The physiological and disturbing effects of surgical face masks in the COVID-19 era.

BACKGROUND: In the COVID-19 pandemic, the concern about mask-harmful effects disturbed mask-adherence. However, it is not certain whether the masks cause cardiopulmonary overload. OBJECTIVE: To investigate the physiological and disturbing effects of surgical face masks during exercise. METHOD: The study was conducted in a tertiary hospital with 100 healthy volunteers between September 2020 and January 2021. Individuals with impaired walking, cardiopulmonary disease, and smoking were not included in the study. Initially, respiratory rate (RR), heart rate (HR), oxygen saturation (SpO2), end-tidal carbon dioxide (EtCO2) were measured.  Participants underwent 6-minute walking test (6MWT) with and without surgical masks.  Mask-discomfort questionnaire was applied before and after 6 MWT with the mask. RESULTS: Surgical masks during 6 MWTs significantly increased HR, RR, and EtCO2 levels (p<0.001).  Walking distance (p<0.001) and SpO2 level (p=0.002) were significantly decreased with mask. In Mask-Discomfort Questionnaire, humidity, temperature, resistance, salinity, odor, fatigue (p<0.001), and itching (p=0.001) scores significantly increased after 6MWT with mask. CONCLUSION: In healthy volunteers, HR, RR, EtCO2 were increased, and SpO2 and walking distance were decreased in the short-term, light exercise performed with the surgical mask. Findings support the concern that masks may cause cardiopulmonary overload (Tab. 3, Fig. 1, Ref. 17). Text in PDF www.elis.sk Keywords: COVID-19, masks, physiology, psychological side effects, questionnaire.

Simulation and experimental measurement of radon activity using a multichannel silicon-based radiation detector.

In this study, high-precision radiation detector (HIPRAD), a new-generation semiconductor microstrip detector, was used for detecting radon (Rn-222) activity. The aim of this study was to detect radon (Rn-222) activity experimentally by measuring the energy of particles in this detector. Count-ADC channel, eta-charge, and dose-response values were experimentally obtained using HIPRAD. The radon simulation in the radiation detector was theoretically performed using the Geant4 software package. The obtained radioactive decay, energy generation, energy values, and efficiency values of the simulation were plotted using the root program. The new-generation radiation detector proved to have 95% reliability according to the obtained dose-response graphs. The experimental and simulation results were found to be compatible with each other and with the radon decays and literature studies.

Experiences in microarray-based evaluation of developmental disabilities and congenital anomalies.

BACKGROUND: Chromosomal microarray analysis is the first-tier test for the evaluation of developmental disabilities and congenital anomalies. In this report, we present CMA results of 971 patient and 301 parent samples. MATERIALS AND METHODS: Among 971 patient samples, 133 (13.6%) had pathogenic variants. RESULTS: While analyzing, an "in-house" variant database was also used besides other databases. Owing to this, we have found chance to report the most frequent benign variants in Turkish population. CONCLUSION: With the additional data we acquired in this study, we also emphasized the high potential of CMA in revealing single gene disorders and novel gene-phenotype associations as well as copy number variations.

The relationship between anticancer effect of metformin and the transcriptional regulation of certain genes (CHOP, CAV-1, HO-1, SGK-1 and Par-4) on MCF-7 cell line.

BACKGROUND: 1,1-dimethylbiguanide hydrochloride (biguanide metformin) is a hypoglycemic agent that is widely used in the treatment of Type 2 diabetes. Use of metformin was found to be associated with the lower risk of cancer. It is suggested that metformin has an anticancer and antiproliferative effect and affects the apoptosis by activating the AMPK and inhibiting the mammalian target of rapamycin (mTOR). Although the effects of metformin treatment of various types of cancers are defined with many mechanisms, the literature provides only sufficient information about how it affects the SGK-1, Par-4 and Cav-1 mRNA expressions and the impact of this effect on cytotoxicity. The breast cancer is globally one of the most important causes of cancer-related mortality for women. We, therefore investigated the possible effects of metmorfin on proliferation, cytotoxicity and some unfolded protein response (UPR) genes in the breast cancer cells (MCF-7). MATERIALS AND METHODS: We administrated 0.31 mM, 2.5 mM and 10 mM of metformin alone and in combination with 2-DG to the MCF-7 cells and monitored the cell viability and proliferation with real-time cell analyzer system for 48 hours. We also measured CHOP, Cav-1, HO-1, SGK-1 and Par-4 genes mRNA expression levels using Real Time-Polymerase Chain Reaction (RT-PCR). We considered the GAPDH gene as reference gene and the control groups as calibrator. We performed an analysis for relative gene expressions of the study groups. RESULTS: Metformin caused transcriptional regulation of UPR and tumor-related genes in MCF-7 cells and inhibited the proliferation depending on the dose, resulting in cytotoxic effect. CONCLUSIONS: We consider that administration of metformin with chemotherapeutic agents could be an effective method in treatment of breast cancer through mechanisms such as reduced resistance to chemotherapy and increased cytotoxic activity.

Car-borne survey of natural background gamma dose rate in Çanakkale region, Turkey.

Natural background gamma radiation was measured along roads in the environs of Çanakkale region by using a car-borne spectrometer system with a plastic gamma radiation detector. In addition, activity concentrations of ²³8U, ²²6Ra, ²³²Th and 4°K in soil samples from the Çanakkale region were determined by using a gamma spectrometer with an HPGe detector. A total of 92,856 data of the background gamma dose rate were collected for the Çanakkale region. The background gamma dose rate of the Çanakkale region was mapped using ArcGIS software, applying the geostatistical inverse distance-weighted method. The average and population-weighted average of the gamma dose are 55.4 and 40.6 nGy h⁻¹, respectively. The corresponding average annual effective dose to the public ranged from 26.6 to 96.8 µSv.

Plasma cell-free DNA levels in children on peritoneal dialysis.

BACKGROUND/AIMS: Plasma levels of cell-free DNA (cfDNA) are elevated in various clinical conditions including cancer, stroke, trauma, myocardial infarction, autoimmune disorders, and pregnancy-associated complications. Previously, increased cfDNA levels were reported during hemodialysis. However, there is limited data regarding cfDNA levels in peritoneal dialysis (PD) patients. The aim of this study was to investigate the levels of cfDNA in children on PD. METHODS: Twenty-one children on PD (median age: 12; range: 4-18 years) and 21 healthy children (median age: 10; range: 6-16 years) were enrolled into the study. Plasma cfDNA was measured using a real-time quantitative PCR for the beta-globin gene. RESULTS: The median concentrations of cfDNA in the plasma of PD patients and healthy controls were 2,205 genome-equivalents/ml of plasma (range: 39-5,845) and 1,033 genome-equivalents/ml of plasma (range: 254-5,116), respectively (p = 0.026). A significant positive correlation was observed between C-reactive protein levels and plasma cfDNA levels (r: 0.52, p < 0.0001). CONCLUSION: Our data have demonstrated for the first time that cfDNA is increased in children on PD treatment. However, the mechanism by which the levels of cfDNA is increased and the clinical significance of this finding in PD patients is unclear. Further studies are warranted to clarify the precise mechanism and clinical significance of elevated cfDNA in children on PD.

Analysis of mosses along Sarp-Samsun highway in Turkey.

The elemental analysis of mosses along Sarp-Samsun highway in Turkey was determined using energy dispersive X-ray fluorescence method. A radioisotope excited X-ray fluorescence analysis using the method of multiple standard additions is applied for the elemental analysis of mosses. An annular 50 mCi (241)Am radioactive source and annular 50 mCi (55)Fe radioactive source were used for excitation of characteristic K X-rays. An Si(Li) detector which has a 147 eV full width at half maximum for 5.9 keV photons was used for intensity measurements. A qualitative analysis of spectral peaks showed that the samples contained phosphates, potassium, calcium, titanium, iron, strontium, tin and barium. Since this study is the elemental analysis along the highway, one can expect to detect Pb. Due to the detection limit of EDXRF, elements were analyzed with Atomic Absorption Spectroscopy (AAS) for Pb. Evaluation of these elements with their potential hazards for ecology and human is briefly discussed.

Epiphytic algae on mosses in the Altindere Valley National Park (Maçka-Trabzon/Turkey).

Species composition and abundance of epiphytic algae on mosses growing in the Altindere Valley National Park were investigated in March 2008. The epiphytic algae identified in these samples were 27 species in total, 15 of the Bacillariophyta, 7 of the Cyanophyta, 4 of the Chlorophyta and a single of the Euglenophyta species. The members of the Bacillariophyta were more frequently found among these epiphytic algae on mosses. Netrium digitus (Ehrenb.) Itzigs and Rothe var. curtum (Borge) Willi Krieg. was recorded for the first time in the desmids flora of Turkey. The epiphytic algal flora on mosses at the submerged habitat was the richest of the three habitats.

Contributions to the moss flora of Giresun Region (Sebinkarahisar and Alucra district).

The aim of the study was to obtain knowledge on the moss flora of the Giresun Region-rather than to identify the entire range moss flora of the region. After the identification of 287 moss specimens collected from the research area between June and August in 2007 and 2008, total 85 taxa were defined. These taxa belong to 17 families and 37 genera of Bryopsida (Musci). Among them, 14 taxa -Hygroamblystegium irriguum Hedw., Rhynchostegium confertum (Dicks.) B. S. G., Rhynchostegium alpinum Huds. ex With., Bryum dichotomum Hedw., Bryum laevifilum Syed., Hygrohypnum smithii (Sw.) Broth., Grimmia decipiens (Schultz) Lindb., Grimmia tergestina Tomm. Ex Bruch and Schimp., Schistidium flaccidum (DeNot.) Ochyra., Schistidium platyphyllum (Mitt.) Kindb., Palustriella decipens (De Not.) Ochyra., Desmatodon latifolius (Hedw.) Brid., Phascum curvicolle Hedw., Syntrichia princeps (De Not.) Mitt. new for A4 grid square (40 degrees- 42' N, 38 degrees -42' E) which was adopted by Henderson. Thirty six taxa are new for Giresun Province. All taxa are new for study area. For every each taxon, the habitat pattern and distribution data are presented.

Lung cancer detection with low-dose spiral computed tomography in chronic obstructive pulmonary disease patients.

PURPOSE: To determine whether low-dose spiral computed tomography (LDCT) can improve the lung cancer detection rate in chronic obstructive pulmonary disease (COPD) subjects. MATERIAL AND METHODS: From October 1999 to December 2003, 374 COPD patients underwent LDCT for lung carcinoma screening. All subjects with an abnormal baseline CT scan were followed with serial CT scans as part of our protocol. Follow-up was continued until the demonstration of no change over a minimum of 24 months, or resolution. Sputum samples were also obtained for cytological analysis. RESULTS: On the baseline spiral CT scan, 132 of 374 patients (35.2%) had at least one non-calcified nodule that required periodic follow-up with CT scans. The median follow-up time was 21 months (range 2-48 months). Of the 374 COPD subjects, nine patients with primary lung cancer (2.4%) were detected: six were squamous cell carcinomas, two were small-cell lung carcinomas (SCLC), and one was adenosquamous carcinoma. Three of the nine tumors were in stage IA, two in stage IIB, two in stage IIIA, and two were limited SCLC. Potentially curative pulmonary resection was performed in four patients, pulmonary lobectomy in three, and wedge excision in one. One subject with stage IA squamous cell carcinoma received radiotherapy, as pulmonary function was severely impaired. In addition, four patients underwent removal of benign lesions. Sputum was collected in 205 (54.8%) of 374 patients. There were 154 (75 %) metaplasia, 14 (6%) moderate dysplasia, and one (0.4%) malignant case. CONCLUSION: LDCT increases early lung carcinoma detection rate in COPD patients, but pulmonary function impairment may reduce its benefit.

The Arg753GLn polymorphism of the human toll-like receptor 2 gene in tuberculosis disease.

Toll-like receptor 2 (TLR2), a member of the Toll-like receptor family, plays an important role in recognition of, and subsequent immune response activation against, mycobacteria. The genetic polymorphism of TLR2 (arginine to glutamine substitution at residue 753 (Arg753Gln)) has been associated with a negative influence on TLR2 function, which may, in turn, determine the innate host response to mycobacteria. The aim of the present study was to investigate the Arg753Gln single nucleotide polymorphism of the TLR2 gene in tuberculosis (TB) patients compared to healthy controls. A retrospective case/control study was carried out. The Arg753Gln polymorphism of the TLR2 gene was studied in 151 TB patients compared to 116 ethnically and age-matched healthy control subjects. The TLR2 polymorphism (adenine (A) allele) was observed in 17.9 and 7.7% of TB patients and controls, respectively. When the ratios of the three genotypes were compared between the two groups, the AA genotype was found to be more significantly associated with TB. Allele frequencies for guanine (G) and A were found to be 0.95 and 0.05 in the control group and 0.86 and 0.14 in the TB patient group, respectively. The risk of developing TB disease was increased 6.04- and 1.60-fold for carriers of the AA and GA genotypes, respectively. In conclusion, the present data suggest that the arginine to glutamine substitution at residue 753 polymorphism of the Toll-like receptor 2 gene influences the risk of developing tuberculosis.

Effects of oral montelukast on airway function in acute asthma.

Montelukast, a specific cysteinyl leukotriene receptor antagonist, has been shown to improve pulmonary function within 1 h of ingestion. This study was undertaken to compare the effects on peak expiratory flow rate (PEFR) of oral montelukast added to intravenous steroid, intravenous steroid alone and placebo during the 24 h period following administration. Seventy asthmatic patients (FEV1 40-80% predicted and > or = 15% improvement after inhaled beta agonist) were enrolled in a single blind study to receive oral montelukast (10 mg) plus intravenous prednisolone (1 mg/kg), intravenous prednisolone (1 mg/kg) or placebo in a randomised fashion. The patients received one ofthe above three groups of medication before any other treatments. This was immediately followed by the aerosol treatments of 100 mcg of terbutaline sulphate divided into three doses during 1 h as described in the consensus statement. Thereafter, patients were observed for 24 h to document the effects on PEFR, Borg dyspnoea score and need for rescue medication. The primary end point was percentage change at different time points. Secondary end points were Borg dyspnoea score and use of rescue medication. Compared with placebo, montelukast added to the prednisolone group and the prednisolone alone group had significant percentage change from baseline in PEFR in the entire 24 h period (P<0.05). The difference in PEFR between montelukast plus prednisolone group and prednisolone group favoured the montelukast plus prednisolone group but did not reach statistical significance. Furthermore, montelukast plus prednisolone group required less inhaled short-acting beta agonistthan other two groups. The results of this study indicate that adding montelukast to steroid in acute asthma may have some additive improvement in lung functions.

Experimentally prefabricated bladder.

PURPOSE: Long life expectancy after augmentation cystoplasty increases the importance of late complications of augmentation cystoplasty. Many complications are related to the mucosa of the intestinal flap used for augmentation cystoplasty. We compared a new prefabricated enterocystoplasty flap with the classic techniques of enterocystoplasty using seromuscular flaps. For prefabrication the seromuscular flap was partially grafted with uro-epithelium before augmentation cystoplasty. MATERIALS AND METHODS: The study consisted of 4 groups. In the first 2 groups seromuscular flaps were used for augmentation cystoplasty with different sides of the flap inside the bladder. The muscular and serosal surfaces were prefabricated in groups 3 and 4, respectively. Prefabricated seromuscular flaps were used for augmentation cystoplasty after remaining in situ for 2 weeks. RESULTS: While mean augmented bladder capacity in groups 1, 2 and 4 was 18 to 20 ml. after 8 weeks, capacity in the prefabricated seromuscular enterocystoplasty group was 50 ml. Histopathological examination showed severe fibrosis in all except the prefabricated seromuscular enterocystoplasty group. CONCLUSIONS: Prefabrication allows the avoidance of the complications caused by intestinal mucosa in the reservoir and results in good capacity when the raw surface of the seromuscular flap is partially grafted with uro-epithelium before use.

Takayasu's arteritis presenting with bilateral parenchymal consolidations and severe respiratory failure.

This is a report of an unusual case of Takayasu's arteritis presenting with bilateral parenchymal infiltrations and severe respiratory failure caused by pulmonary hemorrhage. The patient was initially diagnosed and treated as protracted pneumonia. After the diagnosis of Takayasu's arteritis, she was successfully treated with high-fractioned oxygen and corticosteroid therapy.

Reliability of frozen section in determining tumor thickness intraoperatively in laryngeal cancer.

OBJECTIVES: The relationship between locoregional lymph metastasis and tumor thickness in head and neck cancer has been well documented in recent years. Determining tumor thickness by frozen section may help the surgeon decide intraoperatively whether to perform elective neck dissection, whereas paraffin section results could be obtained at a later time for this decision. The aim of this study was to evaluate the accuracy of tumor thickness measurements obtained by macroscopic measurement and by frozen section intraoperatively in laryngeal cancer. STUDY DESIGN: Prospectively we compared the tumor thickness results obtained by gross visual examination, by frozen section, and by paraffin section in 20 total, near-total, and horizontal supraglottic laryngectomy specimens. METHODS: The sections were stained with hematoxylin and eosin and tumor thickness was measured under a light microscope with an ocular micrometer. RESULTS: A strong correlation was found between frozen section and paraffin section tumor thickness measurements (Pearson correlation coefficient = 0.993, P <.001). Paired t test showed a 4.59 mm mean difference between macroscopic and paraffin section measurements, and a 0.76 mm mean difference between frozen and paraffin section measurements. CONCLUSION: Assessment of tumor thickness in laryngeal cancer intraoperatively by frozen section is a reliable method.

Amniotic fluid exchange for the prevention of neural tissue damage in myelomeningocele: an alternative minimally invasive method to open in utero surgery.

OBJECTIVE: Experimental studies have shown that neural tissue damage in myelomeningocele (MMC) is acquired, resulting from exposure of neural tissue to amniotic fluid (AF). Similar to neural tissue damage in MMC, in gastroschisis, intestines exposed to AF are damaged. In gastroschisis, intestinal damage can be prevented by changing the composition of the AF with partial AF exchanges. An experimental study was performed to investigate whether the neural tissue damage in MMC can be prevented by AF exchange. METHODS: Thirteen-day-old fertilized chick eggs were used. In group 1, the amnio-allantoic membrane was opened to create a common cavity, and MMC was created (MMC-only group). In group 2, after creation of MMC, amnio-allantoic fluid exchange was performed (MMC-plus-exchange group). Chicks were extirpated for histopathologic examination 5 days later. RESULTS: While edema, focal calcification, fibrosis, capillary cell proliferation and scattered mononuclear cells were observed in the MMC-only group, histopathologic changes were mild in the exchange group. The number of neuron-specific enolase stainings (+) neural cell count was significantly higher in the exchange group compared to the MMC-only group (p < 0.01). CONCLUSION: Exposure of MMC to AF causes structural neural tissue damage that can be prevented by AF exchange. AF exchange is minimally invasive compared to open in utero surgery for the closure of MMC. By AF exchange, neural tissue damage that occurs during the gestational period may be prevented.

A case of split notochord syndrome: presence of dorsal enteric diverticulum adjacent to the dorsal enteric fistula.

Like umblical enteric remnants (eg, umblical sinus and omphalomesenteric fistula), enteric remnants can be seen on the dorsal aspect of the body (dorsal enteric sinus, dorsal enteric fistula IDEF], dorsal enteric diverticulum) in conjunction with complete cleft of the vertebral column. Complete cleft of the vertebral column associated with gastrointestinal tract and central nervous system anomalies is known as "split notochord syndrome" (SNS). The authors present an unreported variant of SNS having dorsal enteric diverticulum adjacent to the DEF. The patient died 17 days after surgical repair.