Is there a relationship between serum vitamin D levels and onychomycosis?

Background and Design: Vitamins are necessary for various biochemical functions and are either insufficiently synthesized or not synthesized by the organism; therefore, they are taken from the diet. Many dermatoses such as psoriasis, atopic dermatitis, rosacea, acne vulgaris, vitiligo, and pityriasis versicolor, which are associated with vitamin D deficiency, have been reported. This cross-sectional study aimed to compare vitamin D levels between patients with onychomycosis and healthy controls and determine the relationship between vitamin D and onychomycosis. Materials and Methods: Serum 25-hydroxyvitamin D [25(OH)D] levels were measured in the blood sample for any reason in the last 1 month of patients diagnosed with onychomycosis and healthy controls. Results: The study included 40 participants (21 men). The mean level of serum 25(OH)D of all participants was 12.66 ng/mL. No significant correlation was found between the age of the participants and 25(OH)D levels. 25(OH)D levels were lower in the patient group (10.79+-8.12 ng/mL) than in the control group (13.91+-6.76 ng/mL) (p=0.02). Conclusion: The results of this study revealed that vitamin D levels are low in the Turkish population, but mean values are lower in patients with onychomycosis

Magnetic resonance dacryocystography: Its role in the diagnosis and treatment plan of lacrimal drainage system obstructions

Objective: To evaluate the role of magnetic resonance dacryocystography (MR-DCG) technique in patients with obstruction of lacrimal drainage system. Methods: A total of 40 patients who had presented to the ophthalmology clinic were suspected to have obstruction of lacrimal drainage system, were evaluated with MR-DCG after instillation of 0.5% Gd-DTPA conjunctival contrast medium. Dacryocystorhinostomy (DCR) was performed in patients who were found to have lacrimal drainage system obstruction on either side on MR-DCG. Results: Obstruction of lacrimal drainage system was successfully detected in a total of 49 eyes of 40 patients undergoing examination with MR-DCG. The MR-DCG findings of 29 nasolacrimal systems were compared with the intraoperative findings in 28 out of 40 patients who had undergone the DCR operation. The sensitivity of MR-DCG was determined as 100% and specificity as 96.7% for identification of nasolacrimal system obstruction when compared with the intraoperative findings, and MR-DCG was found to detect obstruction with high accuracy. Conclusion: MR-DCG has a high success rate in detection of lacrimal drainage system obstructions and the level and cause of the obstruction

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

An investigation of the effects of polydioxanone thread, hyaluronic acid filler and botulinum toxin-A treatments on the rats skin, connective tissue and photoaging

Bu projede polidioksanon (PDO) ip, hyaluronik asit (HA) dolgu ve botulinum toksin-A (BTX-A) uygulamaları tek ve kombin kullanım yoluyla değerlendirilmiş olup, deri ve derialtı dokuda oluşturdukları olumlu ya da olumsuz değişimler, kombine uygulamalarında birbirleri üzerindeki sinerjistik ya da antagonistik etkileri, ultraviolet (UV) maruziyetiyle oluşan fotohasar ve fotoyaşlanma süreçlerinde bu etkilerin nasıl değişeceği incelenmiştir. Bu sayede insan derisindeki yaşlanmada seçilecek yönteme karar verilmesi için bakış açısı oluşturulması hedeflenmiştir. Yöntem Projemizde Wistar albino sıçanlar (2-5 aylık, 200-250 g ağırlığında, erkek, 20 adet 10'arlı 2 grup) çalışmaya alınmıştır. Sıçanların bakım ve beslenmeleri Necmettin Erbakan Üniversitesi KONÜDAM Deneysel Tıp Uygulama ve Araştırma Merkezi'nde yapılmıştır. Tüm sıçanların sırt derisi 5 eşit parçaya bölünüp 1-2-3-4-5 olarak numaralandırılmış ve sırt bölgeleri tıraşlandıktan sonra uygun anestezik ajanla genel anesteziye alınmışlardır. 1 nolu alan kontrol alanı olup buraya ip'siz iğne derialtına uygulanıp çıkarılmıştır. 2.alana PDO ip uygulaması deri altında Panniculus carnosus (PC) bölgesine uygulanmıştır. 3.alana HA maddesi intradermal dolgu olarak 0.02 ml uygulanmıştır. 4.alana PDO ip uygulaması ve aynı seansta HA 0.02 ml uygulaması yapılmıştır. 5.alana ise PDO ip ile beraber aynı seansta HA 0.02 ml ve BTX-A 1U olarak uygulanmıştır. İkinci gruptaki 10 sıçana ise aynı işlemler yine tek seferlik uygulanıp 320-400 nm dalga boyunda UVA, 138 mj/cm2 ve 290-320 nm dalga boyu olan UVB 130 mj/cm2 haftada 3 gün olmak üzere 12 hafta boyunca uygulanmıştır. Her 2 gruptaki sıçanların genel durumu haftalık olarak kontrol edilmiştir. Uygulama bölgeleri (ip aksında) ve çevresini de kapsayan doku örnekleri, transvers kesit histolojik değerlendirme ve PCR ekspresyon analizi için 5 mm punch biyopsi işlemi ile başlangıçta, 4. ve 12. haftalarda elde edilmiştir. Histopatolojik olarak epidermis ve dermis kalınlıkları, dermisteki kollagen ve elastinin kalitatif düzeyleri ve dizilimleri, neokollagenez ve yeni elastin sentezi, yabancı cisim granulomları, fibröz kapsül yapısı, histiosit ve dev hücre formasyonu, fibroblast sayıları, inflamatuar hücreler incelenmiş ve kıyaslamalı olarak değerlendirilmiştir. Kollagen 1 (Col1A1), Kollagen-3 (Col3A1), elastin, matriks metalloproteinaz (MMP) 2 ve 9, Nüklear faktör kappa B (NF-κB), interlökin-6 (IL-6) değerleri RT-QPCR ile ölçülmüştür. İstatistiksel hesaplamalarda histopatolojik değerlendirme için SAS University Edition 9.4 programı kullanılarak yapılmış ve RT-qPCR analizi için web tabanlı "RT² Profiler™ PCR Array Data Analysis" programı kullanılmıştır. p<0.05 istatistiksel olarak anlamlı kabul edilmiştir. Bulgular Çalışma 18 sıçanla tamamlanmıştır. Histopatolojik olarak solar elastoz UV alan grupta anlamlı olarak yüksek çıkmıştır. Tüm uygulama alanlarında kollajenin kalitatif düzeyi ve organizasyonu kontrol alanı olan 1. alana kıyasla yüksek bulunmuştur. UV alan deney grubunda UV almayan kontrol gruba kıyasla kollajen histopatolojik olarak daha az ve daha dezorganize saptanmıştır. PCR incelemede Col1A1 ve Col3A1 düzeylerinde UV uygulamasının etkisiyle anlamlı düşüşler gözlenmiştir. İnflamasyon ve vaskülarizasyonda kontrol alana göre materyal uygulanan alanlarda anlamlı artışlar gözlenmiştir. Histopatolojik olarak kapsül yapısı, dev hücre granülomu ve yabancı cisim reaksiyonu da madde uygulanan alanlarda gözlenmiş ve gösterilmiştir. Sonuç Çalışma neticesinde yaşlanma ve fotoyaşlanmada etkili olabilecek PDO ip uygulama, HA dolgu maddesi ve BTX-A'nın deri ve derialtı dokuda meydana getirdikleri reaksiyonlar neticesinde kollajen liflerinin organize düzenlenmesi ve ekspresyonlarını artırması gösterilmiştir. Fotoyaşlanmayı gösteren solar elastozda ve NF-KB ekspresyonunda artış, tip 1 ve tip 3 kollajen düzeylerinde ise azalış anlamlı olarak gösterilmiştir. UV uygulanan grupta (fotoyaşlanma) tek başına dolgu uygulamasının, UV almayan grupta (fizyolojik yaşlanma) ip+dolgu kombine uygulamasının kronik dönemde (12.hafta) antiaging olarak daha effektif sonuçlar getirdiği gözlenmiştir.This project evaluates polydioxanone (PDO) thread, hyaluronic acid (HA) injection and botulinum toxin type A (BTX-A) practices via single and combined use and analyzes their positive or negative effects on skin and subcutaneous tissue, the synergistic or antagonistic impacts they have on each other during combined application and how these impacts may change during photo damage and photo aging processes caused by UV exposition. It is aimed to create a perspective to make a decision about the method on aging of human skin. Materials and Methods Our project includes Wistar albino rats (2-5 months, weighing 200-250 g, male, and 2 groups consisting of 10). The rats were taken care of and fed in Experimental Medicine Application and Research Centre (KONUDAM) in Necmettin Erbakan University. The skin on the back of all rats were separated into 5 equal parts and given numbers from 1 to 5. After shaving their backs, general anesthesia was induced through a suitable anesthetic agent. Area No. 1 is the control area and thread without needle was applied under the skin and removed from this location. On the Area No. 2, PDO thread application was realized on panniculus carnosus (PC) area of the rats. On the Area No. 3, HA material was applied as 0.02 ml intradermal injection. On the Area No. 4, both PDO thread application and HA 0.02 ml application during the same session were realized. PDO thread and HA 0.02 ml and BTX-A 1U was applied on the Are No. 5 within the same session. The same procedures were applied on 10 rats in the second group only once and then 320-400 nm wavelength UVA 138 mj/cm2 was applied 3 times per week, with combination of 290-320 nm wavelength UVB 130 mj/cm2 for 12 weeks. The general conditions of the rats in both groups were checked on a weekly basis. The tissue samples including the areas of and around the application will initially be obtained during the 4th and 12th weeks through 5 mm punch biopsy for the histological evaluation of transverse section. Histopathologically epidermis and dermis thickness, qualitative levels and alignment of collagen and elastin in dermis, neocollagenesis and new elastin synthesis, foreign body granulomas, fibrosis capsule structure, histiocyte and giant cell formation, fibroblast counts, inflammatory cells were examined and comparatively evaluated. Collagen 1, Collagen 3, elastin, MMP-2, MMP-9, NF-κB, IL-6 gene expression levels were measured. In the statistical analysis, SAS University Edition 9.4 for the histopathological assessments and "RT² Profiler™ PCR Array Data Analysis" for the RT-qPCR analysis were used. p<0.05 value were accepted significant. Results The study was completed with 18 rats. Histopathologically, solar elastosis was significantly higher in the group receiving UV. The qualitative level and organization of collagen in all application areas were found to be higher compared to the control area 1. In the experimental group receiving UV, collagen was less histopathologically less and more disorganized than the non-UV control group. In the PCR examination, significant decreases were observed in Col1A1 and Col3A1 levels due to the effect of UV application. In inflammation and vascularization, significant increases were observed in the areas where the material was applied compared to the control area. Histopathologically, capsule structure, giant cell granuloma and foreign body reaction were also observed and demonstrated in the areas where the substances were applied. Conclusion As a result of the study, it has been shown that PDO thread application, HA filler and BTX-A, which may be effective in aging and photoaging, increase the organized regulation and increase the expression of the collagen fibers. An increase in solar elastosis and NF-KB expression, which shows photoaging, and a decrease in type 1 and type 3 collagen levels were shown to be significant. It was observed that the application of filler alone in the UV treated group (photoaging), and the combination of the application of thread + filler in the non-UV receiving group (physiological aging) brought more effective results in the chronic period (week 12) as antiaging

Creative cities and the film industry: Antalya's transition to a Eurasian film centre

In the knowledge era, cites are competing to attract and retain creative industries and workers for securing their economic, social and urban growth as well as ensuring their creative city formation. During the last decade rapidly growing popularity of creative cities has encouraged many cities seeking creativity to specialise in specific sectors of the creative industries. In this context, the paper explores creativity strategies and the role of film industry in creative city formulation. Antalya, Turkey is investigated as an emerging film industry-oriented creative city due to recent industry developments, its natural and constructed assets and amenities along with its openness to creativity. This paper also examines some of the creative city examples, scrutinises potentials and constraints of Antalya and Turkish film industry, and provides discussion and recommendation for Antalya's transition to a Eurasian film centre