The use of family planning methods in an administrative district of Istanbul.

In Turkey, the first population and family planning law was accepted by the government in 1965, and this law was revised in 1982. This study was carried out to evaluate the family planning methods of women who applied to rural health centers of Kü?ük?ekmece and were willing to use the health-care service and consultancy about birth control methods. The data of the study were gathered by means of an appropriate inquiry form and face-to-face interview with the women willing to use the family planning service between September 1998 and June 1999 at the health-care centers of Kü?ük?ekmece of Istanbul. There were 699 women participants in the study. The last pregnancy of 27.2% (n = 175) of the women had been undesired; 86.8% of all the women who participated in the study declared that they did not desire any more children, but only 81.3% (n = 568) out of these were using a method to protect from pregnancy. The most frequently known (84.8%) and used (45.9%) method of the participants was an intrauterine device (IUD), and 80.8% of the women using an IUD wanted to continue using that method. A total of 223 women (39.3%) using any method protecting from pregnancy became pregnant. Approximately half (57.8%) of those occurred during the use of withdrawal. According to the findings of this study, the level of knowledge about family planning and the consequent behavior of the women within the fertile age group are better than the average of Turkey, but still not satisfactory.     

Comparison of Intramuscular and Intradermal Applications of Hepatitis B Vaccine in Hemodialysis Patients

This study compared the application of intramuscular recombinant hepatitis B vaccine in hemodialysis patients with the application of accelerated intradermal recombinant hepatitis B vaccine, which can be applied with one-tenth of the standard dose. Sixty seronegative patients for hepatitis B were randomly separated into two groups. Twenty μg of the recombinant hepatitis B vaccine was intramuscularly applied at 0-, 1-, 2-, and 6-month intervals to the first group (32 cases). One more dose was applied at month 12 to those whose anti-HBs titers remained below 100 mIU/mL at month 7. The same vaccine was intradermally applied at 2μg dose six times with one-month intervals to the second group (28 cases). Vaccine applications were continued in those whose anti-HBs titers remained below 100 mIU/mL at month 7 until antibody titers reached above this value or until the dose number became 12. Measurements of antibody titers were repeated at month 13 in both groups. As a result, in the vaccination of hemodialysis patients against hepatitis B, the accelerated ID application of hepatitis B vaccine with a dose reduced to one-tenth is more cost-effective than the standard dose vaccination schedules. Especially for hemodialysis patients, the time has come for routine application of ID hepatitis B vaccine as an alternative vaccination method.     

Magnetic resonance imaging findings of breast juvenile papillomatosis

Juvenile papillomatosis is a rare disease affecting young women. Here we present magnetic resonance imaging features of two cases with histopathologically proven juvenile papillomatosis of the breast and review some of the relevant literature. Case 1 exhibited bilateral, well-bordered breast masses, with complex cystic and solid components. The kinetic evaluation showed continuous and plateau patterns. Case 2 featured a giant mass with a few cystic and many solid nodular components and filled the entire right breast. The kinetic evaluation showed a continuous curve.     

Breast lesions with high signal intensity on T1-weighted MR images

Magnetic resonance imaging of the breast supplies much information concerning the signal characteristics of a lesion. Among these, high signal intensity on non-fat saturated T1-weighted imaging (WI) is a special finding. Such a finding may result from different causes, such as a paramagnetic substance or fatty, bloody or proteinaceous content. In this article, we present hyperintense breast lesions on T1-WI.     

Use of the Brucella IgM and IgG flow assays in the serodiagnosis of human brucellosis in an area endemic for brucellosis

The clinical utility of two complementary tests for brucellosis, the Brucella IgM and IgG flow assays, was evaluated in a hospital in eastern Turkey. The results show that the flow assays are convenient diagnostic tests for use in endemic areas. A positive result in the flow assays was obtained in 91% and 97% of the admission sera from adult and pediatric patients with brucellosis, respectively, and the sensitivity at admission was 100% for culture-confirmed brucellosis. The assay system performed equally well in diagnosing patients at different stages of illness including patients with acute, subacute, or chronic disease and with relapse. The results of the flow assays correlated well with those of a serum agglutination test at a cut-off > or =1:160. The agreement was 92%. Application of the flow assays on serum samples collected during a village survey for brucellosis after an outbreak demonstrated their diagnostic potential as field tests.     

Lymphatic reprogramming of microvascular endothelial cells by CEA-related cell adhesion molecule-1 via interaction with VEGFR-3 and Prox1

Here, we demonstrate that carcinoembryonic antigen-related cell adhesion molecule-1 (CEACAM1) is expressed and co-localized with podoplanin in lymphatic endothelial cells (LECs) of tumor but not of normal tissue. CEACAM1 overexpression in human dermal microvascular endothelial cells (HDMECs) results in a significant increase of podoplanin-positive cells in fluorescence-activated cell sorting analyses, while such effects are not observed in CEACAM1 overexpressing human umbilical vein endothelial cell (HUVECs). This effect of CEACAM1 is ceased when HDMECs are transfected with CEACAM1/y- missing the tyrosine residues in its cytoplasmic domain. CEACAM1 overexpression in HDMECs leads to an up-regulation of vascular endothelial growth factor C, -D (VEGF-C, -D) and their receptor vascular endothelial growth factor receptor 3 (VEGFR-3) at mRNA and protein levels. HDMECs transfected with CEACAM1 but not those with CEACAM1/y- show enhanced expression of the lymphatic markers Prox1, podoplanin, and LYVE-1. Furthermore, Prox1 silencing in HDMECs via small interfering RNA blocks the CEACAM1-induced increase of VEGFR-3 expression. Number and network of endothelial tubes induced by VEGF-C and -D are enhanced in CEACAM1-overexpressing HDMECs. Moreover, VEGF-A treatment of CEACAM1-silenced HDMECs restores their survival but not that with VEGF-C and VEGF-D. These data imply that the interaction of CEACAM1 with Prox1 and VEGFR-3 plays a crucial role in tumor lymphangiogenesis and reprogramming of vascular endothelial cells to LECs. CEACAM1-induced signaling effects appear to be dependent on the presence of tyrosine residues in the CEACAM1 cytoplasmic domain.     

How were lipofilling cannulae designed and are they as safe as we believe?

Background:

Most practitioners in plastic surgery believe that blunt tipped cannulae are safer. Interestingly, there is no study about their safety, and the problem is exactly this. As the use of blunt tipped cannulae is somehow difficult, some surgeons try other extreme alternatives, such as sharp and cutting tipped injection needles. But, they can cause complications such as vessel damage. According to these hypotheses, we tried to design a cannula which would ease the application of lipofilling and which would minimise the trauma. Contrary to the injection needle, the tips of the cannula would be blunter, and trauma would be diminished.

Objectives:

After designing such a cannula, we compared it with the most frequently used Coleman type cannulae with regard to ease in utilisation, and safety. We also tried to evaluate the potential for trauma, of the regularly used cannulae.

Materials and Methods:

In the first part, the penetration capacity of all cannulae was measured and compared, and in the second part, the tissue damage was evaluated in an experimental model.

Results:

According to the statistical and histological findings, the pointed-tip cannulae, blunted to a certain degree, can be applied easily through the tissues. The surgeon works more comfortably and we have noted that these cannulae cause less tissue damage.KEY WORDS: Cannula tip, fat graft, microinjection cannula     

Anticipation of monetary and social reward differently activates mesolimbic brain structures in men and women

Motivation for goal-directed behaviour largely depends on the expected value of the anticipated reward. The aim of the present study was to examine how different levels of reward value are coded in the brain for two common forms of human reward: money and social approval. To account for gender differences 16 male and 16 female participants performed an incentive delay task expecting to win either money or positive social feedback. fMRI recording during the anticipation phase revealed proportional activation of neural structures constituting the human reward system for increasing levels of reward, independent of incentive type. However, in men activation in the prospect of monetary rewards encompassed a wide network of mesolimbic brain regions compared to only limited activation for social rewards. In contrast, in women, anticipation of either incentive type activated identical brain regions. Our findings represent an important step towards a better understanding of motivated behaviour by taking into account individual differences in reward valuation.     

How image quality can be improved: our experience with multidetector computed tomography coronary angiography

PURPOSE: The objective of this study was to investigate the factors that may influence image quality on multidetector computed tomography (MDCT) coronary angiography (CA). MATERIALS AND METHODS: Two hundred twenty-four consecutive patients (161 men and 63 women; mean age, 52 years; age range, 34-76 years) evaluated with MDCT CA were included in the study. The evaluation of the quality of the patients' images was mainly based on the contrast material phase (early phase, optimal phase, or late phase) and the level of stepladder artifact (none, acceptable, or unacceptable). In addition, factors such as patient selection, patient preparation, scanning, processing, and steps of analysis, which may be affecting the quality of a final image, were examined independently. RESULTS: Patients who could not achieve sufficient breath-holding despite multiple breath exercises, those with a calcium score of 500 or higher, those with a heart rate greater than 90 bpm after metoprolol administration (because of shortening of the diastolic phase in the most still period), and those whose scanning was not completed were excluded from the study. The results for the remaining 224 patients were evaluated. Based on the contrast phase, there were 66 (29.5%) patients in the first group (early), 93 (41.5%) in the second group (optimal), and 65 (29%) in the third group (late). Among the 224 patients, the images of 152 (67.9%) had no stepladder artifact, those of 67 (29.9%) were of acceptable image quality, and those of 5 (2.2%) were of unacceptable image quality. CONCLUSION: It is important to obtain high-quality images to achieve correct interpretation with coronary artery CT angiography. This study aimed to describe a technique performed on 224 patients based on an array of factors ranging from patient selection to postprocessing. The results show that patient selection, cooperation with the patient, and breath-holding exercises play a very important role in obtaining the best images. In addition, a proper scanning technique (e.g., placement of electrocardiographic electrodes and contrast material phase) and postprocessing (e.g., reconstruction interval) may also contribute to obtaining high-quality images.