Cell necrosis, intrinsic apoptosis and senescence contribute to the progression of exencephaly to anencephaly in a mice model of congenital chranioschisis

Amniotic fluid; Neonatal mortality; ExencephalyLíquido amniótico; Mortalidad neonatal; ExencefaliaLíquid amniòtic; Mortalitat neonatal; ExencefàliaExencephaly/anencephaly is one of the leading causes of neonatal mortality and the most extreme open neural tube defect with no current treatments and limited mechanistic understanding. We hypothesized that exencephaly leads to a local neurodegenerative process in the brain exposed to the amniotic fluid as well as diffuse degeneration in other encephalic areas and the spinal cord. To evaluate the consequences of in utero neural tissue exposure, brain and spinal cord samples from E17 exencephalic murine fetuses (maternal intraperitoneal administration of valproic acid at E8) were analyzed and compared to controls and saline-injected shams (n = 11/group). Expression of apoptosis and senescence genes (p53, p21, p16, Rbl2, Casp3, Casp9) was determined by qRT-PCR and protein expression analyzed by western blot. Apoptosis was measured by TUNEL assay and PI/AV flow cytometry. Valproic acid at E8 induced exencephaly in 22% of fetuses. At E17 the fetuses exhibited the characteristic absence of cranial bones. The brain structures from exencephalic fetuses demonstrated a loss of layers in cortical regions and a complete loss of structural organization in the olfactory bulb, hippocampus, dental gyrus and septal cortex. E17 fetuses had reduced expression of NeuN, GFAP and Oligodendrocytes in the brain with primed microglia. Intrinsic apoptotic activation (p53, Caspase9 and 3) was upregulated and active Caspase3 localized to the layer of brain exposed to the amniotic fluid. Senescence via p21-Rbl2 was increased in the brain and in the spinal cord at the lamina I-II of the somatosensory dorsal horn. The current study characterizes CNS alterations in murine exencephaly and demonstrates that degeneration due to intrinsic apoptosis and senescence occurs in the directly exposed brain but also remotely in the spinal cord.This work was supported by Prof. Jose L. Peiro internal Cincinnati Children's Hospital funding

Cell necrosis, intrinsic apoptosis and senescence contribute to the progression of exencephaly to anencephaly in a mice model of congenital chranioschisis

Exencephaly/anencephaly is one of the leading causes of neonatal mortality and the most extreme open neural tube defect with no current treatments and limited mechanistic understanding. We hypothesized that exencephaly leads to a local neurodegenerative process in the brain exposed to the amniotic fluid as well as diffuse degeneration in other encephalic areas and the spinal cord. To evaluate the consequences of in utero neural tissue exposure, brain and spinal cord samples from E17 exencephalic murine fetuses (maternal intraperitoneal administration of valproic acid at E8) were analyzed and compared to controls and saline-injected shams (n = 11/group). Expression of apoptosis and senescence genes (p53, p21, p16, Rbl2, Casp3, Casp9) was determined by qRT-PCR and protein expression analyzed by western blot. Apoptosis was measured by TUNEL assay and PI/AV flow cytometry. Valproic acid at E8 induced exencephaly in 22% of fetuses. At E17 the fetuses exhibited the characteristic absence of cranial bones. The brain structures from exencephalic fetuses demonstrated a loss of layers in cortical regions and a complete loss of structural organization in the olfactory bulb, hippocampus, dental gyrus and septal cortex. E17 fetuses had reduced expression of NeuN, GFAP and Oligodendrocytes in the brain with primed microglia. Intrinsic apoptotic activation (p53, Caspase9 and 3) was upregulated and active Caspase3 localized to the layer of brain exposed to the amniotic fluid. Senescence via p21-Rbl2 was increased in the brain and in the spinal cord at the lamina I-II of the somatosensory dorsal horn. The current study characterizes CNS alterations in murine exencephaly and demonstrates that degeneration due to intrinsic apoptosis and senescence occurs in the directly exposed brain but also remotely in the spinal cord

Port governance in Turkey The age of the global terminal operators

This paper investigates port governance in Turkey from the point of institutional economics and industrial organization. As a newly industrialized country, Turkey still achieves high growth rate and continuous development of global trade. As a result of high volume of trade, the role of ports raises its importance, and it attracts global investors in the port business. Turkey has focused on port devolution in the last two decades, and both domestic and global investors have been authorized to establish new port facilities as well as operating existing ports. Meanwhile, the national logistics industry has achieved a great leap which is also improved by the development of port business. Under various national and global circumstances, a synopsis of port governance in Turkey will be discussed from different perspectives including institutional changes and transport policy. This comparative case study particularly focusses on the last two decades in transition of public ports to various forms of private entities. The change of governance scheme is investigated through its impact on cargo traffic (especially containerized cargo) as well as logistics infrastructure in brief. (C) 2017 Elsevier Ltd. All rights reserved

Beyin ve omurilik tümörlerinin cerrahi tedavisinde doku seçici ultrasonik aspiratörlerin kullanılması

Aim: Ultrasonic surgical aspirators are surgical instruments operated with high frequency sound waves. The brain and/or spinal cord tumors can be removed safely with minimal damaging to neurovascular structures by using tissue-selective ultrasonic aspirators. Besides its benefits to the patient, by shortening the duration of operation, it may also provide cost savings in terms of hospital management. The aim of this study is to evaluate the utility and feasibility of ultrasonic aspirator in central nervous system tumors. Material and Methods: Forty patients who apply to the Department of Neurosurgery at Duzce University Medical Faculty between March 2013 and September 2017 due to brain or spinal cord tumor and operated for a brain or spinal cord tumor were included. Ultrasonic aspirator was used during the operations, and duration of operations were recorded. Results: The total operation time was compared between the groups that their operations performed by using ultrasonic aspirator and by not using it. The mean operation time was significantly higher in the group performed operations by using ultrasonic aspirator (253.8±87.5, 195.4±48.7, p=0.014). Whereas ultrasonic aspirator usage did not change the duration of operation in patients with glioblastoma (237.8±56.3, 235.5±31.9, p=0.689). Conclusion: Technological instruments, that become a part of surgical treatment, are devices that ensure maximum efficiency with minimum damage. However, these devices require prior training on how to use them. Training of healthcare staff in the use of ultrasonic aspirator is very important. Further studies are needed following the training of the assistant healthcare staff in this subject. © 2019, Duzce University Medical School. All rights reserved.Amaç: Ultrasonik cerrahi aspiratörler yüksek frekanslı ses dalgaları ile çalışan cerrahi aletlerdir. Tümör cerrahisinde dokuya seçici ultrasonik aspiratörlerin kullanılması ile normal nöral dokuya en az zarar verecek şekilde beyin ve/veya omurilik tümörlerinin güvenle çıkartılması mümkündür. Ameliyat süresinin kısalması ve hastaya sağladığı yararların dışında hastane işletmesi açısından da maddi tasarruf sağlanmasını mümkün kılabilir. Bu çalışmanın amacı santral sinir sistemi tümörlerinde ultrasonik aspiratörün yarar ve uygulanabilirliğini değerlendirmektir. Gereç ve Yöntemler: Mart 2013 ve Eylül 2017 tarihleri arasında beyin veya omurilik tümörü nedeniyle Düzce Üniversitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalına başvuran, beyin veya omurilik tümörü nedeniyle ameliyatı yapılan 40 hasta çalışmaya alınmıştır. Ameliyat sırasında ultrasonik aspiratör kullanılmış ve ameliyat süreleri kaydedilmiştir. Bulgular: Ameliyatları ultrasonik aspiratör kullanılarak yapılan grup ile ultrasonik aspiratör kullanmadan yapılan gruplar arasında toplam operasyon süresi karşılaştırılmıştır. Ultrasonik aspiratör kullanılan grupta ortalama ameliyat süresinin anlamlı düzeyde yüksek olduğu tespit edilmiştir (253,8±87,5; 195,4±48,7; p=0,014). Oysa ultrasonik aspiratör kullanımının glioblastoma tanılı hastalarda ameliyat süresini değiştirmediği tespit edilmiştir (237,8±56,3; 235,5±31,9; p=0,689). Sonuç: Cerrahi tedavinin bir parçası haline gelen teknolojik aletler, en az hasar ile maksimum verim alınmasını sağlayan cihazlardır. Ancak bu cihazlar nasıl kullanılacakları konusunda önceden eğitim gerektirirler. Ultrasonik aspiratör kullanımında yardımcı sağlık personelinin eğitimi çok önemlidir. Bu konuda yardımcı sağlık personelinin eğitiminin ardından yapılacak daha fazla çalışmalara ihtiyaç vardır

PORT PRODUCTIVITY ASSESSMENT FOR MAJOR CONTAINER TERMINALS OF TURKEY

This paper investigates a number of major productivity metrics for leading container terminals of Turkey, and the interpretation of numerical results is performed to highlight terminal units subject to improvements. The assessment of port performance is always a topical problem, and several approaches are proposed in the last few decades. Comparative port efficiency models (e.g. Data Envelopment Analysis) are frequently utilized, and these models are very instrumental in the port competition environment in which the quality of services are emphasized. Another major approach is based on the performance indicators (productivity approach) defined for each unit of port operation. The downside of productivity approach is the disability of integrating quality dimension. Key performance indicators measuring service quality may still be able to enclose quality dimension while collecting such numerical data is usually impractical or kept confidential. In this study, the productivity approach is preferred to illustrate terminal performance in major units of terminal operation : Berth and vessel operations, crane operations and yard operations

Currarino syndrome: report of five consecutive patients

WOS: 000332319200024PubMed ID: 24013264The Currarino syndrome is regarded as a developmental disorder based on its recognized etiological heterogeneity. This syndrome is thought to result from abnormal separation of the neuroectoderm from the endoderm. Our aim was to report the neurosurgical management of Currarino syndrome in children and adults and to describe what clinician could do if the Currarino triad was suspected. We present five cases of Currarino triad who underwent surgical intervention. All patients had sacral bony deformity, anorectal malformations, and anterior sacral meningocele. A 40-year-old-male had chronic constipation. He was incidentally diagnosed with Currarino syndrome. A 19-year-old-female suffered from a slight weakness in lower extremities and urinary incontinence. Her past medical history was remarkable for anal atresia. The other three cases were children. When an anterior sacral meningocele is encountered, Currarino syndrome should be taken into consideration. Although it is rarity, the Currarino syndrome might be one of the causes of chronic constipation. Endoscopic or endoscope-assisted surgery via a posterior sacral route can be feasible for treatment of some of the patients with anterior sacral meningocele. Anterior meningocele pouch associated with Currarino syndrome will regresses over time following transdural ligation of its neck

Successful endoscopic third ventriculostomy in children depends on age and etiology of hydrocephalus: outcome analysis in 51 pediatric patients

Oria, Marc/0000-0001-9132-9271; Duru, Soner/0000-0002-3449-4673; Aydin, Emrah/0000-0001-7776-9684; Peiro, Jose L./0000-0002-2272-1381WOS: 000438618500016PubMed: 29696356Endoscopic third ventriculostomy (ETV) has become the method of choice in the treatment of hydrocephalus. Age and etiology could determine success rates (SR) of ETV. The purpose of this study is to assess these factors in pediatric population. Retrospective study on 51 children with obstructive hydrocephalus that underwent ETV was performed. The patients were divided into three groups per their age at the time of the treatment: 24 months of age. All ETV procedures were performed by the same neurosurgeon. Overall SR of ETV was 80% (40/51) for all etiologies and ages. In patients 24 months was 94.1% (16/17) (p = 0.012). The highest SR was obtained on aqueductal stenosis. SR of posthemorrhagic, postinfectious, and spina bifida related hydrocephalus was 60% (3/5), 50% (1/2), and 14.3% (1/7), respectively. While SR rate at the first ETV attempt was 85.3%, it was 76.9% in patients with V-P shunt performed previously (p = 0.000). Factors indicating a potential failure of ETV were young age and etiology such as spina bifida, other than isolated aqueductal stenosis. ETV is the method of choice even in patients with former shunting. Fast healing, distensible skulls, and lower pressure gradient in younger children, all can play a role in ETV failure. Based on our experience, ETV could be the first method of choice for hydrocephalus even in children younger than 6 months of age