Improvement of Metabolic Syndrome Following Intragastric Balloon: 1 Year Follow-up Analysis

Objective  This study aimed to assess the impact of intragastric balloon (IGB)-induced body weight loss on metabolic syndrome in obese patients and evaluate what happens during 1-year follow-up. Methods  To this end, data were collected on 143 obese patients (body mass index (BMI) 36.2 ± 5.7 kg/m2) who underwent IGB insertion between January 2000 and December 2005. Outcomes were recorded at BioEnterics Intragastric Balloon removal time (t ₀) and at 6-month (t ₆) and 12-month (t ₁₂) follow-up. Results  Significant BMI, excess body weight loss percentage, and body weight loss percentage (BWL%) were observed at t ₀ (29.6 ± 4.6 kg/m2; 29.3 ± 4.8%; 14.1 ± 5.7%), followed by partial weight regain at t ₁₂ (32.4 ± 4.3 kg/m2; 26.1 ± 4.9%; 11.2 ± 4.6%). Incidence of metabolic syndrome dropped from 34.8% (pre-IGB value) to 14.5% (t ₀) and 11.6% (t ₁₂). Likewise, type 2 diabetes mellitus (DM), hypertriglyceridemia, hypercholesterolemia, and blood hypertension (BH) incidence decreased from 32.6%, 37.7%, 33.4%, and 44.9% (pre-IGB values) to 20.9%, 14.5%, 16.7%, and 30.4% at t ₀ and 21.3%, 17.4%, 18.9%, and 34.8% at t ₁₂. HbA1c blood concentration shifted from an initial value of 7.5 ± 2.1% to 5.7 ± 1.9% (t ₀), 5.6 ± 0.7% (t ₆), and 5.5 ± 0.9% (t ₁₂). Patients suffering from DM or BH stopped or diminished relative drug consumption at t _12. Negligible modifications were reported as regards HDL cholesterol and hyperuricemia. Conclusion  Weight regain is commonly observed during long-term follow-up after IGB removal. Nevertheless, the maintenance of at least 10% of the BWL%, as reported at 1-year follow-up, is associated with an improvement in metabolic syndrome.     

Na, K ATPase beta3 subunit (CD298): association with alpha subunit and expression on peripheral blood cells

Beta3 subunit is described as one of the Na, K ATPase subunits. Recently, we generated a monoclonal antibody (mAb), termed P-3E10. This mAb was shown to react with the Na, K ATPase beta3 subunit or CD298. By immunofluorescence analysis using mAb P-3E10, it was found that all peripheral blood leukocytes express Na, K ATPase beta3. The presence of beta3 subunit on leukocytes is not in a quantitative polymorphic manner. Upon phytohemagglutinin or phorbol myristate acetate activation, the expression level of the Na, K ATPase beta3 subunit on activated peripheral blood mononuclear cells was not altered in comparison with those of unstimulated cells. Red blood cells (RBCs) of healthy donors showed negative reactivity with mAb P-3E10. However, more than 80% of thalassemic RBCs showed positive reactivity. By immunoprecipitation, moreover, a protein band of 55-65 kDa was precipitated from normal RBC membrane using mAb P-3E10. These results evidenced that the beta3 subunit of Na, K ATPase is expressed on RBC membrane but the epitope recognized by mAb P-3E10 is hidden in normal RBCs. Furthermore, we showed the association of beta3 subunit and alpha subunit of Na, K ATPase. This information is important for further understanding of the functional roles of this molecule.     

Villoglandular papillary adenocarcinoma of the uterine cervix with immunohistochemical characteristics

Villoglandular papillary adenocarcinoma of uterine cervix has been recently described and to date fewer than a hundred cases have been reported in the world literature. Here we present a 38-year-old woman who underwent radical hysterectomy combined bilateral pelvic lymphoadenectomy and after 28 months postoperatively no lymph node metastasis and no evidence of recurrent disease ocurred. Immunohistochemically Ki-67 overexpression was detected in the tumour, with no immunoreactivity with p53, estrogen and progesteron receptors and broadly-reactive human papilloma virus including types 6, 11, 16, 18, 31, 33, 42, 51, 52, 56, and 58. In this paper, clinical, macroscopical, microscopical and immunohistochemical characteristics of this tumour are reviewed.     

Ovarian function and vascular resistance after tubal sterilization

OBJECTIVE: To investigate the effect of tubal sterilization (laparoscopic bipolar coagulation) on serum baseline follicle-stimulating hormone (FSH) and estradiol levels, ovarian volume, antral follicle counts and ovarian artery blood flow rate and to evaluate the correlation of these parameters. STUDY DESIGN: Nineteen women who underwent tubal sterilization with laparoscopic bipolar coagulation were enrolled in the study. Ovarian volume, antral follicle counts, serum hormone levels and ovarian artery resistivity index values were measured before and 1 year after the sterilization procedure on the third day of the menstrual cycle. RESULTS: Serum hormone levels, mean ovarian volume (MOV) and mean follicle counts (MFC), were not statistically significant before and 1 year after the operation (P > .05). The difference in ovarian artery resistivity index values was not statistically significant before and 1 year after the operation (P > .05). A significant correlation was observed between FSH, MOV and MFC before and after the operation (P < .05). No correlation was observed between MOV or MFC and resistivity index. CONCLUSION: Ovarian function and vascular resistance do not seem to be affected by laparoscopic bipolar tubal coagulation.     

Is stress urinary incontinence a familial condition?

BACKGROUND: Stress urinary incontinence (SUI) is a common problem of multifactorial origin. Some authors have claimed that it has a familial predisposition. This study was undertaken to investigate the prevalence of SUI among first-degree relatives of 154 women who had been operated on for this disorder and of 100 women without SUI. METHODS: This report is concerned with a questionnaire-based, case-control study. A total of 154 women who had undergone operations for SUI and 100 women who denied having SUI were included. A comparison was made of 413 first-degree relatives of incontinent women and 372 first-degree relatives of continent women according to the demographic characteristics, obstetric and gynecologic history and risk factors for SUI. The prevalence of SUI was investigated among the relatives. Furthermore, the characteristics of the women who had SUI operation were compared according to the continence state of their families. RESULTS: The prevalence of SUI was 71.4% among mothers and 24.6% among sisters of operated women compared with 40.3% among mothers and 11.6% among sisters of continent women (p < 0.05). Furthermore, the age at which symptoms began was significantly lower in the members of the 'incontinent families' (p < 0.001). CONCLUSIONS: The relatives of incontinent women displayed a higher prevalence of SUI than the relatives of continent women. Although this condition has a multifactorial origin, the familial aggregation of SUI and the appearance of symptoms at younger ages in women with a family history of SUI suggest that heredity may play a significant role.     

Microbiology of cerumen in patients with recurrent otitis externa and cases with open mastoidectomy cavities

This study investigated the common flora of human cerumen in patients with recurrent otitis externa, and subjects who had been operated on and had an open mastoidectomy cavity from chronic otitis media. Cerumen samples were collected from three groups; group A (n = 20) consisted of patients with recurrent otitis externa, group B (n = 20) consisted of patients with an open cavity and group C (n = 30) consisted of healthy subjects. The mean of the microbial count was 3.4 x 10(4) in group A, 3.08 x 10(4) in group B and 2.48 x 10(4) in group C. The most commonly isolated microorganism from the three groups was Staphylococcus epidermidis. No growth was observed in five cases (25 per cent) in group A and in three cases (10 per cent) in group C. In group B antimicrobial growth was observed in all samples. In 46 (65 per cent) of the cerumen samples, the isolates were monomicrobial and 24 (35 per cent) of the cerumen samples were polymicrobial. The isolates were polymicrobial in 65 per cent of group A, 20 per cent in group B and 23.3 per cent in group C. In the process of investigating the microbial flora of cerumen in all the three groups, microbial growth was observed from all the samples from patients with an open cavity, unlike the other groups, and it was determined that the group with recurrent external otitis had the most abundant microbial flora.     

A modified sandwich ELISA for accurate measurement of HbF in α-thalassemia carriers containing Hb Bart’s and Hb Portland 1

Hemoglobin F (HbF) in blood lysate can be accurately measured by various methods, including immunoassay. In this study, we have produced polyclonal antibody (pAb) against HbF and established a modified sandwich-type ELISA for HbF quantification in blood lysates. The modified sandwich ELISA utilized anti-γ-globin monoclonal antibody clones Thal N/B as the capture antibody (Ab) coated on solid-phase, fluorescein isothiocyanate (FITC)-labeled pAb as the detecting Ab, and HPR-labeled anti-FITC Ab as the signal-generating Ab. By using an optimized blood lysate dilution, the HbF could be measured with no interference from hemoglobin Bart’s (Hb Bart’s) and hemoglobin Portland (Hb Portland 1) presented in α-thalassemia carriers. HbF levels measured by the modified sandwich ELISA were comparable to those quantified by the standard cation-exchange high performance liquid chromatography. We suggested that this modified sandwich ELISA was able to accurately measure HbF levels even in α-thalassemia carriers containing Hb Bart’s and Hb Portland 1 and be an alternative method for HbF measurement.