; at the end of the 28-day follow-up pe- riod, 46 survived. TNF-α (86.9±10.5 vs 118.6±16.4) and IL-6 levels (906.7±82.7 vs 1323.1±54.3) were sig- nificantly higher in non-survivors, while PON1 activity (140.7±42.3 vs 66.7±46.6) and HDL-cholesterol lev- els (43.6±8.1 vs 34.5±8.9) were significantly higher in survivors (p<0.001 for all). TNF-α (r=-0.763) and IL-6 levels (r=-0.947) showed strong negative correlations, PON1 activity (r=0.644) and HDL-cholesterol levels (r=0.477) showed positive correlations with patient sur- vival (p<0.001 for all). Survival estimates significantly favored TNF-α (Log Rank 59.5, p<0.001) and IL-6 levels (Log Rank 53.2, p<0.001) according to PON1 activity (Log Rank 5.4, p<0.03) and HDL-cholesterol levels (Log Rank 8.3, p<0.005). Regression analyses for relative contributions of parameters to survival showed that higher IL-6 levels (t:-16.489, p<0.001) were the most significant negative factor for survival, and TNF-α levels (t:-4.417, p<0.001), whereas PON1 activity had a positive effect (t:3.210, p<0.003). Conclusion: The present study showed that although low PON1 activity and HDL-cholesterol levels were related to mortality, higher levels were not found to be as predictive as cytokine levels for survival

Robust Repetitive Controller for Fast AFM Imaging

Currently, Atomic Force Microscopy (AFM) is the most preferred Scanning Probe Microscopy (SPM) method due to its numerous advantages. However, increasing the scanning speed and reducing the interaction forces between the probe's tip and the sample surface are still the two main challenges in AFM. To meet these challenges, we take advantage of the fact that the lateral movements performed during an AFM scan is a repetitive motion and propose a Repetitive Controller (RC) for the z-axis movements of the piezo-scanner. The RC utilizes the profile of the previous scan line while scanning the current line to achieve a better scan performance. The results of the scanning experiments performed with our AFM set-up show that the proposed RC significantly outperforms a conventional PI controller that is typically used for the same task. The scan error and the average tapping forces are reduced by 66% and 58%, respectively when the scan speed is increased by 7-fold

Elli beş yaşındaki bir kadında ki-67 ekspresyonu olmamasının düşük malign potansiyeli yansıttığı muhtemel olarak wolffian kaynaklı dişi adneksial tümör

Female adnexial tumors of probable Wolffian origin (FATWO) are rare tumors derived from the remnants of the mesonephric duct. These tumors generally exhibit a low malignant potential, but recurrence and or metastasis is possible during the course of the disease according to the tumors’ possible malignant potential. We report a case of FATWO without estrogen and progesterone receptors and with negative immunostaining for Ki-67 (a proliferation marker) as a probable low-malignant-potential tumor. A 55-year-old woman presented with a complaint of heavy menstrual bleeding and pelvic pain. Preoperative ultrasonographic evaluation revealed an intramural uterine leiomyoma of 4 cm in diameter and a right adnexial solid mass measuring 5 cm in diameter. Following total abdominal hysterectomy and bilateral salpingo-oophorectomy, immunostaining based on the labeled streptavidin-biotin method was performed on sections from representative blocks of paraffin-embedded tissues sampled from the mass, revealing a low mitotic index with negative Ki-67 immunostaining. Immunohistochemical staining with promising new markers and pathological investigation of the entire tumor are needed to determine the malignant behavior of an individual FATWO. Ki-67 is a helpful marker for determining Wolffian duct tumors’ potential malignant behavior

Prevention of adhesion formation in wistar-albino rats by increased bowel movements achieved with oral ricinus oil use for 8 days postoperatively: an experimental study

Objective: Adhesion formation frequently occurs after abdominopelvic surgery and can cause significant morbidity for patients. Meticulous hemostasis, minimal access surgery and utilization of surgical adjuvants intraoperatively are clinically useful measures to minimize adhesion formation. We investigated the clinical efficiency of oral Ricinus oil treatment for 8 days postoperatively to decrease adhesion formation in this case-control study in a rat model. Study design: Following computer-generated randomization, 24 female Wistar-albino rats were operated on, with 10 standard cautery lesions on the right uterine horn and two simple suture lesions on left uterine horn generated with absorbable material. Half (n = 12) the rats received 0.13 g (0.2 ml) Ricinus oil emulsion (40 g/60 ml) via the oral route during the first 8 days postoperatively, and the remaining rats (n = 11) were considered as controls. The extent, severity, degree, total adhesion scores and histopathological features of the adhesions were the main outcome measures. Results: The degree and total adhesion formation scores in the Ricinus oil group and control group revealed significant differences in adhesion extent and severity. The total adhesion scores of the Ricinus oil and control groups were 3.00 +/- 2.21 and 5.18 +/- 2.78 respectively (P 0.05). Conclusions: Ricinus oil treatment following abdominopelvic surgery for the 8-day period that covers the completion of tissue healing process may be a promising, cheap and cost-effective treatment strategy for patients. (C) 2012 Elsevier Ireland Ltd. All rights reserved

US-guided retrograde tibial artery puncture for recanalization of complex infrainguinal arterial occlusions

PURPOSEWe aimed to describe the technical aspects and outcomes of the retrograde tibial approach and balloon predilation for recanalization of complex infrainguinal arterial occlusions and determine the efficacy of this approach in minimizing failure rates. MATERIALS AND METHODSBetween September 2006 and April 2011, antegrade revascularization failed in 22 limbs with complex total occlusions within the infrainguinal arterial territory. For each of these antegrade failure cases in 22 patients, a retrograde tibial puncture had been attempted. Percutaneous recanalization and predilation were initially performed through tibial access, and final balloon dilatation or stent placement was performed from antegrade femoral access. The patients were followed up for functionality and wound healing. RESULTSAccess from the tibial artery was successfully obtained for all patients (100%). Successful recanalization was obtained in 18 patients (82%). Retrograde access was performed from the anterior tibial/dorsalis pedis artery in 12 patients and posterior tibial artery in 10 patients. One major and one minor complications were documented. CONCLUSIONRetrograde tibial recanalization technique in the infrainguinal complex arterial occlusion safely increases the success rates of percutaneous recanalization in the failed traditional approach and is a feasible endovascular option to avoid more invasive, time-consuming, and high-risk procedures

Transhepatic left ventricular only pacing after left bundle branch area pacing attempt with high pacing threshold

A 50-year-old male with a permanent dual chamber pacemaker (DDD) 23 years ago was referred for a rapid increase in right ventricular (RV) pacing impedance. His left ventricular (LV) ejection fraction was 45%. Since the patient was pacemaker-dependent, the insertion of a new RV lead was planned. However, the venography and imaging studies revealed both left and right subclavian veins to be occluded/non-accessible. We failed also to cross the lesion by percutaneous approach. Then, we planned the extraction procedure as a first stage with the thought that it can provide a new venous route via extraction sheath; however, the patient did not accept the procedure as its high risk. Therefore, the surgical epicardial LV lead was implanted and connected to the left subpectoral pocket by using the previous functional right atrial (RA) lead for DDD pacing. Unfortunately, 1 month later, the patent presented with a left-sided pocket infection, and we had to remove all endocardial RA and RV leads using the lead extraction system. We could not again pass the calcified superior vena cava despite the successful lead extraction. Due to an active pocket infection, the surgically placed pacemaker was removed from the skin leaving the epicardial LV lead in place to remove or drain the infected fluid. A leadless pacemaker was an option, but due to financial constraints could not be done for this patient. The femoral venous access could not be taken due to the non-availability of 69 cm RV lead. The hepatic vein was the only available access to implant a DDD pacemaker

Current Concepts of Prolotherapy in Orthopedic Surgery

Context Prolotherapy is a popular injection-based complementary treatment, which has shown promising results in the treatment of sprained and degenerated ligaments, and damaged dense connective tissues structures. More research was conducted in this area and many authors declared successful results for different indications. Evidence Acquisition The purpose of this study was to present a literature review regarding the current concepts of prolotherapy injections and improvements in the orthopedic clinical care practice. The Medline and PubMed databases were searched for the articles related to prolotherapy injections in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation. Results Numerous studies have been conducted on prolotherapy injections for different indications for orthopedics clinical care practice. Prolotherapy injections have successfully used for major orthopedic procedures in terms of rotator cuff lesions, knee ligamentous lesions, osteoarthritis-cartilage defects, and ligament-tendon injuries. Most of the studies showed that prolotherapy provided faster and better healing of tissues. Conclusions There is a great interest to prolotherapy in orthopedic clinics, especially to manage musculoskeletal lesions. More research conducted in this area and many authors declared successful results in their studies. In spite of this increasing trend for prolotherapy injections, there were only one or two clinical studies investigated prolotherapy injections for different indications and most of them have limited participants, short-term follow-up or poor quality studies. There is still need for further high-quality studies investigated optimal strategy of the injections of prolotherapy

Synthesis and biological evaluation of novel 1,3,4-thiadiazole derivatives as possible anticancer agents

The synthesis of new N-(5-substituted-1,3,4-thiadiazol-2-yl)-2-[(5-(substituted amino)-1,3,4-thiadiazol-2-yl)thio]acetamide derivatives and investigation of their anticancer activities were the aims of this work. All the new compounds’ structures were elucidated by elemental analyses, IR, 1H NMR, 13C NMR and MS spectral data. Anticancer activity studies of the compounds were evaluated against MCF-7 and A549 tumor cell lines. In addition, with the purpose of determining the selectivity of cytotoxic activities, the most active compound was screened against a healthy NIH3T3 cell line (mouse embryonic fibroblast cells). Among the tested compounds, compound 4y (N-(5-ethyl-1,3,4-thiadiazol-2-yl)-2-((5-(p-tolylamino)-1,3,4-thiadiazol-2-yl)thio)acetamide), showed promising cytotoxic activity against MCF7 cancer cell with an IC50 value of 0.084 ± 0.020 mmol L–1 and against A549 cancer cell with IC50 value of 0.034 ± 0.008 mmol L–1, compared with cisplatin. The aromatase inhibitory activity was evaluated for compound 4y on MCF-7 cell line showing promising activity with IC50 of 0.062 ± 0.004 mmol L–1