Sex prediction with morphometric measurements of first and fifth metatarsal and phalanx obtained from X-ray images by using machine learning algorithms.

BACKGROUND: The aim of this study is to predict sex with machine learning (ML) algorithms by making morphometric measurements on radiological images of the first and fifth metatarsal and phalanx bones. MATERIALS AND METHODS: In this study, radiologic images of 263 individuals (135 female, 128 male) between the ages of 27 and 60 were analysed retrospectively. The images in digital imaging and communications in medicine (DICOM) format were transferred to personal workstation Radiant DICOM Viewer programme. Length and width measurements of the first and fifth metatarsal and foot phalanx bones were performed on the transferred images. In addition, the ratios of the total length of the first proximal and distal phalanx and length of the first metatarsal and total length of fifth proximal, middle, and distal phalanx and maximum length of fifth metatarsal were calculated. RESULTS: As a result of machine learning algorithms, highest accuracy, specificity, sensitivity, and Matthews correlation coefficient values were found as 0.85, 0.86, 0.85, and 0.71, respectively with decision tree algorithm. It was found that accuracy rates of other algorithms varied between 0.74 and 0.83. CONCLUSIONS: As a result of our study, it was found that sex estimation was made with high accuracy rate by using machine learning algorithms on X-ray images of the first and fifth metatarsal and foot phalanx. We think that in cases when pelvis, cranium and long bones are harmed and examination is difficult, bones of the first and fifth metatarsal and foot phalanx can be used for sex estimation.

Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study.

PURPOSE: The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. METHODS: This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. RESULTS: The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. CONCLUSION: Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.

Diffusion-weighted imaging of the liver in assessing chronic liver disease: effects of fat and iron deposition on ADC values.

OBJECTIVE: This study was designed to evaluate whether fat and iron affect the apparent diffusion coefficient (ADC) values of the liver parenchyma in the settings of fibrosis and inflammation. PATIENTS AND METHODS: We evaluated the diffusion-weighted images (DWIs) of 58 patients with chronic liver disease and 48 control subjects. Liver specimens of patients were assessed for fibrosis, necroinflammation, iron, and steatosis. Liver ADCs, spleen ADCs, and normalized liver ADCs (defined as the ratio of the liver ADC to spleen ADC) values were analyzed after stratifying patients with either fibrosis stages or histology activity index (HAI) scores. The relationship between ADC values and histopathological findings was studied using multiple linear regression analysis. RESULTS: The median liver and normalized liver ADC values were significantly lower in higher stages of fibrosis and HAI scores. Compared to the control group, patients with the highest stages of fibrosis and inflammation had significantly higher spleen ADCs. The effect of the fibrosis stage on liver ADC and normalized liver ADC values was significant in the setting of inflammation, whereas the degree of steatosis and iron grade did not affect these ADC values. CONCLUSIONS: ADC values can distinguish both later stages of liver fibrosis and inflammation. There is no significant effect of fat and iron on ADC values. Therefore, DWI may be reliable in evaluating liver fibrosis and inflammation.

Effects of total knee arthroplasty on balance and fall risk in elderly patients with severe gonarthrosis: An age- and sex-matched comparative study.

Background: Falls are a severe cause of morbidity and mortality in elderly patients, and gonarthrosis causes a tendency to fall. Total knee arthroplasty (TKA) is a widely used successful surgical procedure for end-stage gonarthrosis. Aims: To investigate whether there is a difference in the frequency of falls, balance and fall risk, and clinical and radiological results in patients with end-stage gonarthrosis with and without TKA. Patients and Methods: This was a single-center, retrospective, case-control study with age- and gender-matched groups. A total of 100 patients over 60 years of age, with end-stage gonarthrosis and who met the inclusion criteria were included in the study. Fall risk was analyzed using the Berg Balance Scale (BBS), TUG tests, and the ITAKI Fall Risk Test. Knee varus angles were measured using standing long-leg radiographs, and radiological gonarthrosis grading was performed. Pain levels and quality of life were assessed using the VAS and WOMAC. Each patient's knee extensor muscle strength and range of motion were measured. Results: WOMAC, ITAKI, TUG test, and VAS scores were significantly higher in the control group than in the TKA group. BBS scores were significantly lower in the control group. Although the number of falls was high in the control group, there was no statistically significant difference between the two groups. Conclusion: The results of this study showed that total knee arthroplasty provided statistically significant improvement in the clinical, radiological, and fall risk results of the patients. Although there was a decrease in the frequency of falls compared to the control group, it was statistically insignificant. In addition, in our study, it was evaluated that the most important risk factor for falling was advanced age.

Development of a calculation software for 4πß-γ digital coincidence counting and its application to 60Co and 152Eu activity measurements.

A unique calculation software has been developed for 4πß-γ coincidence counting system that has been recently set up. The combination of the software and the hardware constitutes the measurement system. The developed coincidence counting software uses both of coincidence and anticoincidence methods. Activity calculations have been performed using unique algorithms generated for these methods. The main processing modules of the software are the raw data reading-writing module, energy spectrum composing module, energy filtering module, deadtime application module, coincidence and anticoincidence calculation modules and efficiency extrapolation module. The known activities of 60Co and 152Eu solutions were measured to evaluate the measurement system and the developed software. The results showed that the hardware system and the software can successfully measure the activity of ß-γ decay radionuclides which have complicated decay schemes.

Lycopene supplementation does not change productive performance but lowers egg yolk cholesterol and gene expression of some cholesterol-related proteins in laying hens.

1. This work examined the effects of purified lycopene (LYC) supplementation or a source of LYC as tomato powder (TP) on productive performance, egg yolk cholesterol levels as well as gene expression related to mechanism and regulation of cholesterol.2. One hundred and fifty laying hens (Lohman LSL, hybrid) were randomly divided into one of three treatments, with 10 replicates of five hens per cage, totalling 50 hens per treatment. The hens were fed either a standard diet (control) or a standard diet supplemented with 20 mg purified lycopene/kg diet (LYC) or an equal amount of lycopene-containing tomato powder (TP) for 12 weeks.3. Feed consumption, egg production, and feed efficiency remained similar among treatments (P ≥ 0.27). Supplementing lycopene, either as a purified form or in TP, increased the levels of serum and egg yolk lycopene and reduced serum and egg yolk cholesterol concentrations (P < 0.001). Supplementation in either form decreased gene expression for intestinal NPC1L1, MTP, ACAT2, hepatic SREBP1c, ACLY, and LXRα but increased hepatic ABCG5 and ABCG8 (P < 0.001).4. The results of the present work revealed that egg yolk cholesterol metabolism is regulated by the modulation of a group of genes, particularly with LYC supplementation.

Genotype-phenotype correlation, gonadal malignancy risk, gender preference, and testosterone/dihydrotestosterone ratio in steroid 5-alpha-reductase type 2 deficiency: a multicenter study from Turkey.

BACKGROUND: Studies regarding genetic and clinical characteristics, gender preference, and gonadal malignancy rates for steroid 5-alpha-reductase type 2 deficiency (5α-RD2) are limited and they were conducted on small number of patients. OBJECTIVE: To present genotype-phenotype correlation, gonadal malignancy risk, gender preference, and diagnostic sensitivity of serum testosterone/dihydrotestosterone (T/DHT) ratio in patients with 5α-RD2. MATERIALS AND METHODS: Patients with variations in the SRD5A2 gene were included in the study. Demographic characteristics, phenotype, gender assignment, hormonal tests, molecular genetic data, and presence of gonadal malignancy were evaluated. RESULTS: A total of 85 patients were included in the study. Abnormality of the external genitalia was the most dominant phenotype (92.9%). Gender assignment was male in 58.8% and female in 29.4% of the patients, while it was uncertain for 11.8%. Fourteen patients underwent bilateral gonadectomy, and no gonadal malignancy was detected. The most frequent pathogenic variants were p.Ala65Pro (30.6%), p.Leu55Gln (16.5%), and p.Gly196Ser (15.3%). The p.Ala65Pro and p.Leu55Gln showed more undervirilization than the p.Gly196Ser. The diagnostic sensitivity of stimulated T/DHT ratio was higher than baseline serum T/DHT ratio, even in pubertal patients. The cut-off values yielding the best sensitivity for stimulated T/DHT ratio were ≥ 8.5 for minipuberty, ≥ 10 for prepuberty, and ≥ 17 for puberty. CONCLUSION: There is no significant genotype-phenotype correlation in 5α-RD2. Gonadal malignancy risk seems to be low. If genetic analysis is not available at the time of diagnosis, stimulated T/DHT ratio can be useful, especially if different cut-off values are utilized in accordance with the pubertal status.

Turkish health field periodical editors' Views on publication process and ethical problems.

OBJECTIVE: We aimed in this study to investigate views and suggestions of health field editors about the publication process and ethical problems. MATERIALS AND METHODS: The study involved 42 journal editors who accepted to participate in the study. The data were collected through 70-item "Editor Views Questionnaire" which was developed by the researchers in line with the related literature. RESULTS: The editors who participated in the study were asked about their views about the most common problems they encountered related to publication ethics; the top three problems indicated by the editors included unjustified authorship (40.5%), duplicate publication (33.3%), and falsification (26.2%). An analysis of the problems encountered in the initial evaluation stage revealed the top three issues as articles that did not follow the writing rules of the journal (33.3%), unqualified articles (30.1%), and negligence of the author(s) (14.3%). Views in relation to the problems about the referee evaluation stage included evaluations that were not completed within the time given (28.6%), insufficient importance attached to the evaluation (23.9%), and inability to find sufficient number of referees (16.7%). CONCLUSION: some editors were found to encounter violation of publication ethics, to experience problems in the revision stage, and not to feel fully independent in their contribution to article publication and thus the improvement of the journal quality. Identification of journal editors' views and problems is an important step for the solution to these problems; it could thus contribute to improving the quality of publication process and journal quality.

Effects of the supplemental chromium form on performance and metabolic profile in laying hens exposed to heat stress.

This experiment was conducted to compare the effect of the supplemental chromium (Cr) form on performance, egg quality, and metabolic profile in laying hens exposed to heat stress (HS). Laying hens (n = 1800; 16-wk-old; Lohmann LSL-Lite) were kept in cages in temperature-controlled rooms at either 22 ± 2°C for 24 h/d (thermoneutral, TN) or 34 ± 2°C for 8 h/d, from 08:00 to 17:00 h, followed by 22°C for 16 h (HS) for 12 wks. Hens reared under both environmental conditions were fed 1 of 3 diets: a basal diet and the basal diet supplemented with either 1.600 mg of chromium-picolinate (CrPic, 12.43% Cr) or 0.788 mg of chromium-histidinate (CrHis, 25.22% Cr) per kg of diet, delivering 200 µg elemental Cr per kg diet. Data were analyzed by 2-way ANOVA. Exposure to HS caused decreases in feed intake (P < 0.0001), egg production (P < 0.0001), egg weight (P < 0.0001), eggshell weight (P < 0.0009), eggshell thickness (P < 0.0001), eggshell strength (P < 0.0001), and Haugh unit (P < 0.0001), deterioration in feed conversion ratio (P < 0.0001), increases in serum glucose and cholesterol concentrations (P < 0.0001 for both), decreases in serum and egg yolk Cr concentrations (P < 0.0001 for both), and decreases in serum Na (P < 0.002) and K (P < 0.01) concentrations. Both Cr sources were equally effective in alleviating performance variables under the HS condition. However, neither Cr sources alleviated deteriorations in egg quality parameters and serum electrolytes. Both Cr sources decreased serum glucose and cholesterol concentrations and increased serum and egg yolk Cr concentrations under the HS condition. In conclusion, HS adversely affected laying performance, egg quality, and metabolic profile. Both CrPic and CrHis partially alleviated the adverse effect of HS on these parameters. Inclusion of either Cr source could be a part of nutritional management strategies to overcome the adverse effects of HS performance and metabolic profile in laying hens.

A review of the TAEA proficiency test on natural and anthropogenic radionuclides activities in black tea.

A proficiency test amongst 15 Turkish laboratories with participation of 5 non-Turkish laboratories was organized to determine the 137Cs, 40K and 90Sr massic activities in black tea powder samples. The bulk material, consisting of tea produced in 2014, was mixed with contaminated tea that was withdrawn from the market after the Chernobyl accident. Nineteen laboratories reported 41 results. The evaluation of the results was based on the accuracy and precision criteria adopted by the IAEA Proficiency Testing Group and resulted in 49% acceptable results, 19% acceptable with warning and 32% were found to be not acceptable.

Organic chromium modifies the expression of orexin and glucose transporters of ovarian in heat-stressed laying hens.

In this study, the effect of the supplemental organic chromium (Cr) forms on the expression of ovarian orexin(hypocretin), glucose transporters (GLUTs), heat shock proteins (HSPs) andnuclear factor-kappaB (NF-κB)were investigated in laying hens (HS). Laying hens (n=1800; 16-wk-old; Lohmann LSL-Lite) were allocated to 6 random groups according to a 2 × 3 factorial trial scheme with two different environmental temperatures [Thermoneutral (TN groups; at either 22±2 °C 24 h/d)  and heat stress (HS groups; at 34±2 °C for 8 h/d, 08:00 to 17:00 h, followed by 22°C for 16 h for a period of 12 wks)], andhens reared under both environmental conditions were fed either a basal diet or the basal diet supplemented with 1.600 mg of chromium-picolinate (CrPic, 12.43% Cr) and 0.788 mg of chromium-histidinate (CrHis, 25.22% Cr) per kg of diet, delivering 200 µg elemental Cr per kg diet. HS groups showed decreased levels of orexin and GLUTs(GLUT1, GLUT4), and increased NFκB, HSP60, HSP70 and HSP90 levels compared to the TN groups in ovarian tissue of hens (P < 0.0001 for all).However, dietary chromium supplementation (CrPic-CrHis) increasedorexin and GLUTs levels and significantly reduced the NF-κB and HSPs levels making them closer to those of thermoneutral group (P < 0.0001).In conclusion, CrPic and CrHis showed supported the relief and treatment of stress complications.

Effects of the supplemental chromium form on performance and oxidative stress in broilers exposed to heat stress.

This experiment was conducted to investigate effects of the organic complex form of supplemental chromium (Cr) on performance, oxidative stress markers, and serum profile in broilers exposed to heat stress (HS). A total of 1,200 10-day-old boilers (Ross-308) was divided into one of the 6 treatments (2 environmental temperatures x 3 diets with different Cr forms). The birds were kept in temperature-controlled rooms at either 22 ± 2°C 24 h/d (thermoneutral, TN group) or 34 ± 2°C for 8 h/d, 08:00 to 17:00 h, followed by 22°C for 16 h (HS group) and fed either a basal diet (C) or the basal diet supplemented with Cr (200 µg/kg) through 1.600 mg of CrPic (12.43% Cr) and 0.788 mg of CrHis (25.22% Cr). Feed intake and body weight were recorded weekly. After cervical dislocation, liver samples were harvested to analyze Cr concentration and glucose transporter-2,4 (GLUT-2,4) expression. The breast meat also was sampled for the concentration of Cr and expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor kappa B (NF-κB). Data were analyzed by 2-way ANOVA. Heat stress caused depressions in feed intake (12.1%) and weight gain (21.1%) as well as elevations in feed conversion (11.2%) and abdominal fat (32.8%). It was also associated with depletion of Cr reserves and increases in serum concentrations of glucose, cholesterol, creatine, and enzymes. Exposure to HS was accompanied by suppression of the expressions of Nrf2 and GLUT-2 in muscle and GLUT-4 in the liver and amplification of the expression of NF-κB in muscle. Both Cr sources partially alleviated detrimental effects of HS on performance and metabolic profile. The efficacy of Cr as CrHis was more notable than Cr as CrPic, which could be attributed to higher bioavailability. In conclusion, CrHis can be added into the diet of broilers during hot seasons to overcome deteriorations in performance and wellbeing related to oxidative stress.

Association between fear of childbirth and maternal acceptance of pregnancy.

AIM: This descriptive study aimed to explore the associations between fear of childbirth, acceptance of pregnancy and identification with the motherhood role among primipara women. BACKGROUND: Women who have difficulty accepting their pregnancy have a harder time adapting to pregnancy and motherhood and experience more fears related to childbirth. The number of studies conducted on this topic is limited. METHODS: This study involved 310 pregnant women admitted to a public hospital in Istanbul between January and June of 2013. A participant identification form, the Prenatal Self-Evaluation Questionnaire and the Wijma Delivery Expectancy/Experience Questionnaire Version A were used for data collection. RESULTS: Pregnant women participating in the study experienced moderate levels fear of childbirth. Pregnant women who requested caesarean section experienced more intense fear of childbirth. Fear of childbirth scores had significant but weak correlations with acceptance of pregnancy and identification with the motherhood role. CONCLUSION: The findings showed that acceptance of pregnancy and identification with the motherhood role are weakly associated with fear of childbirth. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The results from this study can be used to help: increase awareness among health professionals (doctors, nurses, midwives) in antenatal care services about a mother's adaptation to pregnancy and the negative effects of fear of childbirth; direct future research examining factors affecting adaptation to pregnancy and fear of childbirth; establish routine assessments for adaptation to pregnancy and fear of childbirth; provide professional support for women with difficulties adapting to pregnancy and with fear of childbirth; result in reduced complications from invasive methods such as caesarean section due to less requests for these procedures; and promote the health of mothers and babies.

MPV, NLR, and platelet count: new hematologic markers in diagnosis of malignant ovarian tumor.

OBJECTIVE: Evaluation of mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet count in the detection of malignant and benign ovarian tumors. MATERIAL AND METHODS: Sixty-six patients admitted to the present clinic over three years were in- cluded in the study. Patients diagnosed with ovarian cancer were grouped into the areas of epithelial and granulosa cell tumor diagno- sis. The values were compared to patients with benign cystic structure. Patients' preoperative hematologic parameters and their values four weeks postoperatively were analyzed. Statistical analyses were performed with SPSS software. RESULTS: MPV, NLR, and platelet count were observed at a higher rate as statistically significant in patients diagnosed with malignant ovarian cancer, compared to those with benign adnexal mass. CONCLUSION: The hemnatological parameters such as MPV, NLR, and platelet count in the detection of malignant ovarian tumors have been evaluated as useful new markers.

Capsaicinoids improve egg production by regulating ovary nuclear transcription factors against heat stress in quail.

1. To examine the molecular mechanism of capsaicinoid supplementation from capsicum extract, laying Japanese quail (n = 180, 5 weeks old) were reared either at 22°C for 24 h/d (thermoneutral, TN) or at 34°C for 8 h/d (heat stress, HS) and fed on one of three diets containing 0, 25 or 50 mg of capsaicinoids per kilogram for 12 weeks (2 × 3 factorial arrangement). 2. The results revealed that exposure to HS decreased feed consumption by 10.7% and egg production by 13.6%, increased serum and ovary malondialdehyde (MDA) levels by 66.9% and 88.1%, respectively, and reduced ovary superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) activities by 28.3%, 48.7% and 43.8%, respectively. 3. There were magnifications in the ovary nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) levels by 42.4% and suppressions in nuclear factor (erythroid-derived 2)-like 2 (Nrf2), protein kinase B (Akt) and haem-oxygenase 1 (HO-1) levels by 29.2%, 38.2% and 30.7%, respectively, in heat-stressed quail. 4. With increasing supplemental capsaicinoids, there were linear increases in egg production, antioxidant enzyme activity, linear decreases in ovary MDA and NF-κB levels and linear increases in ovary Nrf2, Akt and HO-1 levels at a greater extent in quail reared under TN condition than those reared under HS condition. Two-way treatment interactions showed that the degree of restorations in all response variables was more notable under the HS environment than under the TN environment as supplemental capsaicinoid level was increased. 5. In conclusion, capsaicinoid supplementation alleviates oxidative stress through regulating the ovary nuclear transcription factors in heat-stressed quail.

Lycopene activates antioxidant enzymes and nuclear transcription factor systems in heat-stressed broilers.

This study was conducted to evaluate the effects of dietary lycopene supplementation on growth performance, antioxidant status, and muscle nuclear transcription factor [Kelch like-ECH-associated protein 1 (Keap1) and (erythroid-derived 2)-like 2 (Nrf2)] expressions in broiler chickens exposed to heat stress (HS). A total of 180 one-day-old male broiler chicks (Ross 308) were assigned randomly to one of 2×3 factorially arranged treatments: two housing temperatures (22°C for 24 h/d; thermoneutral, TN or 34°C for 8 h/d HS) and three dietary lycopene levels (0, 200, or 400 mg/kg). Each treatment consisted of three replicates of 10 birds. Birds were reared to 42 d of age. Heat stress caused reductions in feed intake and weight gain by 12.2 and 20.7% and increased feed efficiency by 10.8% (P<0.0001 for all). Increasing dietary lycopene level improved performance in both environments. Birds reared under the HS environment had lower serum and muscle lycopene concentration (0.34 vs. 0.50 µg/mL and 2.80 vs. 2.13 µg/g), activities of superoxide dismutase (151 vs. 126 U/mL and 131 vs. 155 U/mg protein), glutathione peroxidase (184 vs. 154 U/mL and 1.39 vs. 1.74 U/mg protein), and higher malondialdehyde (MDA) concentration (0.53 vs. 0.83 µg/mL and 0.78 vs. 0.45 µg/ mg protein) than birds reared under the TN environment. Changes in levels of lycopene and MDA and activities of enzymes in serum and muscle varied by the environmental temperature as dietary lycopene level increased. Moreover, increasing dietary lycopene level suppressed muscle Keap1 expression and enhanced muscle Nrf2 expression, which had increased by 150% and decreased by 40%, respectively in response to HS. In conclusion, lycopene supplementation alleviates adverse effects of HS on performance through modulating expressions of stress-related nuclear transcription factors.

A review of the nationwide proficiency test on natural radioactivity measurements by gamma spectrometry.

This study is the review of the first proficiency test on radioactivity measurement organized in Turkey by Sarayköy Nuclear Research and Training Center (SANAEM) of Turkish Atomic Energy Authority (TAEK) in 2013. The objective of the test was to determine (226)Ra, (232)Th and (40)K activity concentrations in natural soil samples using gamma-ray spectrometry. The bulk material consisting of uranium- and thorium-rich soil and sand was milled, mixed thoroughly and sieved. Homogeneity of the final mix was tested with 6 randomly taken samples. 16 proficiency test samples were distributed to 16 participating laboratories. 12 laboratories reported results. The results were evaluated on the accuracy and precision criteria adopted by the IAEA Proficiency Testing Group. The percentage of acceptable scores was 49%. Some recommendations have been provided to the laboratories to improve the quality of their results. It is planned to extend these proficiency tests periodically for various radionuclides in various matrices.

The Acute Effect of Humic Acid on Iron Accumulation in Rats.

Free iron leads to the formation of pro-oxidant reactive oxygen species (ROS). Humic acids (HAs) enhance permeability of cellular wall and act as a chelator through electron transferring. This study was designed to test chelator effect of HA on iron as well as its anti-oxidant effect against the iron-induced hepatotoxicity and cardiotoxicity. The rats used were randomly divided into four groups (n = 8/group): group I (the control group); group II (the HA group), humic acid (562 mg/kg) was given over 10 days by oral gavage; group III (the iron group), iron III hydroxide polymaltose (250 mg/kg) was given over 10 days by intraperitoneal route; and group IV (the HA plus iron group), received the iron (similar to group II) plus humic acid (similar to those in groups II and III) group. Blood and two tissue samples both from liver and heart were obtained for biochemical and histopathological evaluations. Iron deposition, the iron-induced hepatotoxicity, and cardiotoxicity were demonstrated by histopathological and biochemical manner. However, no significant differences were observed in the serum biochemical values and the histopathological results among the iron and the HA plus iron groups in the liver tissue but not in the heart tissue. The protective effects of humic acid against iron-induced cardiotoxicity were shown but not against hepatotoxicity in our study.

Sarcoidosis of the vagina treated with methotrexate.

We describe the first case of mediolateral episiotomic sarcoidosis of the deep vaginal tissue, without involvement of the pulmonary parenchyma or pulmonary symptoms. A 68-year-old female was admitted with a vaginal mass that had developed about 1 month prior. On bimanual examination, we found a painful solid mass approximately 4 cm in diameter on the episiotomy line of the deep vaginal tissue. The patient underwent pelvic magnetic resonance imaging on suspicion of a malignancy, and a vaginal true-cut biopsy was performed. The biopsy specimen exhibited non-caseating, granulomatous inflammation and many multinucleated giant cells, strongly suggesting sarcoidosis. We had excluded other granulomatous diseases; a final diagnosis was made of stage-1 sarcoidosis in the deep vaginal mass. A 3-month course of methotrexate (2.5 mg/week) was commenced to treat a flare-up of rheumatoid arthritis. The vaginal mass resolved. To the best of our knowledge, this is the first case of sarcoidosis in a deep vaginal mass without pulmonary parenchymal or other solid-organ involvement.