Evaluation of the efficacy of modified De Gramont and modified FOLFOX4 regimens for adjuvant therapy of locally advanced rectal cancer

Objective: To evaluate the efficacy of modified De Gramont (mDG) and FOLFOX4 (mFOLFOX4) regimens in patients with locally advanced rectal cancer (LARC). Methods: Patients that received adjuvant chemotherapy (CT) for the treatment of LARC (stage II and III) were retrospectively evaluated. Results: A total of 231 patients were examined. Median age was 58 (range, 18-83) and, of these patients, 36 (15.6%) had stage II and 195 (84.4%) had stage III disease. While the patients with stage II disease received only mDG regimen (36, 100.0%), of the patients with stage III disease, 71 (36.5%) received mDG and 124 (63.5%) received mFOLFOX4 regimen. Patients with stage III disease showed recurrences more often, but this difference was not statistically significant. Similarly, for the patients with stage III disease, there was no statistically significant relation between the adjuvant CT regimen received and the rate of recurrence. In patients with stage II disease, who received mDG, median DFS was 101 months and median OS was 106 months. For the patients with stage III disease, the patients that received mDG showed a median DFS of 78 months and a median OS of 96 months, while the patients that received mFOLFOX4 had a median DFS of 51 months and a median OS of 78 months. Although, for the patients with stage III disease, there are major differences between the two different regimens of CT in terms of DFS and OS, this difference was not statistically significant.When the results were evaluated from the perspective of toxicity, the patients that received mFOLFOX4 showed more toxicity. Neurotoxicity, which was seen in the patients that were given mFOLFOX4, was the most prominent toxicity. Conclusions: mDG and mFOLFOX4 regimens are applicable regimens as adjuvant CT for the treatment of LARC.     

The presence of insulin resistance and comparison of various insulin sensivity indices in women with androgenetic alopecia

We aimed to identify the association of female androgenetic alopecia with insulin resistance and to evaluate various simple insulin sensitivity indices and beta cell function in women with androgenetic alopecia (AGA). A cross-sectional study was performed in 66 non-obese women (24-44 years old), 41 with AGA alone and 25 healthy individuals. Blood glucose, insulin, c-peptide levels, oral glucose tolerance test (OGTT); insulin sensitivity and beta cell function indices derived from a single blood sample and OGTT were determined and compared in the two groups. Women with AGA had impaired glucose tolerance (IGT) rates of 12.5%. In the control group IGT was 0%. Fasting glucose, c-peptide, insulin were higher in AGA group. When the indices were evaluated, Raynaud index, FIRI and HOMA-IR results found to be higher in the AGA group than in controls (p < 0.05, for all). Fasting insulin(-1), GIR, FIRI(-1), QUICKY index, ISI HOMA, HOMA-IS results were lower in AGAs than in controls (p < 0.05, for all). Our study showed that women with AGA alone were more insulin resistant than healthy subjects. We suggest that beta cell function and insulin sensitivity indices are useful methods for measuring insulin resistance in AGAs, and HOMA-IR is a good predictor of insulin resistance. We propose that OGTT should be applied in women with AGA.     

Lupus vulgaris of the popliteal fossa: a delayed diagnosis

Lupus vulgaris (LV) is the most common form of cutaneous tuberculosis. It commonly presents on the head and neck regions. The diagnosis may be difficult when LV occurs at unexpected regions or in unusual clinical forms. Sometimes special stains for the organism and mycobacterial cultures may be negative. Nevertheless, it is usually possible to reach the correct diagnosis of LV using clinical and histopathological findings. But at times, a therapeutic trial with antitubercular agents may be required.     

Solitary congenital self-healing reticulohistiocytosis in monozygotic twins

We report monozygotic twins with congenital self-healing reticulohistiocytosis, whose lesions initially presented as hemorrhagic bullae at birth with rapid progression into crusted papules the following day. Physical examination disclosed crusted papules on the right side of the neck of twin 1 and a similar solitary lesion on the lateral side of the right thumb of twin 2. Excisional biopsy specimen findings of the neck and thumb lesions were consistent with Langerhans cell histiocytosis, which was further confirmed by positive CD1a staining. The lesions resolved completely by 2 months with no evidence of recurrence or systemic involvement. Congenital self-healing reticulohistiocytosis is a rare, self-limited form of Langerhans cell histiocytosis. Although familial clustering in Langerhans cell histiocytosis was previously reported, to the best of our knowledge there is no report suggesting familial clustering in congenital self-healing reticulohistiocytosis. Our patients are interesting in terms of raising the question of whether the presence of congenital self-healing reticulohistiocytosis in monozygotic twins is implicative of a genetic role in its pathogenesis.     

Evaluation of early results of quick-chop phacoemulsification in the patients with high myopic cataract

AIM:To assess the early surgical outcomes ofquick-chop phacoemulsification technique in patients with high myopia.METHODS: The data of patients with high myopia who underwent quick-chop phacoemulsification were reviewed retrospectively. There were 42 eyes of 31 patients. The axial length was more than 26 mm in all eyes. All eyes underwent quick-chop phacoemulsification surgery with the placement of an intraocular lens (IOL) in the capsular bag. Postoperative visits were performed at 1, 3d; 2wk, 1mo. Early postoperative best corrected visual acuity (BCVA), preoperative and postoperative corneal endothelial cell density (ECD), central corneal thickness (CCT) and postoperative complications were assessed. Paired sample t-test or Wilcoxon tests were used to compare data between preoperative and postoperative data.RESULTS:There was no statistically significant difference between preoperative and postoperative ECD and CCT. Retinal detachment was developed in one eye at postoperative first day. There was an iris prolapsus from side port insicion.CONCLUSION: Quick-chop phacoemulsification technique is a safe surgical technique. However we can encounter some complications in high myopic eyes due to histopathological differences. Both side port and clear corneal tunnel insicion size is crucial for preventing postoperative complications. If any persistent leakage is noticed, suture should be placed.     

Total,free, and bioavailable 25-hydroxyvitamin D levels in patients with periodontitis (stage III): a case–control study

Clinical Oral Investigations - The aim of this study was to investigate the relationship between total, free and bioavailable 25-hydroxyvitamin D levels, and periodontitis. Thirty-nine patients...     

GluK1 inhibits calcium dependent and independent transmitter release at associational/commissural synapses in area CA3 of the hippocampus

CA3 pyramidal cells receive three main excitatory inputs: the first one is the mossy fiber input, synapsing mainly on the proximal apical dendrites. Second, entorhinal cortex cells form excitatory connections with CA3 pyramidal cells via the perforant path in the stratum lacunosum moleculare. The third input involves the ipsi‐and contralateral connections, termed the associational/commissural (A/C) pathway terminating in the stratum radiatum of CA3, thus forming a feedback loop within this region. Since this excitatory recurrent synapse makes the CA3 region extremely prone to seizure development, understanding the regulation of synaptic strength of this connection is of crucial interest. Several studies suggest that kainate receptors (KAR) play a role in the regulation of synaptic strength. Our aim was to characterize the influence of KAR on A/C synaptic transmission: application of ATPA, a selective agonist of the GluK1 KAR, depressed the amplitude fEPSP without affecting the size of the fiber volley. Blockade of GABA receptors had no influence on this effect, arguing against the influence of interneuronal KARs. Pharmacological and genetic deletion studies could show that this effect was selectively due to GluK1 receptor activation. Several lines of evidence, such as PPF changes, coefficient of variance–analysis and glutamate uncaging experiments strongly argue for a presynaptic locus of suppression. This is accompanied by an ATPA‐mediated reduction in Ca²⁺ influx at excitatory synaptic terminals, which is most likely mediated by a G‐Protein dependent mechanism, as suggested by application of pertussis toxin. Finally, analysis of miniature EPSCs in the presence and absence of extracellular Ca²⁺ suggest that presynaptic KAR can also reduce transmitter release downstream and therefore independent of Ca²⁺ influx. © 2010 Wiley Periodicals, Inc., Inc.