Prediction of lymph node metastasis based on tumor size in stage 1A endometrioid endometrium cancer.

OBJECTIVE: Endometrium cancer (EC) is the most prevalent cancer affecting women in developed countries. There is debate about the need to perform lymphadenectomy in cases with a tumor diameter >2 cm. The aim of our study is to research the prediction of lymph node metastasis using tumor size in stage 1A endometrioid endometrium cancer (EEC). PATIENTS AND METHODS: The study enrolled cases operated in the clinic due to stage 1A EEC (FIGO 2009) from December 2010-2021. The correlations of age, age interval, parity, type of operation, tumor diameter, myometrial invasion, histological grade, and lymph node metastasis were statistically analyzed. The cut-off point for tumor size was determined with the ROC curve and Youden index. RESULTS: The study analyzed a total of 292 cases, and the mean age of cases was 62.3±10.0 years. Of the cases, 79.5% had histological grade 1, and 20.5% had grade 2. Myometrial invasion ≤50% was detected in 69.5%, and no myometrial invasion was detected in 30.5%. The mean tumor diameter was 34.0±18.0. Lymph node metastasis was identified in 6 cases (2.1%). Based on the tumor diameter cut-off value of 35 mm, sensitivity was 100%, and specificity was 50.3%. 116 cases with tumor diameter >35 mm and 176 with diameter ≤35 mm, and grade 2 histology and lymph node positivity were found statistically significant between these groups (respectively, p=0.012 and p=0.038). The lymph node metastasis risk was 0% in cases with tumor diameter ≤35 mm, while it was 5.2% in cases with tumor diameter >35 mm. CONCLUSIONS: The general approach in stage 1A EEC is not to perform lymphadenectomy. However, when the tumor diameter is noted, lymphadenectomy may be considered as the lymph node metastasis risk increases in cases with a tumor diameter of 35 mm or more. There is a need for more clinical studies on this topic.

Comparative evaluation of single and combined efficacy of dipyridamole, ketotifen and quercetin on cyclosporine induced hepatorenal toxicity.

Cyclosporine is an immunosuppressive drug that is used to prevent tissue rejection in organ transplants and to treat autoimmune diseases such as psoriasis and rheumatoid arthritis. It has important toxic effects in many organs such as the liver and kidney. The aim of this study was to determine and compare the effectiveness of the single and combined treatment of dipyridamole, which is a vasodilator and has an antioxidant effect, ketotifen which is toll-like receptor-4 inhibitory and has an antioxidant effect, quercetin which is an antioxidant and has an anti-inflammatory effect in cyclosporine-induced hepatorenal toxicity. Forty-eight Wistar Albino rats were divided into 7 groups. The research period was 21 days. The cyclosporine increased serum ALT and AST levels, in contrast to their increased levels prevented by all the treatments. The serum creatinine level decreased significantly with ketotifen and combined treatment, while cyclosporine partially increased serum creatinine and urea levels. The urine microalbumin and protein levels were increased significantly by cyclosporine, whereas they decreased with dipyridamole treatment. The protein levels decreased by quercetin and combined treatments. The kidney injury molecule- 1 and retinol-binding protein levels were increased by the cyclosporine, while ketotifen treatment partially decreased them. In conclusion, ketotifen and dipyridamole can prevent cyclosporine- induced hepatorenal toxicity and quercetin can increase the effectiveness of this treatment.

The effects of dexamethasone and minocycline alone and combined with N-acetylcysteine and vitamin E on serum matrix metalloproteinase-9 and coenzyme Q10 levels in aflatoxin B1 administered rats.

This study aimed to determine the effects of dexamethasone and minocycline alone and combined treatment with N-acetylcysteine (NAC) and vitamin E on serum coenzyme Q10 (CoQ10) and matrix metalloproteinase-9 (MMP-9) levels in rats administered aflatoxin B1 (AFB1). The study was carried out on 66 male Wistar rats. Following the intraperitoneal (IP) administration of AFB1 at dose of 2 mg/kg, minocycline (45 and 90 mg/kg, IP) and dexamethasone (5 and 20 mg/kg, IP) were administered alone and combined with NAC (200 mg/kg, IP) and vitamin E (600 mg/kg, IP). CoQ10 and MMP-9 levels were analyzed using the HPLC-UV method and a commercial kit by ELISA, respectively. AFB1 increased MMP-9 level and decreased CoQ10 level compared to the control group. After dexamethasone and minocycline administration, there is no increase in CoQ10 level, which is caused by AFB1. However, dexamethasone and minocycline combined with NAC+vitamin E caused significant increases in CoQ10 levels. Dexamethasone and minocycline alone and combined with NAC+vitamin E decreased MMP-9 levels compared to the single AFB1 treated group. The use of MMPs inhibitors and oxidative stress-reducing agents is anticipated to be beneficial in the poisoning with AFB1.

Limited relevance and progression of histological alterations in the liver during thioguanine therapy in inflammatory bowel disease patients.

Background: Thioguanine is associated with liver toxicity, especially nodular regenerative hyperplasia (NRH). We assessed if liver histology alters during long-term maintenance treatment with thioguanine in patients with inflammatory bowel disease (IBD). Methods: Liver specimens of thioguanine treated IBD patients with at least two liver biopsies were revised by two independent liver pathologists, blinded to clinical characteristics. Alterations in histopathological findings between first and sequential liver specimen were evaluated and associated clinical data, including laboratory parameters and abdominal imaging reports, were collected. Results: Twenty-five IBD patients underwent sequential liver biopsies prior to, at time of, or after cessation of thioguanine treatment. The median time between the first and second biopsy was 25 months (range: 14-54). Except for one normal liver specimen, any degree of irregularities including inflammation, steatosis, fibrosis and some vascular disturbances were observed in the biopsies. The rates of perisinusoidal fibrosis (91%), sinusoidal dilatation (68%) and nodularity (18%) were the same in the first and second liver biopsies. A trend towards statistical significance was observed for phlebosclerosis (36% of the first vs. 68% of the second biopsies, p = .092). Presence of histopathological liver abnormalities was not associated with clinical outcomes. Furthermore, two patients in this cohort had portal hypertension in presence of phlebosclerosis. In another two patients, nodularity of the liver resolved upon thioguanine withdrawal. Conclusion: Vascular abnormalities of the liver were commonly observed in thioguanine treated IBD patients, although these were not progressive and remained of limited clinical relevance over time.

Pharmacokinetics of cefquinome in red-eared slider turtles (Trachemys scripta elegans) after single intravenous and intramuscular injections.

The purpose of this study was to evaluate the pharmacokinetics of cefquinome (CFQ) following single intravenous (IV) or intramuscular (IM) injections of 2 mg/kg body weight in red-eared slider turtles. Plasma concentrations of CFQ were determined by high-performance liquid chromatography and analyzed using noncompartmental methods. The pharmacokinetic parameters following IV injection were as follows: elimination half-life (t1/2λz ) 21.73 ± 4.95 hr, volume of distribution at steady-state (Vdss ) 0.37 ± 0.11 L/kg, area under the plasma concentration-time curve (AUC0-∞ ) 163 ± 32 µg hr-1  ml-1 , and total body clearance (ClT ) 12.66 ± 2.51 ml hr-1  kg-1 . The pharmacokinetic parameters after IM injection were as follows: peak plasma concentration (Cmax ) 3.94 ± 0.84 µg/ml, time to peak concentration (Tmax ) 3 hr, t1/2λz 26.90 ± 4.33 hr, and AUC0-∞ 145 ± 48 µg hr-1  ml-1 . The bioavailability after IM injection was 88%. Data suggest that CFQ has a favorable pharmacokinetic profile with a long half-life and a high bioavailability in red-eared slider turtles. Further studies are needed to establish a multiple dosage regimen and evaluate clinical efficacy.

The Prevalence of Nodular Regenerative Hyperplasia in Inflammatory Bowel Disease Patients Treated with Thioguanine Is Not Associated with Clinically Significant Liver Disease.

BACKGROUND: Nodular regenerative hyperplasia (NRH) of the liver is associated with inflammatory-mediated diseases and certain drugs. There is conflicting data on the prevalence of NRH and its clinical implications in inflammatory bowel disease (IBD) patients treated with thioguanine. METHODS: A retrospective cohort study involving 7 Dutch centers comprised all IBD patients who were being treated with thioguanine and underwent a liver biopsy as part of the standard toxicity screening. Liver biopsy specimens were reviewed by 2 experienced liver pathologists. Clinical data as well as liver chemistry, blood counts, and abdominal imaging were collected. RESULTS: One hundred eleven IBD patients who submitted to liver biopsy were treated with thioguanine in a daily dose of 0.3 mg/kg for a median duration of 20 (4-64) months. NRH was detected in 6% of patients (7; 95% confidence interval, 3-14 patients). Older age (P = 0.02), elevated gamma-glutamyl transferase (P = 0.01) and alkaline phosphatase (P = 0.01) levels, a higher mean corpuscular volume (P = 0.02), and a lower platelet or leukocyte count (P < 0.01 and P = 0.02, respectively) were associated with NRH. Three of the 7 patients with NRH did not have any associated clinical symptoms or signs. The other 4 had minor biochemical abnormalities only. Ultrasonography revealed splenomegaly in 3 of the 78 patients (4%; 95% confidence interval, 0%-9%), only one of whom had NRH. There was no clinically overt portal hypertension. CONCLUSIONS: The prevalence of NRH was 6% in liver biopsies obtained from IBD patients treated with thioguanine. Histopathological irregularities including NRH were not associated with clinically significant findings over the period of observation.

Protective effect of distillated Nerium oleander on heart of type 2 diabetic rats.

OBJECTIVES: The current study aims to investigate the possible role of NO distillate either for therapeutic or for protective potential in diabetic cardiomyopathy. BACKGROUND: Protective and restorative effects of distillated Nerium oleander (NO) on the diabetes-induced electrophysiological and structural alterations were investigated. METHODS: Type 2 diabetes was induced by combination of single dose streptozotocin injection and high fat diet for four weeks. Experimental groups were designed as follows: control, diabetic, restorative-NO treated diabetic and protective-NO treated diabetic. Intracellular action potentials (AP) and contractile activities were measured form left ventricular papillary muscle strips as well as histopathological examination of heart tissue and biochemical examinations of serum were performed. RESULTS: Type 2 diabetes induced AP prolongation was prevented with both ways of NO treatments. Moreover, treatments produced nearly complete restorations of diabetes-induced depressed amplitude and altered kinetics of contractile activities. In parallel to electrophysiological parameters, both histopathological and biochemical results indicates the NO induced beneficial effects on the diabetes related alterations. CONCLUSION: Distillated Nerium oleander (NO) can be a highly potential therapeutic or preventive agent on the diabetes induced excitation-contraction coupling alterations (Tab. 3, Fig. 3, Ref. 23).

The geographical distribution and first molecular analysis of Culicoides Latreille (Diptera: Ceratopogonidae) species in the Southern and Southeastern Turkey during the 2012 outbreak of bovine ephemeral fever.

This study investigated the geographical distribution and molecular analysis of Culicoides species in the Southern and Southeastern Turkey during the 2012 outbreak of bovine ephemeral fever (BEF). The midge specimens caught by Onderstepoort-type light traps from livestock farms were tested for molecular evidence of existence of viral genome. Blood specimens were collected from clinically BEF-suspected acute febrile cattle. Total nucleic acid samples obtained from field specimens were checked against the BEF virus G gene and Culicoides internal transcribed spacer 1 (ITS-1) gene. A total of 20,845 Culicoides specimens (20,569 ♀♀, 276 ♂♂) comprising 11 species (Culicoides badooshensis, Culicoides circumscriptus, Culicoides gejgelensis, Culicoides imicola, Culicoides kibunensis, Culicoides longipennis, Culicoides newsteadi, Culicoides nubeculosus, Culicoides odiatus, Culicoides punctatus, Culicoides schultzei, Culicoides spp.) were collected. C. schultzei (18,032) was found as the dominant species and followed by C. imicola (1,857), C. nubeculosus complex (545), and C. circumscriptus (259), respectively. C. kibunensis was identified as new species for this region. PCR positivity of BEF was found 37.14% (13/35) in blood samples whereas no viral genome was obtained from Culicoides specimens. Culicoides spp. ITS-1 gene sequences were analyzed phylogenetically with GenBank ITS-1 sequences. Molecular homology of Culicoides ITS-1 gene was ranged between 62.74 and 71.39%. The results described first molecular detection and phylogenetic analysis of Culicoides ITS-1 gene with reference to the 2012 BEF outbreak in Turkey.

Description of breeding sites of Culicoides species (Diptera: Ceratopogonidae) in Turkey.

The aim of this study was to describe the breeding sites of Culicoides species in Konya province, Turkey. The samples taken from 11 different habitats in Konya province were examined for Culicoides species. The collected adult Culicoides specimens were reared in plastic buckets in our laboratory. Among 2,798 specimens reared, 18 species were identified. Culicoides circumscriptus Kieffer, 1918 was the most abundant species reared in the samples taken from mud rich in organic matters near the water reservoirs; C. circumscriptus, C. nubeculosus (Meigen), 1830 and C. shaklawensis Khalaf, 1957 in moist soil with organic matter; C. geigelensis Dzhafarov, 1964 in moist soils, along watering channels and dripping waters; C. festivipennis Kieffer, 1914 and C. circumscriptus along sewage channel; C. festivipennis in reed sites and along garden watering channels; C. circumscriptus in rain pools; C. odiatus Austen, 1921 and C. circumscriptus in mud near the dams; C. geigelensis and C. kibunensis Tokunaga, 1937 from sites along the stream. No Culicoides was reared in the samples obtained from livestock dung and tree holes. It was observed that C. circumscriptus, C. festivipennis and C. shaklawensis preferred mud rich in organic matters near the water reservoirs. Culicoides imicola Kieffer, 1913, which is the main vector of bluetongue, was not detected in Konya province. The others vectors of bluetongue, C. obsoletus gr. (Meigen), 1818, C. schultzei gr. (Enderlein), 1908 and C. pulicaris (Linnaeus), 1758 were only obtained in little numbers.

Prevalence and intensity of Oestrus ovis in Akkaraman sheep in the Konya region of Turkey.

Slaughterhouse surveys to determine the prevalence and intensity of larval Oestrus ovis Linnaeus (Diptera: Oestridae) in sheep, were conducted monthly for 1 year in Konya, Turkey. A total of 624 sheep, selected at random, were examined and 59% were found to be infested by O. ovis. A total of 8801 larvae were collected, of which 68.9% were first-stage, 19.1% second-stage and 12% third-stage larvae. All three larval stadia were seen in each month of the year. The larval intensity for infected sheep was 23.9, with 16.48 L(1), 4.55 L(2) and 2.87 L(3). The monthly prevalence ranged from 34.6% in January to 76.9% in October. The largest number of larvae (180) was obtained from a sheep in August (122 L(1), 52 L(2) and 6 L(3)). The infestation rate was higher in 4 - 6-year-old sheep, at 72.6%. The infestation rates were 64.4% in female and 47.5% in male sheep.

Vertical distribution of Culicoides larvae and pupae.

This study was carried out in the northeast region of Konya in Turkey, between April and December 2004, to determine the vertical distribution of Culicoides (Diptera: Ceratopogonidae) larvae and pupae. Larvae and pupae were collected using the saturated sugar flotation technique in mud samples taken from a range of depths of up to 20 cm. In total, 282 adult Culicoides were obtained. The number of larvae and pupae decreased as the depth increased; at 2.5 cm, 97 Culicoides larvae and 73 Culicoides pupae were found. Larvae and pupae of C. nubeculosus (Meigen) and C. puncticollis (Becker) were mostly found in organic matter-rich breeding sites, while larvae and pupae of C. gejgelensis Dzhafarov and C. festivipennis Kieffer were mostly found in organic matter-poor breeding sites. Culicoides larvae and pupae were obtained largely in July and August.

An inventory of the phlebotomine sandflies (Diptera: Psychodidae) found in the Turkish province of Konya.

Between the April and October of 1997, the sandflies in six areas (Centrum, Altinekin, Kadinhani, Cumra, Beysehir and Bozkir) of the Turkish province of Konya, in Central Anatolia, were surveyed. All the sandflies were caught close to houses, on sticky-paper traps placed in barns used by livestock. All 127 specimens of Sergentomyia collected were either S. theodori (86.6%) or S. dentata (13.4%). The other 2017 sandflies caught represented 12 species of Phlebotomus - mostly P. papatasi (78.4%) or P. halepensis (10.9%), with P. sergenti (3.8%), P. simici (2.2%), P. kandelakii (1.6%), P. similis (0.9%), P. jacusieli (0.5%), P. neglectus (0.4%), P. transcaucasicus (0.3%), P. syriacus (0.3%), P. kyreniae (0.3%) and P. balcanicus (0.3%) relatively rare. Most (87%) of the flies were male. This represents the first report of P. transcaucasicus in Turkey. In addition, P. syriacus, P. neglectus, P. similis and S. dentata have not been detected before in Central Anatolia.

Erosive stomatitis in a white pelican (Pelecanus onocrotalus) caused by Piagetiella titan (Mallophaga: Menoponidae).

Two white pelicans at the garden of a restaurant in Beysehir, a county of Konya province were examined for the presence of ectoparasites. Nine lice were collected from the oral cavity of one of them. They were identified as Piagetiella titan. Diffuse erosions, erosive ulcers covered by dried yellowish-brown exudate and petechial haemorrhages were observed in oral mucosa.