Microvesicular steatosis: a missed item in the management of nonalcoholic fatty liver disease?

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease and cirrhosis. In NAFLD, histological course of steatosis is usually macrovesicular (MacroS), but it may be accompanied by varying degrees of microvesicular steatosis (MicroS). Thus, in this study, we aimed to evaluate the prevalence and significance of MicroS in subjects with NAFLD. METHODS: A retrospective analysis of clinical and laboratory data of patients with histologically proven NAFLD was performed. The liver biopsy specimens which stained with hematoxylin eosin, reticulin, and Masson's Trichrome stains were evaluated by single expert liver pathologist. Scoring and semiquantitative assessment of steatosis and NAFLD severity was done according to Kleiner scale known as NAFLD activity score (NAS). Grading for steatosis, steatosis type, zonal distribution of steatosis and other histological findings were also determined. RESULTS: The prevalence of MicroS among the study population (n= 191) was 30.4%. There was no difference regarding the demographic and biochemical parameters between patients with or without MicroS. On the other hand, the prevalence of ballooning injury and megamitochondria were higher in patients with MicroS (p= 0.019 and p= 0.036, respectively). There was a significant association of MicroS with ballooning injury (OR 2.65, 95% CI= 1.26-5.55 ; p= 0.005) and the presence of megamitochondria (OR 3.72, 95% CI= 1.00-13.72 ; p= 0.037). CONCLUSION: MicroS is common in patients with NAFLD and is associated with early histological findings in this clinically relevant condition. Further longitudinal studies are needed to characterize the role of MicroS in the natural history of NAFLD.

Plasma pentraxin-3 is associated with endothelial dysfunction in non-alcoholic fatty liver disease.

OBJECTIVE: Pentraxin-3 (PTX-3) is an acute-phase protein belonging to the PTX family. It has been reported that PTX-3 is significantly associated with obesity, metabolic syndrome, and cardiovascular diseases (CVD). Non-alcoholic fatty liver disease (NAFLD) is strongly associated with atherosclerosis and CVD. In this study, we aimed to investigate the relationship of PTX-3 with circulating markers of endothelial dysfunction and atherosclerosis in patients with NAFLD. PATIENTS AND METHODS: Seventy patients with biopsy-proven NAFLD and seventy healthy controls were enrolled in the study. Plasma asymmetric dimethylarginine (ADMA), adiponectin, and PTX-3 levels were determined using enzyme-linked immunosorbent assay (ELISA). High-sensitivity C-reactive protein (hsCRP) serum levels were measured with the immunoturbidimetric assay. Insulin resistance was estimated using the HOMA-IR index. RESULTS: PTX-3 and hsCRP levels were higher and adiponectin levels were lower in the NAFLD group compared to the healthy controls (p < 0.001 for all). In correlation analysis, a significant association was observed between PTX-3 and ADMA levels (r = 0.423, p < 0.001). CONCLUSIONS: Our study demonstrated for the first time that increased circulating PTX-3 is strongly associated with endothelial dysfunction in subjects with NAFLD. However, large prospective studies are needed to establish the independent predictive value of PTX-3 for CVD endpoints in this clinically relevant condition.

Enhanced reduction of graphene oxide by means of charging and electric fields applied to hydroxyl groups.

We present a first-principles study of the effects of charging and perpendicular electric fields on hydroxyl groups, both of which mediate the reduction of graphene oxide through the formation of H2O and H2O2. Starting with an investigation of the interaction between the hydroxyl groups and graphene, we determine the equilibrium binding geometry, binding energy, and the diffusion path with a minimum energy barrier and show that those equilibrium properties are strongly affected by external agents. While co-adsorbed H and O form bound OH, co-adsorbed H and OH in close proximity form H2O with almost no energy barrier. When negatively charged or subjected to a perpendicular electric field, the energy barrier between two OH co-adsorbed in close proximity is weakened or totally suppressed, forming an oxygen atom strongly bound at the bridge site, together with a water molecule. The water molecule by itself is very weakly bound to graphene and is prone to desorb from the surface, leading to the reduction of graphene oxide. It is therefore demonstrated that the reduction of graphene oxide is promoted to a large extent by negative charging or an applied perpendicular electric field, through the formation of weakly bound water molecules from hydroxyl groups.

Effects of charging and perpendicular electric field on the properties of silicene and germanene.

Using first-principles density functional theory calculations, we showed that electronic and magnetic properties of bare and Ti adatom adsorbed single-layer silicene and germanene, which are charged or subjected to a perpendicular electric field, can be modified to attain new functionalities. In particular, when subjected to a perpendicular electric field, buckled atoms have the symmetry between their planes broken, opening a gap at the Dirac points. The occupation of 3d orbitals of the adsorbed Ti atom changes with charging or applied electric field, inducing significant changes in magnetic moment. We predict neutral silicene uniformly covered by Ti atoms to become a half-metal at a specific value of coverage and hence allow the transport of electrons in one spin direction, but block the opposite direction. These calculated properties, however, exhibit a dependence on the size of the vacuum spacing between periodically repeating silicene and germanene layers, if they are treated using a plane wave basis set within periodic boundary conditions. We clarified the cause of this spurious dependence and show that it can be eliminated by the use of a local orbital basis set.

Effects of charging and electric field on graphene functionalized with titanium.

Titanium atoms are adsorbed to graphene with a significant binding energy and render diverse functionalities to it. Carrying out first-principles calculations, we investigated the effects of charging and static electric field on the physical and chemical properties of graphene covered by Ti adatoms. When uniformly Ti covered graphene is charged positively, its antiferromagnetic ground state changes to ferromagnetic metal and attains a permanent magnetic moment. Static electric field applied perpendicularly causes charge transfer between Ti and graphene, and can induce metal-insulator transition. While each Ti adatom adsorbed to graphene atom can hold four hydrogen molecules with a weak binding, these molecules can be released by charging or applying electric field perpendicularly. Hence, it is demonstrated that charging and applied static electric field induce quasi-continuous and side specific modifications in the charge distribution and potential energy of adatoms absorbed to single-layer nanostructures, resulting in fundamentally crucial effects on their physical and chemical properties.

Tight binding modelling of energy band structure in nitride heterostructures.

We studied the electronic structure of group III-V nitride ternary/binary heterostructures by using a semi-empirical sp(3)s* tight binding theory, parametrized to provide accurate description of both valence and conductions bands. It is shown that the sp(3)s* basis, along with the second nearest neighbor (2NN) interactions, spin-orbit splitting of cation and anion atoms, and nonlinear composition variations of atomic energy levels and bond length of ternary, is sufficient to describe the electronic structure of III-V ternary/binary nitride heterostructures. Comparison with experiment shows that tight binding theory provides good description of band structure of III-V nitride semiconductors. The effect of interface strain on valence band offsets in the conventional Al(1-x)Ga(x)N/GaN and In(1-x) Ga(x) N/GaN and dilute GaAs(1-x)Nx/GaAs nitride heterostructures is found to be linear function of composition for the entire composition range (0 < or = x < or = 1) because of smaller valence band deformations.

Prevalence and antibiotic susceptibility of genital Mycoplasma hominis and Ureaplasma urealyticum in a university hospital in Turkey.

This study aimed to assess the colonization prevalence and antibiotic susceptibility of genital Ureaplasma urealyticum and Mycoplasma hominis in a teaching hospital, in Turkey. A total of 382 sexually active women with abnormal vaginal discharge were included in the study. Samples that were obtained with cotton swabs were microbiologically analyzed for U. urealyticum and M. hominis, together with antimicrobial susceptibility to doxycycline, ciprofloxacin, ofloxacin, erythromycin, josamycin, pristinamycin, and tetracycline. Ureaplasma urealyticum was detected in 185 (48.4%) cultures, and M. hominis in 17 (4.4%). Eight (2.1%) cultures were positive for both. Resistance of M. hominis to doxycycline, ciprofloxacin, ofloxacin, erytromycin, josamycin, pristinamycin and tetrascycline was 5.9%, 17.6%, 41.2%, 88.2%, 5.9%, 5.9% and 11.8%, respectively. Resistance to doxycycline, ciprofloxacin, ofloxacin, erytromycin, josamycin, pristinamycin and tetrascycline in U. urealyticum isolates was 1.6%, 40.5%, 58.4%, 54.0%, 1.6%, 8.1% and 13.5%, respectively. Both U. urealyticum (94.1%) and M. hominis (96.2) were most sensitive to josamycin, and most resistant to erytromycin (U. urealyticum 54.0%, M. hominis 88.2) and ofloxacin (U. urealyticum 58.4%, M. hominis 41.2%). As a result, the rate of U. urealyticum and M. hominis was found to be 48.4% and 4.4%, respectively. We conclude that doxycycline may be used in empirical treatment of genital tract infections in sexually active women.

The evaluation of determinants of early postpartum low mood: the importance of parity and inter-pregnancy interval.

OBJECTIVES: The aim of this study is to determine the extent of early postpartum low mood and possible relevant variables in our population. STUDY DESIGN: Depressive symptoms were examined in a sample of 85 women in the first week of postpartum period using Beck Depression Inventory (BDI). The relevant sociodemographic variables were tested by multiple logistic regression analysis. RESULTS: The rate of postpartum low mood (BDI score >10) was found 35.2%. High parity, long marriage period and low education level were all significantly associated with low mood in the postpartum first week. When logistic regression analysis was used to eliminate confounding effect of the parameters; grandmultiparity, short inter-pregnancy interval and low educational level were found to have important effect on postpartum low mood. CONCLUSION: Pregnant women with risk factors for postpartum low mood such as grandmultiparity, short inter-pregnancy interval and low educational level should be identified early during antenatal period. Educational and social support should be given to those in such a risk. We believe that effective family planning programs and improvement of women's educational level are important preventive factors for postpartum low mood and subsequently developing depression.

A large yolk sac may be important in the early diagnosis of gestational trophoblastic disease: a case report.

A large yolk sac in a deformed shape gestational sac was detected by ultrasonography in an 8 week pregnant woman. The disappearance of the yolk sac and the gestational sac, enlargement of the uterine cavity and a heterogeneous appearance similar to early gestational trophoblastic disease were recognized when ultrasonographic examination was performed 2 weeks later. After uterine evacuation, partial hydatidiform mole was diagnosed by histopathological evaluation of the curettage material. In our study, the role of the large yolk sac in predicting trophoblastic disease is discussed.

Dyspareunia, back pain and chronic pelvic pain: the importance of this pain complex in gynecological practice and its relation with grandmultiparity and pelvic relaxation.

The aim of this study was to evaluate the correlation between severe dyspareunia, back pain, dysmenorrhea and chronic pelvic pain (CPP), and the relationship of each pain type with various sociodemographic factors, pelvic relaxation and high parity. Two hundred thirty-five premenstrual individuals were included. The prevalences of CPP, deep dyspareunia, dysmenorrhea and back pain were found to be 80.4, 30.6, 57.0 and 57.4%, respectively. Marriage duration was longer (p < 0. 01) and also parity was higher (p < 0.0001) in CPP cases than controls. However, none of the demographic factors had a significant correlation with dyspareunia, back pain and dysmenorrhea. CPP was correlated with both back pain (r = 0.18, p < 0.005) and dyspareunia (r = 0.19, p < 0.004). However, there was no correlation between back pain and dyspareunia. On the other hand, dysmenorrhea did not show a correlation with any pain types. While grandmultiparity had a significant effect on CPP (p < 0.0001), it did not have a significant effect on other pain types in a MANOVA model. CPP is very often seen in our population and it often makes a pain complex with dyspareunia and back pain. The prevention of grandmultiparity is important to decrease the incidence of CPP.

Urethral syndrome and associated risk factors related to obstetrics and gynecology.

OBJECTIVE: To evaluate the risk factors related to gynecology and obstetrics, and the incidence of urethral syndrome in our gynecological practice. STUDY DESIGN: The study comprised 35 patients without urinary tract infection who admitted to our department of gynecology with the complaints of recurrent urinary irritation symptoms, sensation of incomplete emptying and burning sensation during urination after sexual intercourse. A total of 200 women served as controls. RESULTS: We found urethral syndrome in 15% of patients. The incidence of grandmultiparity and the delivery without episiotomy were significantly higher in the study group than controls using univariate analysis. Considering logistic regression analysis, we found that grandmultiparity, two or more abortus, hospital delivery, delivery without episiotomy and pelvic relaxation were risk factors for the urethral syndrome. CONCLUSION: Although urethral syndrome is often detected in gynecological practice, it has not yet been reached utmost importance. Grandmultiparity and delivery without episiotomy are the major risk factors accompanying urethral syndrome.

Pelvic relaxation and associated risk factors: the results of logistic regression analysis.

BACKGROUND: To determine the possible risk factors in our population. METHODS: From 250 patients attending our clinic 28 patients with pelvic relaxation were the study group and the rest, 222 in all, were the control group. RESULTS: Age, marriage period, parity and number of abortus in pelvic relaxation group are found to be significantly higher with univariate analysis. With logistic regression analysis menopause, grandmultiparity, abortus (two or more), home deliveries, history of macrosomic infant (4500 gr. or more), deliveries without episiotomy and laceration of uterine cervix are found to be risk factors for pelvic relaxation. CONCLUSIONS: Good family planning programs to reduce grandmultiparity and unnecessary curettage for undesired pregnancies, preventing harmful home deliveries by inexperienced people, and fearless usage of episiotomy in difficult deliveries are necessary to prevent pelvic relaxation.

Early development of HELLP syndrome associated with eclampsia: a case report.

The syndrome of haemolysis, elevated liver enzymes and low platelet count during pregnancy (HELLP syndrome) is recognized as a serious, multisystem disease and diagnosed generally after thirtieth week of pregnancy. In this report, a case who developed eclampsia with HELLP syndrome was discussed.

The effect of grandmultiparity on chronic pelvic pain and sexual discomfort.

OBJECTIVES: To investigate the effect of grandmultiparity on chronic pelvic pain and sexual complaints. METHODS: 71 grandmultiparas and 65 non-grandmultiparas were interviewed. RESULTS: Pelvic pain, chronic pelvic pain and other pain compliants were significantly more frequent in grandmultiparas than non-grandmultiparas (P < 0.001). Of the grandmultiparas, 94.4% had pelvic pain and 81.7% had chronic pelvic pain. Coital complaints were observed in nearly half of both groups. CONCLUSION: Grandmultiparity has lasting reproductive health consequences in addition to its affect on obstetrical outcome and pelvic support.