Apolipoprotein E gene polymorphism and polycystic ovary syndrome patients in Western Anatolia, Turkey

Purpose  Dyslipidemia, cardiovascular disease and hypertension are more frequently seen in patients with PCOS than in normal patients. We aimed at evaluating the distribution of Apo E alleles that can influence cardiovascular risk of the PCOS patients and control subjects. Methods  In this study, 129 young women with PCOS and 91 healthy women were included. In all subjects we performed hormonal, biochemical and Apo E genetic analysis. Results  The Apo E3 allele was found at a significantly higher frequency in the PCOS patient group compared with the control group. The Apo E2 allele was found at a significantly higher frequency in the control group compared with the patient group with PCOS. Conclusions  Although there were genotype and allele differences between control and patient groups in this study, no statistically significant change was determined in lipid and other cardiovascular risk factors in connection with allele and genotype.     

The correlation between birth weight and insulin-like growth factor-binding protein-1 (IGFBP-1), kisspeptin-1 (KISS-1), and three-dimensional fetal volume

Purpose: This study aimed to determine the relationship between birth weight, and maternal serum insulin-like growth factor-binding protein-1 (IGFBP-1) and kisspeptin-1 (KISS-1) levels, and first-trimester fetal volume (FV) based on three-dimensional ultrasonography.

Materials and methods: The study included 142 pregnant women at gestational week 11°–13⁶. All fetuses were imaged ultrasonographically by the same physician. Maternal blood samples were collected at the time of ultrasonographic evaluation and analyzed for IGFBP-1 and KISS-1 levels via enzyme-linked immunosorbent assay (ELISA). Maternal and neonatal weights were recorded at birth. Birth weight ≤10th and the >90th percentiles was defined as small and large for gestational age (SGA and LGA), respectively.

Results: Median crown-rump length (CRL), FV, and maternal serum IGFBP-1 and KISS-1 levels were 58.2?mm (35.3–79.2?mm), 16.3?cm³ (3.8–34.4?cm³), 68.1?ng?mL^?1 (3.8–377.9?mL^?1), and 99.7?ng?L^?1 (42.1–965.3?ng?L^?1), respectively. First-trimester IGFBP-1 levels were significantly lower in the mothers with LGA neonates (p?p?>?.05). The maternal IGFBP-1 level during the first trimester was a significant independent factor for SGA and LGA neonates (Odds ratio (OR): 0.011, 95%CI: 1.005–1.018, p?p?=?.007, respectively). There was no significant relationship between SGA or LGA, and CRL, FV, or the KISS-1 level.

Conclusions: As compared to the maternal KISS-1 level, the maternal IGFBP-1 level during the first trimester might be a better biomarker of fetal growth. Additional larger scale studies are needed to further delineate the utility of IGFBP-1 as a marker of abnormal birth weight.     

Elevated mean platelet volume is associated with gestational diabetes mellitus

The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Elevated MPV values are associated with larger and more active platelets and perceived as a new independent cardiovascular risk factor. The aim of this study was to determine the MPV in women with gestational diabetes mellitus (GDM) and to determine the correlation of MPV with metabolic parameters in GDM. We retrospectively analyzed 30 women with GDM and 38 body mass index-matched women with healthy pregnancies as controls. MPV and platelet counts were recorded in the third trimester and at postpartum 6–12 months for GDM group and in the third trimester for control group. Third-trimester MPV was significantly higher in GDM group compared to control group (8.8?±?1.0 versus 8.1?±?0.7?fl, p?=?0.002). In women with GDM, there was a significant decrease in MPV in the postpartum period (8.8?±?1.0 versus 8.1?±?0.8?fl, p?r?=?0.346, p?=?0.007 and r?=?0.346, p?=?0.02, respectively). Our results indicate that MPV is increased in GDM. Monitoring MPV, which is widely available in clinical practice, may potentially identify women who will develop gestational diabetes during pregnancy.     

Dermoscopic and clinical features of head and neck melanoma

BACKGROUND

The dermoscopic criteria of extrafacial melanomas are well-known.

OBJECTIVE

To determine the frequency of dermatoscopic findings in head and neck melanomas (HNM) and to assess the distinguishing dermoscopic criteria of facial and extrafacial melanoma.

METHODS

This observational study included 108 patients with HNM (63% male, mean age 64 years). Participants underwent individual dermoscopic imaging of clinically melanoma. All lesions were excised, and histopathological examination was performed on all specimens.

RESULTS

Drawing on histopathological analysis, lentigo maligna melanoma or lentigo maligna was diagnosed in 60 lesions, superficial spreading melanoma in 18, nodular in 10, desmoplastic in 8, superficial spreading melanoma in situ in 12. The most frequent location for head and neck melanoma was the cheek (60 patients, 55.6%). Eight prominent dermatoscopic features were observed in facial melanoma: annular-granular pattern (18%); rhomboidal structures (29%); pseudonetwork (29%); asymmetrical, pigmented, follicular openings (51%); obliterated hair follicles (8%); red rhomboidal structures (18%); increased density of the vascular network (32%); scar-like depigmentation (59%).

CONCLUSIONS

HNM has specific dermoscopic features, and classical extrafacial dermoscopic rules are less useful for diagnosis of facial melanoma. In our study, further characteristic dermatoscopic findings were detected in facial melanoma such as low frequencies of irregular dots, 2 or fewer colors in lesions, the presence of pseudonetwork, increased density of the vascular network, red rhomboidal structures, in addition to dermatoscopic findings of extrafacial melanoma. Thus, it is concluded that the prediction and identification of HNM may be evident with the help of these signs.     

Validity, reliability, and comparison of the WOMAC osteoarthritis index and Lequesne algofunctional index in Turkish patients with hip or knee osteoarthritis

To assess validity and reliability of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis (OA) index and Lequesne algofunctional index in Turkish patients with hip or knee OA and to compare the results of the instruments for these two particular sites of involvement. Two disease-specific instruments: WOMAC LK 3.1 and Lequesne indices were administered to 117 outpatients with OA (44 hip and 73 knee) living in Turkey. These indices were administered twice 7–10 days apart to ensure the test–retest reliability. All patients were asked to reply a generic health-related quality-of-life instrument (Short Form-36, SF-36) and a structured interview assessing demographic and other characteristics. Internal consistency and reliability was evaluated by Cronbach’s alpha and intra-class correlation coefficients (ICC). Construct validity was tested by correlating the WOMAC or Lequesne with each other, and also with SF-36 and visual analog scale (VAS). The Cronbach’s alphas of the WOMAC and Lequesne subscales were ranged 0.78–0.95 and 0.51–0.85 for hip and 0.78–0.94 and 0.61–0.71 for knee OA, respectively. Test–retest reliability of the WOMAC and Lequesne subscales yielded ICCs of 0.77–0.94 and 0.51–0.85 for hip and 0.80–0.98 and 0.61–0.71 for knee OA, respectively. WOMAC and Lequesne showed moderate-good correlations between comparable subscales of SF-36 (physical functioning and bodily pain) and weak-moderate correlations between VAS. All subscales and total WOMAC had better internal consistency and more satisfactory concurrent validity compared with Lequesne. Our results indicated that WOMAC is a more reliable index for use in Turkish patients with hip or knee OA than Lequesne.     

Simvastatin Improves Wound Strength after Intestinal Anastomosis in the Rat

Background  Simvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor commonly known as a cholesterol-lowering drug with additional pleiotropic effects. Also, it is demonstrated that it prevents postoperative peritoneal adhesions in rat. This study was designed to assess its effects on the healing process of colonic anastomosis. Methods  Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with simvastatin and the control group received only tap water instead. The rats were killed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline content, histopathology, and biochemical analysis. Results  Compared to the control group, simvastatin-treated rats displayed a higher bursting pressure (p < 0.001) and anastomotic hydroxyproline content (p < 0.05). Simvastatin treatment leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.001) at both time points. Histopathological analysis revealed that simvastatin administration leads to a better anastomotic healing in terms of reepithelialization, decreased granuloma formation, reduced ischemic necrosis, and inflammatory infiltration to muscle layer. Conclusion  Clinically relevant doses of simvastatin do not have a negative impact on colonic anastomosis but improve intestinal wound healing in rats. Oral presentation at the “Turkish National Surgery Congress”, Antalya, Turkey, May 2008.     

Obstructive jaundice leads to accumulation of oxidized low density lipoprotein in human liver tissue

Oxidized low density lipoprotein (ox-LDL) molecule is one of the most important modified lipoproteins produced during the oxidative stress. Modified lipoproteins have been defined as being part of the immune inflammatory mechanisms in association with oxidant stress. We have reported the accumulation of ox-LDL in Balb/c mice liver after bile duct ligation previously. Here, we investigated this finding in human beings with obstructive jaundice. Our study demonstrates that obstructive jaundice results in tremendous accumulation of ox-LDL in the liver tissue of patients.