Plasma adropin level in patients with pseudoexfoliation

The aim of this study was to evaluate plasma adropin levels in patients with pseudoexfoliation (PEX). This retrospective case–control study included 35 patients with PEX and 35 individuals without PEX who served as controls. Plasma adropin levels with triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and haemoglobin A1c (HGBA1C) concentrations were measured in both groups. The mean serum adropin levels were 3.24 ± 0.95 ng/mL (range, 1.90–7.88 ng/mL) in patients with PEX syndrome and 5.78 ± 2.85 ng/mL (range, 2.08–5.41 ng/mL) in PEX glaucoma patients. There was no statistically significant difference in mean adropin levels between PEX syndrome and PEX glaucoma patients. However, similar adropin levels were found in the PEX glaucoma patients and the control group (P > 0.05). The mean serum adropin levels were 3.34 ± 0.89 ng/mL (range, 1.90–5.39 ng/mL) in the PEX group and 5.78 ± 2.85 ng/mL (range, 3.08–11.06 ng/mL) in the control group. The mean serum adropin level of the PEX group was significantly lower than that of the control group (P < 0.001). There were no significant differences between the two groups in terms of serum glucose, total cholesterol, LDL, HDL, HGBA1C, triglycerides levels, or body mass index (all P > 0.05). Adropin level is lower in patients with PEX.     

Evaluation of Retinal Nerve Fiber Layer Thickness in Acromegalic Patients Using Spectral-Domain Optical Coherence Tomography

Purpose: To evaluate retinal nerve fiber layer (RNFL) thickness in acromegalic patients. Methods: A study group of 29 patients with acromegaly and a control group of 38 age-matched healthy individuals were enrolled in a cross-sectional study. The study group was further divided by tumor size into two subgroups, a macroadenoma group and a microadenoma group. Serum growth hormone (GH) and insulin-like growth factor-1 (IGF-I) levels were detected at the time of ophthalmological examination in the study group. In both the study and control group, the RNFL thickness in the four quadrants was measured by optical coherence tomography. The relationship between GH and IGF-I levels and RNLF thickness was also evaluated. Results: The difference in mean RNLF thickness in all quadrants between the study and control groups was not statistically significant. In acromegalic patients with macroadenoma, the mean RNLF thickness of the inferior quadrant decreased significantly compared to both patients with microadenoma and healthy individuals (p?=?0,032 and p?=?0,046). GH and IGF-1 levels were not significantly correlated with the RNLF thickness in the study group. Conclusions: Excessive GH and IGF-1 levels do not affect the optic nerve or RNLF thickness, whereas the RNLF becomes thinner in the inferior quadrant in acromegalic patients with macroadenoma as a result of the chiasmal compression.     

Congenital hypothyroidism in Rieger Syndrome

Rieger syndrome (RS) is a multiple malformation syndrome characterized by ocular manifestations and extraocular defects. Herein, we report a 9-year-old boy who exhibited Rieger Syndrome phenotype as well as congenital hypothyroidism which may be an underappreciated feature of RS.     

Classical and Follicular Variant Papillary Thyroid Carcinoma: Comparison of Clinical,Ultrasonographical, Cytological,and Histopathological Features in 444 Patients

Follicular variant papillary thyroid carcinoma (FVPTC) is the most common variant of papillary thyroid carcinoma (PTC) after classical PTC (CPTC). In this study, we aimed to compare functional status, ultrasonographical features, cytological results, and histopathological characteristics of patients with CPTC and FVPTC. Preoperative thyroid functions, thyroid autoantibodies, ultrasonographical features, cytology, and histopathology results of 354 (79.9%) CPTC and 90 (20.3%) FVPTC patients were reviewed retrospectively. Sex distribution, mean age, thyroid autoantibody positivity, and thyroid dysfunctions were similar in two groups. Among 320 patients with preoperative ultrasonography (US) findings, a hypoechoic halo was observed more frequently (p = 0.003), and marginal irregularity was observed less commonly (p = 0.024) in FVPTC lesions. In CPTC, rate of malignant cytology (p = 0.001), and in FVPTC, rate of suspicious cytology (p < 0.001) were significantly higher. Histopathologically, mean tumor diameter was markedly higher in FVPTC compared to CPTC (16.89 ± 13.86 vs 10.64 ± 9.70 mm, p < 0.001), while capsular invasion and extrathyroidal spread were significantly lower in patients with FVPTC (p = 0.018 and p = 0.039, respectively). FVPTC tend to have more benign features in US and less malignant results in cytology. Higher tumor size in FVPTC might be explained by the recognition of clinical importance of these lesions after reaching particular sizes due to benign US features.     

In vivo modulation of the expressions of Fas and CD25 by intravenous immunoglobulin in common variable immunodeficiency

Although the presence of physiologic anti-CD95 (Fas, APO-1) autoantibodies in intravenous immunoglobulin (IVIG) preparations is known, the effects of these antibodies in patients with common variable immunodeficiency are unclear (CVID). The aim of the study was to assess the effects of IVIG in Fas expression, activation markers and the subsets of T cells in patients with CVID. We studied 15 cases with CVID and 10 healthy controls with no signs of immunodeficiency. The Fas expression of T cells, activation markers (CD25, CD69 and HLA-DR) and T-cell subsets were analyzed by four-color flow cytometry. We found that the Fas expression of CD3⁺ T cells in patients was significantly higher than in controls. In addition, there was a significant increase in the Fas expression of CD3⁺ T cells and CD4⁺ T cells, and the CD25 expression of CD3⁺ and CD4⁺ T cells after IVIG supplementation (P < 0.05). The CD69 and HLA-DR expressions of T cells and CD8⁺ T cells were not affected by IVIG infusion. Our observation showed that IVIG replacement causes an increase in the Fas and CD25 expressions in patients with CVID. These data suggest that the Fas protein may have an important role in the effects of IVIG for the control of autoimmunity in patients with CVID, as well as in the generation of autoimmune disease.     

Overexpression of Fc mu receptor (<Emphasis Type="Italic">FCMR</Emphasis>, <Emphasis Type="Italic">TOSO</Emphasis>) gene in chronic lymphocytic leukemia patients

Rai and Binet staging systems that have been used as a standard method for evaluating the prognosis of chronic lymphocytic leukemia (CLL) have some restrictions in distinguishing the early stage CLL patients that will progress rapidly. To solve this shortcoming, prognostic parameters other than staging have become important in the recent years. Intracellular upregulation of Fc mu receptor (FCMR, FAIM3/TOSO) gene in the leukemic lymphocytes of the patients with CLL may be an important parameter in predicting the progression of the disease. In this study, FCMR mRNA expression levels were evaluated in 50 CLL patients and in 50 healthy controls. FCMR mRNA expression was found to be significantly higher in CLL patients than in healthy controls. We, then, evaluated FCMR mRNA levels according to the stages of CLL. Rai stage 0, I, II cases were compared with stage III and IV, and Binet A was compared with Binet B and C according to FCMR mRNA levels. In cases with higher risks, Rai stage III, IV and Binet stage B and C, FCMR mRNA levels were also significantly higher. In addition, overexpression of the FCMR seems to be promoting the chromosomal abnormalities. As a result, we found that the mRNA levels of FCMR in the CLL patients are 23-fold higher than that of the control group and this may suggest that it can be associated with the disease progression and survival. For this reason and because of the simplicity of analyzing with Q-PCR, it can be a useful clinical parameter, after its importance has been shown in larger and multi-variate studies.     

Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis scores for diagnosis of acute appendicitis

AIM:To assess the reliability and practical applicability of the widely used Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA)scoring systems in patients with suspected acute appendicitis.METHODS:Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group.Patients were divided into two groups.appendicitis group(Group A)consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis,and non-appendicitis group(Group N-A)consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively.The operative findings for the patients,the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms.RESULTS:One hundred and thirteen patients with suspected acute appendicitis were included in the study.Of the 113 patients(62 males,51 females),the mean age was 30.2±10.1(range 18-67)years.Of the 113patients,94 patients underwent surgery,while the rest were followed non-operatively.Of the 94 patients,77patients were histopathologically diagnosed with acute appendicitis.Our study showed a sensitivity level of81%for the Alvarado system when a cut-off value of 6.5was used,a sensitivity level of 83.1%for the Ohmann system when a cut-off value of 13.75 was used,a sensitivity level of 80.5%for the Eskelinen system when a cut-off value of 63.72 was used,and a sensitivity level of 83.1%for the RIPASA system when a cut-off value of 10.25 was used.CONCLUSION:The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.     

Sequential use of Foley catheter with misoprostol for second trimester pregnancy termination in women with and without caesarean scars: a prospective cohort study

Purpose: The aim of this study is to evaluate the effectiveness and safety of misoprostol and Foley catheter in second trimester termination in women with and without caesarean section (CS) scars.

Materials and methods: Women with an indication for pregnancy termination between 14 and 22 completed weeks of gestation were included to the study. Enrolled women were allocated into three groups: (1) women with no history of CS, (2) women with one CS and (3) women with ≥2 CS. Study consisted 337 patients (233 group 1, 88 group 2 and 16 group 3). Misoprostol and Foley catheter were used sequentially. The primary outcome was the induction to abortion interval. Secondary outcomes were the successful vaginal abortion rate, the percentage of abortions in 24?h and the rates of surgical removal of the placenta, Foley catheter use and major maternal complications (transfusions, thromboembolic events, uterine rupture and death).

Results: Demographic characteristics were comparable. All study outcomes were statistically similar among groups. There was no major maternal complication among all patients.

Conclusions: Sequential use of misoprostol and Foley catheter is safe and effective in second trimester pregnancy termination for patients with and without CS scars.     

Quantitative assessment of systolic and diastolic left ventricular twist using Fourier Analysis of Stimulated echoes (FAST) and CSPAMM

Purpose:

To evaluate Fourier Analysis of Stimulated echoes (FAST) and CSPAMM for the quantification of left ventricular (LV) systolic and diastolic function and compare it with the previously validated FAST+SPAMM technique.

Materials and Methods:

LV short‐axis tagged images were acquired with CSPAMM and SPAMM in healthy volunteers (n = 13). The FAST method was used to automatically estimate LV systolic and diastolic twist parameters from rotation of the stimulated echo and stimulated anti‐echo about the middle of k‐space subsequent to ～3 min of user interaction.

Results:

There was no significant difference between measures obtained for FAST+CSPAMM and FAST+SPAMM for mean peak twist (13.5 ± 2.7° versus 11.9 ± 4.0°), torsion (3.4 ± 0.8°/cm versus 2.9 ± 1.0°/cm), twisting rate (76.8 ± 22.2°/s versus 68.2 ± 23.4°/s), untwisting rate (?102.7 ± 24.6°/s versus ?106.6 ± 32.4°/s), normalized untwisting rate (?7.9 ± 2.2/s versus ?9.9 ± 4.4/s), and time of peak twist (279 ± 23 ms versus 293 ± 25 ms) (all P > 0.01). FAST+CSPAMM also provided measures of duration of untwisting (148 ± 21 ms) and the ratio of rapid untwist to peak twist (0.8 ± 0.3). Bland‐Altman analysis of FAST+CSPAMM and FAST+SPAMM twist data demonstrates excellent agreement with a bias of 1.1° and 95% confidence intervals of [?3.3°, 5.2°].

Conclusion:

FAST+CSPAMM is a semi‐automated method that provides a quick and quantitative assessment of LV systolic and diastolic twist and torsion. J. Magn. Reson. Imaging 2013;37:678–683. © 2013 Wiley Periodicals, Inc.