Does sarcopenia predict perioperative mortality in patients with advanced ovarian cancer?

OBJECTIVE: The aim of this study was to assess prognostic value of frailty for the prediction of surgical complications and mortality in women with end-stage ovarian cancer subjected to curative oncological surgery and its value for long-term follow-up. PATIENTS AND METHODS: A total of 75 advanced-stage consecutive ovarian cancer patients who underwent elective surgery were investigated. The demographic data and clinical information related to the oncologic treatment were collected in the electronic and physical case records and included the following: age, ethnic group, comorbidities, staging of cancer, surgical procedure details, lymphadenectomy, American Society of Anesthesiology (ASA) grade, anesthetic technique, operative blood loss, operative time, and residual disease. A radiologist, who was blinded to patient outcomes, performed quantitative assessment of psoas muscle areas using the available computed tomography scan images at the caudal end of the third lumbar vertebra. RESULTS: The mean age was 61.2 ± 18.2 years, and the percentage of patients over 65 years was 78%. Comorbidities (hypertension, diabetes, chronic obstructive pulmonary disease, renal insufficiency) were seen in 37 patients (49%). Histological types were adenocarcinoma in all patients (0) mostly serous adenocarcinoma (62%) and stage 3 (58%). According to psoas muscle measurement, 55 patients (73%) were nonsarcopenic and 20 patients (26%) were sarcopenic. Debulking procedures were performed on all patients. Also, bowel resection was applied in 40% of patients. Preoperative anesthetic examinations had shown that they were mostly ASA score 2 (44 patients). Moreover, 26 patients were ASA score 3. Generally, total operative time was between 121-240 minutes, and total blood loss was generally under 500 ml. Postoperative complications were seen in 26% of the patients. Non-surgical complications were observed in 14% of the patients, while non-surgical complications were observed in 12%. Length of the hospital stay >10 days was seen in 10 patients. Mortality was seen in 1 patient 30 days after operation. Nonsurgical complications (pneumonia, urinary tract infections, cardiac complications) were significantly higher in comparison to nonsarcopenic patients. However surgical complications were comparable between each group. Mortality after hospitalization and length of hospital stay were significantly higher in sarcopenic patients in comparison with the nonsarcopenic group. CONCLUSIONS: The use of the value of the psoas muscle region is considered to be a method to predict the in-hospital mortality when there is an available abdominal CT scan that has already been performed for ovarian cancer patients with a significant comparable clinical and laboratory background. According to the findings, patients had worse surgical outcomes and higher postoperative nonsurgical complication rate when sarcopenic patients were compared to nonsarcopenic patients. Moreover, postoperative mortality and length of hospital stay were significantly higher in sarcopenic patients in comparison to non-sarcopenic group.

The Effects of 2100 MHz Radio Frequency Radiation on Thyroid Tissues

ABSTRACT Objective: To reveal the effect of 2100 MHz radio frequency (RF) radiation on thyroid tissues of rats in the 10 days (group E1) and 40 days (group G1) exposure groups. Methods: In this study, 30 healthy female Wistar albino rats, weighing 200−256 g each, were used. The animals were randomly divided into four groups (E1, E2, G1 and G2). Groups E2 and G2 served as the control groups. The exposure groups were exposed to 2100 MHz RF radiation emitted by a generator, simulating a 3G-mobile phone for 6 hours/day, 5 consecutive days/week, at the same time of the day (between 9 am and 3 pm), for 10 days (group E1) and 40 days (group G1). Results: Catalase and xanthine oxidase enzyme activities were compared between the groups E1 and E2; it was found that the difference was statistically significant (p < 0.05). Between the groups G1 and G2, the difference was found to be significant with respect to catalase activities. Tissue samples of the early and late groups showed no serious pathological findings in the histopathological examination. Conclusion: We believe that comprehensive, clinical and experimental studies are needed to assess the effect of the RF exposure duration and dosage of exposure on thyroid tissues.

Oxidative effects of extremely low frequency magnetic field and radio frequency radiation on testes tissues of diabetic and healthy rats.

With the development of technology, people are increasingly under the exposure of electromagnetic fields. Individuals with chronic diseases such as diabetes are now long-term exposed to Radio Frequency-RF radiation and extremely low frequency (ELF) magnetic fields (MFs). The purpose of this present study is to investigate oxidative effects and antioxidant parameters of ELF MFs and RF radiation on testis tissue in diabetic and healthy rats. Wistar male rats were divided into 10 groups. Intraperitoneal single dose STZ (65 mg/kg) dissolved in citrate buffer (0.1M (pH 4.5)) was injected to diabetes groups. ELF MFs and RF radiation were used as an electromagnetic exposure for 20 min/day, 5 days/week for one month. Testis tissue oxidant malondialdehyde (MDA), and antioxidants glutathione (GSH), and total nitric oxide (NOx) levels were determined. The results of ANOVA and Mann-Whitney tests were compared; p < 0.05 was considered significant. ELF and RF radiation resulted in an increase in testicular tissue MDA and NOX levels (p < 0.05), and caused a decrease in GSH levels (p < 0.05) in both healthy and diabetic rats, yet more distinctively in diabetic rats. The most pronounced effect was recorded in D-RF + ELF group (p < 0.005). Both radiation practices increased the oxidative stress in testis tissue while causing a decrease in antioxidant level which was more distinctive in diabetic rats (Tab. 1, Fig. 3, Ref. 30).

Effects of 2100 MHz radio frequency radiation on ductus epididymis tissue in rats.

PURPOSE: The use of mobile phones is widespread since the beginning of 1990s. A great debate exists about the possible damage that the Radio Frequency - RF radiation from mobile phones exerts on different organs. The objective of this study was to investigate the possible histopathological effects of 2100 MHz RF radiation on rat ductus epididymis tissue using a light microscopy and immunohistochemical method after one or two month exposure. MATERIALS AND METHODS: The study was performed on 36 adult Wistar albino rats. 2100 MHz RF radiation was used with a specific absorption rate (SAR) of 0.36 W/kg for 30 min/day, 6 days per week for one or two months. There were 3 groups (n = 6 for each group): one month RF exposed group, two months RF exposed group, and the control group. RESULTS: At the end of the study, the structural changes in ductus epididymis tissue were evaluated. In both 2100 MHz RF exposed groups, the rat ductus epididymis sperm were not observed in some channels, a reduction in sperm density in some of the channels drew an attention. The loss of connective tissue and edematous areas were observed in cross channel interstitial connective tissue. In addition, it was observed that vascularization was highly increased with respect to the control group in cross-channel interstitial connective tissue. CONCLUSION: 2100 MHz RF exposure resulted in some structural changes in the male genital ducts of rats (Tab. 1, Fig. 5, Ref 20).

GSM-like radiofrequency exposure induces apoptosis via caspase-dependent pathway in infant rabbits.

BACKGROUND: There have been several Radio Frequency (RF) field researches on various populations and groups of different ages in recent years. However, the most important group for research has been declared as the pregnant women and their babies. OBJECTIVE: The aim of the study was to analyse the effect on apoptotic factors of RF fields on newborn rabbit liver tissues. MATERIALS AND METHODS: Cytochrome c and AIF (Apoptosis Inducing Factor) levels were measured by western blot and caspase 1, 3 and 9 activities were measured by colorimetric method. RESULTS: Cytochrome c and AIF levels were not altered, but all caspase activities were increased in female infant rabbits that exposed to 1800 MHz GSM-like RF signals when they reached 1 month of age and caspase 1 and caspase 3 levels were decreased in male infant rabbits that exposed to 1800 MHz GSM-like RF signals between 15th and 22nd days of the gestational period. Results showed that 1800 MHz GSM-like RF exposure might lead to apoptosis in infant rabbit's liver tissues. CONCLUSION: According to the results, we suggest that postnatal RF exposure causes caspase dependent apoptosis in female infant rabbits liver tissues (Tab. 1, Fig. 2, Ref. 27).

Does radio frequency radiation induce micronuclei frequency in exfoliated bladder cells of diabetic rats?

OBJECTIVE: For many years there has been a discussion among both experts and the general public regarding the effects of radio frequency (RF) radiation on the human organism. The purpose of the present study was to evaluate the relationship of micronucleui (MN) frequency and RF radiation in exfoliated bladder cells of non-diabetic and diabetic rats. METHODS: Three groups were used in the experiment: Group I (n=6): diabetic group without RF exposure; Group II (n=6): diabetic group exposed 2100 MHz RF radiation and Group III (n=6): control animals (non-diabetic group, no RF exposure). RF exposure in the experiment resulted in a whole body average SAR of 0.24 W/kg with an ERMS field of 17.5 V/m in non-thermal levels. RESULT: Results showed that there was no statistically important differences between non-RF exposed diabetes group and control group; Group I and Group III (p>0.05). There was no statistically important differences between diabetes group and diabetes+RF exposed group (Group I and Group II) (p>0.05). RF exposure did not result in increased MN frequencies in exfoliated bladder cells of diabetic rats with respect to control animals (Group II and Group III), either and this result found no statistically important (p>0.05). CONCLUSIONS: This study suggested no possible genotoxic effects of RF radiation among human beings especially with chronic disorders, such as diabetes.

The use of human hair as biodosimeter.

The potential use of human hair samples as biologic dosimeter was investigated by electron spin resonance (ESR) spectroscopy. The hair samples were obtained from female volunteers and classified according to the color, age and whether they are natural or dyed. Natural black, brown, red, blonde and dyed black hair samples were irradiated at low doses (5-50Gy) and high doses (75-750Gy) by gamma source giving the dose rate of 0.25Gy/s in The Sarayköy Establishment of Turkish Atomic Energy Authority. While the peak heights and g-values (2.0021-2.0023) determined from recorded spectra of hair were color dependent, the peak-to-peak line widths were varied according to natural or dyed hair (ΔHpp: 0.522-0.744mT). In all samples, the linear dose-response curves at low doses saturated after ~300Gy. In black hair samples taken from different individuals, differences in the structure of the spectrum and signal intensities were not observed. The EPR signal intensities of samples stored at room temperature for 22 days fell to their half-values in 44h in black hair, 41h in blonde and brown hairs, 35h in dyed black hair and in 17h in red hair. The activation energies of samples annealed at high temperatures for different periods of time were correlated well with those obtained in the literature. In conclusion, hair samples can be used as a biological dosimeter considering the limitations showed in this study.

No genotoxic effect in exfoliated bladder cells of rat under the exposure of 1800 and 2100 MHz radio frequency radiation.

In this study, we aimed to investigate the effects of 1800 and 2100 MHz Radio Frequency (RF) radiation on the number of micronucleus (MN) in exfoliated bladder cells of rat which shows the genotoxic damage. Exposure period was 30 min/day, 6 days/week for a month and two months exposure periods. Thirty male wistar albino rats were used for five groups: Group I (n = 6): 1800 MHz RF exposed animals for one month, Group II (n = 6): 2100 MHz RF exposed animals for one month, Group III (n = 6): 2100 MHz RF exposed for two months, Group IV (n = 6): control group for one month, Group V (n = 6): control group for two months. Rats of the control groups were housed in their home cages during the entire experimental period without subjecting to any experimental manipulation. 1800 and 2100 MHz RF exposures did not result in any significant MN frequencies in rat bladder cells with respect to the control groups (p > 0.05). There was no statistically significant difference between 2100 MHz RF exposed groups, either. Further studies are needed to demonstrate if there is any genotoxic effect, micronucleus formation in other tissues of rats.

Effects of static and 50 Hz alternating electric fields on superoxide dismutase activity and TBARS levels in guinea pigs.

The toxic oxygen free radicals are extremely reactive and can cause considerable damage to biomolecules, such as RNA, enzymes, membranes, proteins, and lipids, which may in turn lead to various pathological consequences. Lipid peroxidation, evaluated by determination of thiobarbituric acid reactive substances (TBARS) is the free radical-induced oxidation of polyunsaturated fatty acids. Normally, the oxygen free radicals are neutralized by highly efficient systems in the body. These include antioxidant enzymes like superoxide dismutase (SOD). In a healthy subject, there is a balance between free radicals and levels of antioxidants. The aim of this study was to determine lipid peroxidation and SOD levels in plasma, liver, lung and kidney tissues exposed to different intensities, directions and exposure periods of static and 50 Hz alternating electric fields. Electric field intensities ranging from 0.3 kV/m to 1.8 kV/m were applied in vertical or horizontal direction in exposure periods of 1, 3, 5, 7, and 10 days. The increase in SOD and TBARS levels of plasma, liver, lung, and kidney tissues was found to depend significantly on the type of electric field and the exposure period.

Miliary tuberculosis: clinical manifestations, diagnosis and outcome in 38 adults.

OBJECTIVE: The aim of the study was to determine the clinical, radiographic and laboratory characteristics, diagnostic methods, and prognostic variables in patients with miliary tuberculosis (TB). METHODOLOGY: The records of 38 patients (15 male, 23 female; mean age 41 years, range 16-76 years) with miliary TB from 1978 to 1998 were analyzed. Patients were evaluated also as to whether they presented with a fever of unknown origin (FUO). Criteria for the diagnosis of miliary TB were (i) miliary pattern on chest X-ray or (ii) biopsy or autopsy evidence of miliary organ involvement. Paraffin-embedded tissues with granulomata (n = 15) were re-evaluated for the presence of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR). RESULTS: Predisposing conditions were present in 24% of the patients. The findings were fever, weakness, night sweats, anorexia/weight loss (100% for each), hepatomegaly (37%), splenomegaly (32%), choroidal tubercles (13%), neck stiffness (11%), altered mental status (8%), anaemia (76%), leukopenia (26%), thrombocytopenia (16%), lymphopenia (76%), pancytopenia (8%) and hypertransaminasemia (55%). Eighteen patients (47%) met the criteria for a FUO. Miliary infiltrates were found on chest X-rays of 32 of 38 cases (84%). In six cases without miliary infiltrates, the diagnosis was made by laparotomy in four cases, and autopsy in two cases. Tuberculin skin test was positive in 32% of cases. Acid-fast bacilli were demonstrated in 37% (16/43), and cultures for M. tuberculosis were positive in 90% (9/10) of tested specimens (predominantly sputum and bronchial lavage). Granulomas were found in 85% (11/13) of lung, 100% (15/15) of liver, and 56% (9/16) of bone marrow tissue specimens. Acid-fast bacilli staining was negative in all (0/21), while PCR was positive in 47% (7/15) of specimens with granulomata. Mortality was 18%. Stepwise logistic regression identified male sex (P = 0.005), non-typical miliary pattern (P = 0.015), altered mental status (P = 0.002) and failure to treat for TB (P = 0.00001) as independent predictors of mortality. CONCLUSIONS: Miliary infiltrates on chest X-ray or FUO should raise the possibility of miliary TB. Therapy should be administered urgently to prevent an otherwise fatal outcome.

No effect of 50 Hz magnetic field observed in a pilot study on pentylenetetrazol-induced seizures and mortality in mice.

This study was planned so as to evaluate whether magnetic field exposure has any significant effect on the pentylenetetrazol (PTZ)-induced seizures. Mice were exposed to 50 Hz, 2 G (0.2 mT) magnetic field in glass cages for 1 h. Sham exposure was produced by turning off the current while the animals were in the same exposure volume. Then, PTZ was administered intraperitoneally (i.p.) at a dose of 60 mg/kg and the animals were observed for 30 min. Subsequently, the latency to seizure onset, total seizure duration, the number of seizure episodes and mortality were recorded for each subject. There was no evidence for a significant effect of the 50 Hz magnetic field on the mean number of PTZ induced seizures, seizure latency, total seizure duration and mortality (P>0.05). As a conclusion the present study failed to provide any further support for a therapeutic potential of magnetic field.