The Use of Human Epididymis 4 and Cancer Antigen 125 Tumor Markers in the Benign or Malignant Differential Diagnosis of Pelvic or Adnexal Masses

Background: Ovarian cancer is one of the highest mortality cancers in gynaecology. Discrimination of benign masses from malignant ones may sometimes become a challenge for the clinician since there is not a reliable tumour marker, thus some unnecessary, highly morbid operations can be performed. Aims: To explore the efficacy of human epididymis 4 (HE 4) and cancer antigen 125 (CA 125) markers in differentiating malignant and benign pelvic masses of ovarian origin and to identify the cut-off points for those markers. Study Design: Prospective study. Methods: Fifty-one patients who were diagnosed and planned to undergo surgery for ovarian mass between June 2008 and December 2008 were enrolled into this study. Preoperative venous blood samples were taken and frozen for marker investigation and final diagnoses were concluded by histopathological examination. After recruitment of all cases CA 125 and HE 4 levels were evaluated. Results: The statistical analysis did not indicate any statistically significant difference between the CA 125 levels of the patients with malignant and benign adnexal masses (p=0.105). The HE 4 levels of the patients with malignant adnexal masses were higher at a statistically significant level compared to the patients with benign adnexal masses (p=0.002). For HE 4 tumour marker and at the cut-off point of >25 pM, sensitivity was 1, specificity 0.40, positive cut-off value 0.19, negative cut-off value 1, accuracy 0.47 and positive likelihood ratio 1.65. Conclusion: Human epididymis 4 is a better diagnostic tool than CA 125 in benign-malignant discrimination of adnexal masses. The cut-off value of 25 pmol/L for human epididymis 4 will contribute to providing proper guidance to patients with adnexal masses and applying the proper treatment method

Yeni medyanın toplumsal yansımaları

Yeni medya, hayatımızın her alanında etkisini gösteren ve değiştiren bir olgu haline gelmiştir. Günümüzde insanlar, haberlerini, bilgilerini ve iletişimlerini yeni medya araçları aracılığıyla alıp vermektedirler. Bu araçlar, çok çeşitli işlevleri yerine getirerek kullanıcılarına hız, çeşitlilik, çok seslilik, derinlik, yeni katmanlar, kolaylıklar ve çeşitli seviyelerde iletişim imkanları sunmaktadır. Ancak bu avantajların yanı sıra, yeni medya araçları beraberinde çeşitli sorunları da getirmektedir. Özellikle sosyal medya platformları, kişisel bilgilerin paylaşımı, zorbalık, nefret söylemi ve özel hayatın ihlali gibi güvenlik sorunlarını da beraberinde getirmektedir. Bunun yanı sıra, sosyal medya üzerinden yayılan yanlış bilgiler, manipülasyon ve sahte haberler, hakikatin Önemsizleşmesi gibi sorunları da ortaya çıkarmaktadır..

Distribution of RET mutations and evaluation of treatment approaches in hereditary medullary thyroid carcinoma in Turkey

Objective: This retrospective multicenter study, centrally conducted and supported by the Society of Endocrinology and Metabolism of Turkey, aimed to evaluate the impact of free RET proto-oncogene testing in medullary thyroid carcinoma (MTC) patients. Surgical timing, adequacy of the treatment, and frequency of prophylactic thyroidectomy (PTx) in mutation carriers were also assessed. Methods: Genetic testing for MTC and pheochromocytoma was conducted between July 2008 and January 2012 in 512 patients. Application forms and RET mutation analyses of these patients whose blood samples were sent from various centers around Turkey were assessed retrospectively. An evaluation form was sent to the physicians of the eligible 319 patients who had confirmed sporadic MTC, familial MTC (FMTC), multiple endocrine neoplasia type 2 (MEN2), or who were mutation carriers. Physicians were asked to give information about the surgical history, latest calcitonin levels, morbidity, mortality, genetic screening, and PTx among family members. Twenty-five centers responded by filling in the forms of 192 patients. Results: Among the 319 patients, RET mutation was detected in 71 (22.3%). Cys634Arg mutation was the most prevalent mutation (43.7%), followed by Val804Met in 18 patients (25.4%), and Cys634Tyr in 6 patients (8.5%). Among 192 MTC patients, the diagnosis was sporadic MTC in 146 (76.4%), FMTC in 14 (7.3%), MEN2A in 15 patients (7.9%), and MEN2B in one patient. The number of mutation carriers among 154 apparently sporadic MTC patients was 8 (5.2%). Ten patients were submitted to PTx out of twenty-four mutation carriers at a mean age of 35 +/- 19 years. Conclusion: Turkish people have a similar RET proto-oncogene mutation distribution when compared to other Mediterranean countries. Despite free RET gene testing, the number of the PTx in Turkey is limited and relatively late in the life span of the carriers. This is mainly due to patient and family incompliance and incomplete family counselling.SEM

The role of renal hypoperfusion in development of renal microcirculatory dysfunction in endotoxemic rats

To study the role of renal hypoperfusion in development of renal microcirculatory dysfunction in endotoxemic rats. Rats were randomized into four groups: a sham group (n = 6), a lipopolysaccharide (LPS) group (n = 6), a group in which LPS administration was followed by immediate fluid resuscitation which prevented the drop of renal blood flow (EARLY group) (n = 6), and a group in which LPS administration was followed by delayed (i.e., a 2-h delay) fluid resuscitation (LATE group) (n = 6). Renal blood flow was measured using a transit-time ultrasound flow probe. Microvascular perfusion and oxygenation distributions in the renal cortex were assessed using laser speckle imaging and phosphorimetry, respectively. Interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α were measured as markers of systemic inflammation. Furthermore, renal tissue samples were stained for leukocyte infiltration and inducible nitric oxide synthase (iNOS) expression in the kidney. LPS infusion worsened both microvascular perfusion and oxygenation distributions. Fluid resuscitation improved perfusion histograms but not oxygenation histograms. Improvement of microvascular perfusion was more pronounced in the EARLY group compared with the LATE group. Serum cytokine levels decreased in the resuscitated groups, with no difference between the EARLY and LATE groups. However, iNOS expression and leukocyte infiltration in glomeruli were lower in the EARLY group compared with the LATE group. In our model, prevention of endotoxemia-induced systemic hypotension by immediate fluid resuscitation (EARLY group) did not prevent systemic inflammatory activation (IL-6, IL-10, TNF-α) but did reduce renal inflammation (iNOS expression and glomerular leukocyte infiltration). However, it could not prevent reduced renal microvascular oxygenatio

INVESTIGATION OF A QUADRATIC FORM FACE MANUFACTURING ON CNC MILLING MACHINES

The study aims the manufacture of an elliptical cone shaped with A.X B.Y C.Z 0 2 2 2 + - = quadratic general equation on CNC milling machines. It shows how a CAM program can be developed using the Fanuc system macros for this special case. For the implementation, the program was run on a vertical machining center CNC milling machine, Dyna 2900 Myte machine and the results were evaluated

Maahanmuuttajataustaisten perheiden toiveita uudelle perhekeskukselle

Opinnäytetyön tarkoituksena oli tuottaa kooste maahanmuuttajataustaisten lapsiperheiden toiveista uudelle perhekeskukselle. Kysely toteutettiin keväällä 2020. Kyselytutkimuksen kysymykset oli laadittu etukäteen Laurea-ammattikorkeakoulun lehtorin ja Espoon kaupungin ylihoitajan kesken. Tavoitteena oli selvittää palveluita ja sähköisiä palveluita, joita perheet toivoisivat perhekeskuksen tarjoavan. Tavoitteena oli myös selvittää tilatoiveet sekä toiveita moniammatillisista asiantuntijoista. Suomi otti käyttöön perhekeskustoimintamallin vuonna 2002. Perhekeskuksen tarkoituksena on edistää perheiden ja lasten terveyttä ja hyvinvointia. Perhekeskus mahdollistaa vertaistuen ja yhteisöllisyyden vahvistamista. Opinnäytetyön tutkimusote oli kvalitatiivinen. Aineistonkeruumenetelmänä käytettiin kyselylomaketta, jossa oli avoimia kysymyksiä. Kysely toteutettiin verkossa ja vastauksia saatiin kolmekymmentä. Kohderyhmänä toimii maahanmuuttajataustaiset lapsiperheet, joita löytyi lähipiiristä, tuttujen keskuudesta sekä sosiaalisen median ryhmistä. Kyselylomake käännettiin myös viron kielelle, lähestyäkseen vironkielisiä maahanmuuttajataustaisia lapsiperheitä. Analysoitaessa ainestoa nousi selkeästi esiin, että maahanmuuttajataustaiset perheet toivoivat uuden perhekeskuksen olevan kutsuva ja kodinomainen. Perheet toivoivat palveluiden saannin olevan helppoa, yksinkertaista ja mahdollisesti omalla äidinkielellään. Maahanmuuttajataustaisten perheiden mielestä sähköisten palveluiden kuuluisi olla yksinkertaisia ja helppoja. Asiantuntijoiden suhteen maahanmuuttajataustaiset lapsiperheet kokivat sosiaalityöntekijöiden ja erilaisten terapeuttien palveluista olevan hyötyä. Opinnäytetyössä kyselylomakkeen kysymyksiin vastaaminen saattoi tuntua työläältä ja kysymyksiä saatettiin ymmärtää eri tavalla kuin kysyjä oli alun perin tarkoittanut. Tutkielmassa nousi esille perheiden tietämättömyys perhekeskuksen toimintaa kohtaan. Opinnäytetyötä voitaisiin jatkaa toiminnallisena tai määrällisenä

Efficacy of 50-G Glucose Challenge Test in The Diagnosis of Gestational Diabetes Mellitus

Aim: Our aim in this study was to investigate the efficacy of 50 g glucose challenge test (GCT) in the diagnosis of gestational diabetes mellitus (GDM) and to determine a cut-off value for screening. Methods: 50-g GCT was performed in 444 pregnant women at 24-28 gestational weeks. The threshold was taken as 130 mg/dl in order not to miss GDM cases. A plasma glucose level of ≥130 mg/dl at the first hour was considered to be a positive result and 100-g oral glucose tolerance test (OGTT) was given to these women. Results: The cut-off value for 50-g GCT was found to be 145 mg/dl. The sensitivity and specificity of the test for predicting GDM at the levels of ≥145 mg/dl were determined to be 96.30% and 80.34%, respectively. The sensitivity and specificity of the test at the level of 88 mg/dl determined for fasting blood glucose cut-off value were found to be 48.15% and 70.84%, respectively. Conclusion: It was concluded that the efficacy in making diagnosis of GDM was increased at the first hour blood glucose levels of ≥145 mg/dl, especially in 50-g GCT, and fasting blood glucose level could not be a good screening test for GDM. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 181-6

Maternal and fetal outcomes in pregnancies with pulmonary hypertension: Experience of a tertiary center

Objective: Pregnancies complicated with PHT are serious debates for obstetricians due to high maternal and fetal complication potentials. The aim of the study was to present our maternofetal outcomes in pregnant women with pulmonary hypertension. Materials and methods: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department. Results: The average age was 27.09 ± 6.97 (range: 14–38) years. The most frequent maternal cardiac pathologies were cardiac valvular disease (mitral or aortic insufficiency) (n = 4), atrial septal defect (n = 3), mitral stenosis (n = 3), ventricular septal defect (n = 2) and arrhythmia (n = 2). Caesarean section and normal vaginal delivery were performed in 13 and 7 deliveries, respectively. Therapeutic dilatation and curettage was performed in 3 patients. Preterm delivery occurred in 4 pregnancies and there were 2 intrauterine growth retardations, 1 preeclampsia and 2 maternal pulmonary edemas. One patient underwent re-laparotomy 5 days after delivery due to uterine hematoma. Totally, 20 newborns (14 female, 6 male) were delivered. Most of the complications were seen in advanced PHT classes. Conclusion: The care of the pregnant women with PHT necessitates a well-planned, multidisciplinary approach focusing on close monitoring before, during and after delivery. This approach may contribute to reduction of poor maternal and fetal outcomes

Efficacy of native entomopathogenic nematodes from Turkey against the alder leaf beetle, Agelastica alni L. (Coleoptera: Chrysomelidae), under laboratory conditions

Abstract The alder leaf beetle, Agelastica alni L. (Coleoptera: Chrysomelidae), is one of the most defoliator pests of oak and alder trees. In the present study, the efficacies of three native strains of entomopathogenic nematodes, Heterorhabditis bacteriophora (ZET35), Steinernema feltiae (ZET31), and Steinernema websteri (AS-1), were tested against pre-pupae and adults of A. alni. Experiments were conducted by four concentrations under laboratory conditions in 2015. Four different temperature regimes were tested at concentration of 1000 infective juveniles (IJs)/ml under laboratory conditions. It was observed that pre-pupae were more sensitive than adults in all tests. Based on screening tests, S. websteri was the most effective isolate on both pre-pupae and adults of A. alni at concentration of 1000 IJs/ml with 79.17 and 71.11% mortality, respectively. It caused the highest mortality values at all temperatures, except for 30 °C against pre-pupae and adults. Results of the present study suggested that S. websteri and H. bacteriophora had significant potentials against A. alni

Genome sequence analysis of a Helicoverpa armigera single nucleopolyhedrovirus (HearNPV-TR) isolated from Heliothis peltigera in Turkey.

The entire genome of Helicoverpa armigera single nucleopolyhedrovirus (HearNPV-TR) was sequenced, and compared to genomes of other existing isolates. HearNPV-TR genome is 130.691 base pairs with a 38.9% G+C content and has 137 open reading frames (ORFs) of ≥ 150 nucleotides. Five homologous repeated sequences (hrs) and two baculovirus repeated ORFs (bro-a and bro-b) were identified. Phylogenetic analysis showed that HearNPV-TR is closer to HaSNPV-C1, HaSNPV-G4, HaSNPV-AU and HasNPV. However, there are significant differences in hr3, hr5 regions and in bro-a gene. Pairwise Kimura-2 parameter analysis of 38 core genes sequences of HearNPV-TR and other Helicoverpa NPVs showed that the genetic distances for these sequences were below 0.015 substitutions/site. Genomic differences as revealed by restriction profiles indicated that hr3, hr5 regions and bro-a gene may play a role in the virulence of HearNPV-TR