A Rare Occurrence of Endometriosis Externa Individually Within the Rectus Abdominis Muscle.

Endometriosis is defined as the presence of ectopic functional endometrial tissue outside the uterine cavity. It most commonly occurs in the pelvic organs, including the ovaries, ligaments of the uterus, and the pouch of Douglas. Extrapelvic implantation of endometrial tissue has also been reported in the literature. Extrapelvic endometriosis can be explained by lymphatic/vascular migration or mechanical transplantation of the tissue during surgery. Rectus abdominis muscle endometriosis is a rare phenomenon that usually presents with a palpable abdominal mass and cyclic pain. Ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) can be effective to define the location and size of the mass. Our patient was a 32-year-old woman presenting with cyclic abdominal pain and the development of an abdominal mass she had noticed for a year. USG and MRI scans revealed an endometrial focus in the right rectus abdominis muscle. Surgical excision with negative margins was performed, since surgical treatment of the lesion is offered as the definitive treatment.

A novel multifunctional NCQDs-based injectable self-crosslinking and in situ forming hydrogel as an innovative stimuli responsive smart drug delivery system for cancer therapy.

In this work, we offer an easy approach to develop a novel injectable, pH sensitive and in situ smart drug delivery system for use in cancer treatments. The developed hydrogels containing nitrogen doped carbon quantum dots (NCQD), doxorubicin (Dox) and hydroxyapatite (HA) were obtained by in situ self-crosslinking. Characterization of the synthesized nanomaterials, interactions between NCQD/Dox/HA hydrogel structure were carried out by TEM, FESEM, EDS, FTIR, XPS, XRD, Zeta potential, DLS, UV-Vis, SEM, gelation time, injectability and DIST measurements. In addition, antibacterial evaluation which was performed against Staphylococcus aureus realized that HA compound significantly increased the antibacterial activity of the hybrid hydrogel. The anticancer drug release to the tumor cell microenvironment with a pH of 5.5 was found to be higher compared to the release in the normal physiological range of pH 6.5 and 7.4. MTT and live/dead assays were also performed using L929 fibroblastic cell lines to investigate the cytotoxic behavior of NCQDs, and NCQDs/Dox/HA hydrogels. Furthermore, the NCQDs/Dox/HA hydrogel could transport Dox within a MCF-7 cancerous cell at specifically acidic pH. Additionally, imaging of cell line was observed using NCQDs and their use in imaging applications and multicolor features in the living cell system were evaluated. The overall study showed that in situ formed NCQDs/Dox/HA hydrogel represented a novel and multifunctional smart injectable controlled-release drug delivery system with great potential, which may be considered as an attractive minimal invasive smart material for future intelligent delivery of chemotherapeutic drug and disease therapy applications.

Biomimetic synthesis of Ag, Zn or Co doped HA and coating of Ag, Zn or Co doped HA/fMWCNT composite on functionalized Ti.

In this study a novel composite containing fMWCNT and Ag, Zn or Co doped hydroxyapatite (HA) and undoped HA successfully synthesized using biomimetic process and coated on the chemically silane functionalized Ti via facile surface functionalization and deposition approach through the covalent immobilization. In this approach, the properties of Ti pretreated with NaOH and APTES were examined before the composite coating. Functional groups with oxygen were created on the MWCNT surface by acidic treatment. The synthesized powders were characterized using SEM, XRD, EDS, TGA, FTIR, Raman. Surface energies were decreased from 46.03 mN/m (Ti) to 43,79 mN/m (Ti-/fMWCNT/Ag, Zn or Co doped HA). The contact angles of APTES, fMWCNT and undoped or doped HA containing Ti surfaces increased from 40.03 ±â€¯1.2 to 49.05 ±â€¯1.6°. The bond strengths between the coatings and Ti substrates were measured using an adhesive strength test which indicates that the crosslinking process increased the adhesion strength (from 14.6 ±â€¯0.9 to 19.8 ±â€¯1.2 MPa). The results indicated that the Ag+, Zn2+ or Co2+ added in prepared SBF medium have been located in the HA lattice structure at rate of 1.06, 1.86 and 1.78 at.%, respectively. The biocompatibility of the synthesized composites was evaluated using MTT assays in vitro and no negative effect was observed on cell viability. This work shows that the fMWCNT/Ag, Zn or Co doped HA coating promise for the potential implementation in biomaterial coating fields.

3D porous collagen/functionalized multiwalled carbon nanotube/chitosan/hydroxyapatite composite scaffolds for bone tissue engineering.

In this study, we describe new collagen/functionalized multiwalled carbon nanotube/chitosan/hydroxyapatite (Col/f-MWCNT/CS/HA) composite scaffolds which were fabricated by freezing (-40 °C at 0.9 °C/min) and lyophilization (48 h, 0 °C and 200 mtorr). The compressive stresses (from 523 to 1112 kPa), swelling (from 513.9 ±â€¯27 to 481.05 ±â€¯25%), porosity (from 98 ±â€¯0.15 to 95.7 ±â€¯0.1%), contact angle (from 87.8 to 76.7°) properties examined before and after biomineralization for comparison 3D porous Col, CS, Col/f-MWCNT and Col/f-MWCNT/CS scaffolds. Biomineralization was performed by biomimetic method in concentrated SBF (10 × SBF, at 37 °C and 6.5 pH). XRD, SEM, EDS, FTIR, TGA, Optical microscopy and BET results showed that compared to Col, CS and Col/f-MWCNT scaffolds, Col/f-MWCNT/CS scaffolds had higher in vitro bioactivity, large surface area (11.746 m2/g) and a good pore volume (0.026 cc/g), interconnected porous microstructure (with 20-350 µm pore size) and incorporates the advantageous properties of both Col, f-MWCNT, CS and HA. Finally, the methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate scaffolds cytotoxicity which showed that Col/f-MWCNT/CS scaffolds have the best biocompatibility.

Microwave-assisted biomimetic synthesis of hydroxyapatite using different sources of calcium.

In this study, some properties of biomimetic synthesized hydroxyapatite by using different sources of calcium were investigated. Biomimetic synthesis of hydroxyapatite was carried out in microwave oven using 1.5 simulated body fluid (SBF) solution having different calcium sources with 800W power for 15min. As phosphorus source di-ammonium hydrogen phosphate ((NH4)2HPO4) while for each sample as a calcium sources calcium chloride (CaCl2), calcium nitrate tetra hydrate (Ca(NO3)2·4H2O) and calcium hydroxide (Ca(OH)2) were utilized, respectively. For comparison, precipitation process was also performed in only 1.5 SBF solution without calcium and phosphorus sources. The presence of phases in synthesized hydroxyapatite was confirmed by XRD. The crystallinity and crystalline size of the phases in as synthesized powders were also calculated by using XRD data. It was found that the unique phase is hydroxyapatite (HAp, Ca5(PO4)3(OH)) by using the calcium nitrate tetra hydrate and calcium hydroxide sources, while the dominant phases are tri-calcium phosphates (TCP) and HAp for CaCl2 source and 1.5SBF which does not contain any additional Ca source. SEM studies revealed that nano-hexagonal rods and nano-spherical hydroxyapatites could be synthesized by using this process. Energy-dispersive X-ray spectroscopy (EDS) analysis revealed that the Ca/P ratio near to be as 1.5 which is the value for HAp in bone. Raman and Fourier transform-infrared spectroscopy (FT-IR) results combined with the X-ray diffraction (XRD) indicates that dominantly the present of single phase is HAp. The crystal size and fraction crystallinity of as synthesized HAp powders were changed between 29.5 and 45.4nm and 0.53-2.37, respectively. Results showed that microwave assisted biomimetic synthesis is a promising method for obtaining HAp powders in shorter process time.

Association of SSR markers with contents of fatty acids in olive oil and genetic diversity analysis of an olive core collection.

The purpose of this research was to characterize an olive core collection using some agronomic characters and simple sequence repeat (SSR) markers and to determine SSR markers associated with the content of fatty acids in olive oil. SSR marker analysis demonstrated the presence of a high amount of genetic variation between the olive cultivars analyzed. A UPGMA dendrogram demonstrated that olive cultivars did not cluster on the basis of their geographic origin. Fatty acid components of olive oil in these cultivars were determined. The results also showed that there was a great amount of variation between the olive cultivars in terms of fatty acid composition. For example, oleic acid content ranged from 57.76 to 76.9% with standard deviation of 5.10%. Significant correlations between fatty acids of olive oil were observed. For instance, a very high negative correlation (-0.812) between oleic and linoleic acids was detected. A structured association analysis between the content of fatty acids in olive oil and SSR markers was performed. STRUCTURE analysis assigned olive cultivars to two gene pools (K = 2). Assignment of olive cultivars to these gene pools was not based on geographical origin. Association between fatty acid traits and SSR markers was evaluated using the general linear model of TASSEL. Significant associations were determined between five SSR markers and stearic, oleic, linoleic, and linolenic acids of olive oil. Very high associations (P < 0.001) between ssrOeUA-DCA14 and stearic acid and between GAPU71B and oleic acid indicated that these markers could be used for marker-assisted selection in olive.

Identification of molecular markers associated with fruit traits in olive and assessment of olive core collection with AFLP markers and fruit traits.

The purpose of this study was to characterize olive core collection with amplified fragment length polymorphism (AFLP) markers and fruit traits and to determine AFLP markers significantly associated with these fruit characters in olive. A total of 168 polymorphic AFLP markers generated by five primer combinations and nine fruit traits were used to characterize relationships between 18 olive cultivars. Although all olive cultivars were discriminated from each other by either AFLP markers (<0.75 similarity level) or fruit traits, clustering based on the AFLP markers and fruit traits was not significantly correlated (r = 0.13). Partial clustering of olive cultivars by AFLP markers according to their geographical origin was observed. Associations of AFLP markers with fruits were determined using a multiple-regression analysis with stepwise addition of AFLP markers. Significant associations between eight AFLP markers and fruit traits were identified. While five AFLP markers demonstrated significant negative correlation with fruit and stone weight, width and length and total polyphenols (P < 0.05), three AFLP markers displayed significant positive correlation with α-tocopherol and γ-tocopherol (P < 0.01). This is the first report on the association of molecular markers with fruit traits in olive. Molecular markers associated with morphological and agronomic traits could be utilized for the breeding of olive cultivars. However, the association power of these markers needs to be confirmed in larger populations, and highly correlated markers should then be converted to PCR-based DNA markers such as sequence-characterized amplified region markers for better utilization.

Relationship between 1,25-dihydroxy Vitamin D levels and homeostatic model assessment insulin resistance values in obese subjects.

AIM: In this study, our aim is to evaluate the insulin resistance and quality of life in obese subjects and nonobese subjects and to find out the Vitamin D (VD) status and correlations between obesity and control groups and also according to their quality of life scores. MATERIALS AND METHOD: The study was carried out between May and October 2013 which is the period of VD synthesis in Turkey. The participants of this study were volunteering individuals - obese and nonobese individuals defined according to the body mass index (BMI) - that did not receive any VD support in the last 1-year and did not have any known chronic diseases. 1,25-OH VD status and homeostatic model assessment insulin resistance (HOMA-IR) values were evaluated. RESULTS: The study population consisted of 39 individuals with normal weight (23 women, 16 men) and 66 individuals categorized as obese (51 women, 15 men). The difference in HOMA-IR and VD values between the group of obese individuals and the group of nonobese individuals was significant (P < 0.001 vs. P <0.001). The median value of HOMA-IR was higher in the obese group than in the nonobese group (P < 0.001) while the median value of VD was higher in the nonobese group than in the obese group (P < 0.001). The results regarding the relationship of BMI with HOMA-IR and VD show that there was a positive correlation between HOMA-IR and BMI (rs = 0.507; P < 0.001) and there was a negative correlation between HOMA-IR and VD (rs = -0.316; P = 0.0001). CONCLUSION: Given serious diseases associated with low serum VD levels such as diabetes and cardiovascular disorders as well as low side effect incidence and low cost of VD treatment, it would be a reasonable approach to identify routine serum 25(OH) D and/or 1,25-OH VD levels of obese patients and administer a treatment to patients with low levels of VD.

Alemtuzumab (anti-CD52 monoclonal antibody) as single-agent therapy in patients with relapsed/refractory chronic lymphocytic leukaemia (CLL)-a single region experience on consecutive patients.

Alemtuzumab, a humanized anti-CD52 monoclonal antibody, is used in patients with refractory chronic lymphocytic leukaemia (CLL). We report results in health care with alemtuzumab on consecutive, advanced-stage patients from a well-defined geographical region. Records from 1,301 patients (Stockholm-Cancer-Registry 1991-2010) identified 56 relapsed/refractory patients treated with alemtuzumab. Median age was 69 years, 88 % had advanced Rai-stage with median 3 prior therapies. One fourth had bulky lymphadenopathy and 73 % were refractory to purine analogues. Median treatment length was 11.6 weeks. Median cumulative dose was 930 mg, significantly higher (p = 0.0277) for responders. Overall response-rate (ORR) was 43 %; 32.5 %, 50 % and 87.5 % in the Refractory, Purine analogue relapsed and Relapsed/Other subgroup, respectively. Response rate was significantly associated with subgroup (p = 0.0104). Good performance status (PS) was associated with better response rate (p = 0.0227). Median time-to-treatment-failure (TTF) (months) was 7.8 months, significantly (p < 0.0001) longer for responders (13.4) Major infections occurred in 36 %. Median overall survival was 22.5 months (range 0.4-74.3). Positive predictive factors were good PS (p < 0.0001) and fewer previous therapies (p = 0.0038). Twenty percent were retreated with alemtuzumab with an ORR of 54.5 %, and a TTF of 7.1 months. A high cumulative dose/longer duration of therapy and a relatively high response rate was observed compared to previous reports. Optimal patient identification and management may result in avoidance of early discontinuation and possibly better outcomes.

Clinical course of community-acquired respiratory syncytial virus pneumonia in newborns hospitalized in neonatal intensive care unit.

INTRODUCTION: Respiratory syncytial virus (RSV) is a major cause of pneumonia in infants worldwide. We aimed to evaluate the clinical course of community-acquired RSV pneumonia in newborns hospitalized in neonatal intensive care unit. MATERIALS AND METHODS: All the newborns diagnosed as pneumonia were prospectively evaluated for RSV infection between November 2010 and April 2011. Fifty-four specimens of nasopharyngeal secretions were tested in parallel with the RAT and the multiplex real time polymerase chain reaction (RT- PCR). Downes' score was used to assess the disease severity in patients with pneumonia. RESULTS: RAT has a sensitivity of 90% and a specificity of 78.5%, as the PCR technique target assay. Four of the patients with RSV pneumonia had secundum atrial septal defect (ASD) and all of four needed mechanical ventilation support. The first day Downes' score was positively correlated with time of intravenous fluid requirement (p= 0.001, r= 0.48), total oxygen need (p= 0.000, r= 0.63), and re-enteral feeding (p= 0.001, r= 0.46). Blood pH (p= 0.031, r= 0.46) were negatively correlated with Downes' score. The second day Downes' score was higher in patients with ASD than those of without ASD (3.8 ± 2.6 vs. 2 ± 1.1, p= 0.01). The most possible risk factor for longer hospital stay was the higher second day Downes' score (p= 0.02 OR: 1.9, CI 95% (1.1-3.2). All infants were discharged from hospital in a good health. CONCLUSION: RAT is sensitive and specific in detecting RSV infections in newborns. Physicians may use Downes' score for evaluation of disease severity in infants with RSV pneumonia. In these patients, ASD has increased the disease severity.

A novel mutation of laminin ß-2 gene in Pierson syndrome manifested with nephrotic syndrome in the early neonatal period.

Pierson syndrome is a rare autosomal recessive disorder which is mainly characterized by congenital nephrotic syndrome (CNS), diffuse mesangial sclerosis (DMS) and distinct ocular abnormalities, including microcoria. Most affected children exhibit early onset of chronic renal failure, neurodevelopmental deficits, and blindness. It is caused by a homozygous or compound heterozygous mutation in the gene encoding laminin beta2 (LAMB2) on chromosome 3p21. In this article, we report on a patient with CNS, bilateral megalocornea and microcoria. The patient had developed renal failure at very early postnatal period and died of septic shock. A novel homozygous donor splice mutation (IVS4 + 2T > C) in LAMB2 gene was identified in the patient.

Wallenberg Syndrome following neck cracking: a case report.

Cracking the neck is an age-old practice in contravention of its dangerous affects. One of these affects is Brain stem strokes and in this report we describe a patient with Wallenberg syndrome due to neck cracking who is the one of the rare cases in the literature.

Determination of self-incompatibility groups of sweet cherry genotypes from Turkey.

Determination of S-allele combinations of sweet cherry genotypes and cultivars has importance for both growers and breeders. We determined S-allele combinations of 40 local Turkish sweet cherry genotypes using a PCR-based method. Ten different S-alleles were detected. Although the most common S-allele was S3, as also found in Western genotypes and cultivars, there were some differences in the frequencies of some S-alleles between Turkish and Western sweet cherry genotypes. According to their S-allele compositions, 30 local Turkish sweet cherry genotypes were assigned to 10 previously identified incompatibility groups. For the remaining genotypes, whose S-allele combinations did not fit to any previous incompatibility groups, three more incompatibility groups, XLII, XLIII and XLIV, were proposed. Results obtained from this study will help both sweet cherry growers and breeders to better manage these local Turkish sweet cherry genotypes in their orchards.

Neuronal plasticity in a case with total hemispheric lesion.

RATIONALE: The adult brain maintains the ability for reorganization or plasticity throughout life. Non-invasive techniques such as functional magnetic resonance imaging (f-MRI), Transcranial Magnetic Stimulation (TMS) and magnetoencephalography could be used to show recovery of function after stroke. OBJECTIVE: Explanation of neuronal plastisity and intra-hemisferic reorganization with functional recovery of a case who has total extensive damage on the left hemisphere. case report: Twenty-five years old female patient was admitted to our hospital with a right-sided sequel hemiparesis and homonymous hemianopia. She had right-sided paresia after an inguinal hernia operation when she was one and a half years old. On neurological examination she was speaking fluently, and cooperated on complicated comments. Motor examination revealed right-sided spastic hemiparesis predominant on distal parts and right sided visual field defect. But she was continuing her activity of daily livings without help. Her detailed neuropsycological examination revealed mild cognitive dysfunction. Cranial MRI showed total left hemisphere encephalomalasia. Right hemisphere function was noticed on task-related brain activation during voluntary movement of her right leg (she was not capable of performing right hand function tasks by herself ) on functional MRI. CONCLUSION: Cerebral lesions in the early life can be compensated with the unaffected hemisphere by the neuronal reorganisation and a patient with complete left hemisphere lesion such as our patient can speak, maintain her life without assistance but with mild cognitive decline, compared with elderly stroke patients.

An uncommon association of vacterl complex with hypertrophic pyloric stenosis and horseshoe lung.

We report a case of VACTERL complex which had concomitant horseshoe lung, laryngeal cleft, and hypertrophic pyloric stenosis, which has not been previously reported.

Neonatal thrombo-embolism: risk factors, clinical features and outcome.

BACKGROUND: There are few data with respect to prothrombotic risk factors in neonates. AIM: To determine the associated risk factors, clinical features and outcome in newborn infants diagnosed with thrombo-embolism. METHODS: Case records of 25 infants (17 full-term and eight preterm) diagnosed with thrombo-embolism between January 2005 and April 2008 in a neonatal intensive care unit were reviewed. RESULTS: Of the 25 infants, 18 cases of venous (72%) and seven of arterial (28%) thrombo-embolism were recorded; in 18 it was associated with central catheterisation. The sites of thrombosis were portal vein (15), right renal vein (one), right femoral vein (one), multiple veins (one), right femoral artery (3), right iliac artery (2), bilateral iliac and renal arteries (one) and left renal artery (one). Hereditary thrombotic mutations were detected in three patients and anticardiolipin antibody was detected in one, none of whom had been catheterised. The remaining three non-catheterised patients had perinatal risk factors. Venous catheter placement was undertaken in 12 patients (48%), eleven of whom had: umbilical venous catheterisation for exchange transfusion (9), partial exchange transfusion (one) and venous access (one), and one had femoral venous catheterisation for an angiographic study. Arterial catheterisation was undertaken in seven patients (28%) (one infant had both umbilical venous and arterial catheters) for angiographic studies (5) and blood sampling (2). Of the 18 catheterised patients (72%), thrombophilic studies were undertaken in 13 and none had abnormal results. Additional perinatal risk factors were present in 18 patients (72%) and included prematurity (8), congenital heart disease (8), septicaemia (5), dehydration (3), respiratory distress syndrome (3), polycythemia (2), meconium aspiration syndrome (one), pneumonia (one), maternal diabetes (one), necrotising enterocolitis (one) and perinatal asphyxia (one). Although most of the patients recovered after anticoagulant or fibrinolytic therapy, the five (20%) deaths were associated mainly with underlying diseases. CONCLUSION: The most important risk factor for thrombo-embolic events in neonates is placement of central catheters and some perinatal prothrombotic conditions. Nevertheless, hereditary or acquired thrombophilic risk factors may also be a cause of thrombo-embolism.

SSR analysis demonstrates that olive production in the southern Marmara region in Turkey uses a single genotype.

The southern Marmara region in Turkey was surveyed to determine the olive cultivars that are used for olive production. Genetic diversity analysis using simple sequence repeat (SSR) markers indicated that the cultivar Gemlik is the major olive cultivar grown in this region, while other olive cultivars are grown only for use as pollinators of Gemlik or for growers' own exotic consumption. Although the quality of Gemlik is widely accepted in Turkey, its tendency toward alternate bearing is a major drawback. Twenty-four genotypes were selected within the cultivar Gemlik because of their tolerance to alternate bearing. These selected genotypes have the same SSR alleles as Gemlik, making them good candidates for developing a Gemlik olive with reduced alternate bearing. About 8% of samples did not share the same SSR alleles with Gemlik, though these genotypes were identified as Gemlik by the growers. Some other standard cultivars that are grown in other regions of Turkey were mistakenly called Gemlik in this region, probably due to the popularity of this cultivar in the southern Marmara region. In conclusion, as indicated by SSR analysis, Gemlik has become the standard cultivar in this region; future research should be focused on techniques to improve the production and quality of table olives and olive oil from this cultivar.

Hyperparathyroidism secondary to maternal hypoparathyroidism and vitamin D deficiency: an uncommon cause of neonatal respiratory distress.

A 4-day-old neonate presented with respiratory distress owing to chest wall deformity associated with metabolic bone disease. He was found to have congenital hyperparathyroidism and his mother was suffering from post-surgical hypoparathyroidism and vitamin D deficiency. The patient was given calcium lactate and maintenance doses of vitamin D. The respiratory distress subsided, the parathyroid hormone level returned to normal and by 4 weeks of age bone mineral content had improved. Congenital hyperparathyroidism should be considered in neonates presenting with respiratory distress and chest deformity.