In Vitro Evaluation of the Apoptotic, Autophagic, and Necrotic Molecular Pathways of Fluoride.

Prolonged exposure to high doses of fluoride causes chronic poisoning called fluorosis, which affects many tissues and causes serious health problems. This study was planned to investigate the apoptotic, autophagic, and necrotic molecular pathways of fluoride. Sodium fluoride (NaF) was administered to normal rat kidney epithelial (NRK-52E) cells. The NaF IC50 value was determined using the MTT assay. The expression of the genes in the autophagic, apoptotic, and necrotic pathways was determined by real-time PCR. It was determined that there were significant changes in NaF-induced molecular pathways depending on the time. There were no increases in apoptotic and necrotic pathway markers except for Atg3, an autophagy gene, at the 3rd and the 12th hours. However, there was an induction in all cell death signaling pathways at 24 h. The molecular mechanisms demonstrated NaF-induced cellular death in the NRK-52E cell line. It was concluded that these molecular mechanisms were activated with NaF, and different mechanisms accelerated the cellular death at the 24th hour.

Could hematologic parameters be useful biomarkers for the diagnosis of endometriosis?

OBJECTIVES: The objective of this study was to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte­to­monocyte ratio (LMR), and mean platelet volume (MPV) in patients with endometriosis as compared with healthy controls. BACKGROUND: Currently, no non-invasive diagnostic test of endometriosis has been implemented in clinical practice. METHODS: A total of 121 women with endometriosis and 136 controls participated in this retrospective study. The extent of the disease in the patients with endometriosis was determined using the American Society of Reproductive Medicine revised classification. Sensitivities and specificities of NLR, LMR and MPV were evaluated by receiver-operating characteristic (ROC) analysis. RESULTS: Patients with endometriosis had higher neutrophil counts, white blood cell (WBC) levels, NLR, MPV, and lower lymphocyte count and LMR than the control group. The cut-off values were found to be 1.6 for NLR at 87.6 % sensitivity and 44.8 % specificity and 8 for MPV at 75.2 % sensitivity and 68.4 % specficity. For LMR, the cut-off value was 5.6 with 66.1 % sensitivity, 50 % specificity. Patients with stages III or IV had significantly lower MPV (p = 0.039) and LMR levels (p = 0.016) than patients with stages I or II. CONCLUSION: NLR, LMR, and MPV may be used to distinguish patients with endometriosis from controls (Tab. 4, Fig. 4, Ref. 37).

Outcome of ICSI with motile testicular spermatozoa obtained through microscopically assisted testicular sperm extraction in relation to the ovarian response.

INTRODUCTION: To determine the relationship between AFC, basal FSH level, woman's age, the number of oocytes retrieved and the outcome of ICSI with testicular spermatozoa obtained with microscopically assisted testicular sperm extraction. MATERIAL AND METHODS: In this retrospective cohort study, a total of 340 couples who underwent ICSI treatment with testicular sperm were enrolled. Women aged?40years and the first cycles of couples were included. ICSI was performed with motile testicular spermatozoa obtained from 89 men with obstructive azoospermia and 251 men with nonobstructive azoospermia. GnRH-antagonist protocol was used for ovulation induction. Simple linear regression was carried out to analyze relationship between the AFC, basal FSH, woman's age, the number of oocytes, and the live birth rate (LBR). Receiver operator characteristic curves (ROC) were formed to detect cut-off values below which LBR was significantly decreased. ROC curve analysis demonstrated that the cut-off level of the number of oocytes retrieved to predict the LBR was 7. According to this cut-off level, all patients were divided into two groups. Women with retrieved<7 oocytes were included in Group 1 and women with retrieved?7 oocytes were included in Group 2. RESULTS: The mean age of men was 35.1±4.9years. The mean age, mean FSH level and mean AFC of women were 32.1±4.9years, 6.9±2.7 IU/L, 7.6±3.4, respectively. Significant correlations were found between AFC, the number of oocytes retrieved, and the LBR per ICSI cycle with testicular spermatozoa. The LBR was significantly lower in women with AFC<8 than those with AFC?8. Independently, the LBR was significantly lower in cycles with<7 oocytes retrieved compared to those with ?7. Embryo transfer was not achieved in 37 cycles with<7 oocytes (37/167, 22.1%) and 18 cycles with?7 (18/173, 10.4%) because of the absence of transfer-quality embryos (P=0.005). The LBRs were the lowest in cycles with one or two oocytes available (8.3 and 8.3%, respectively), but these rates were not statistically different than those in cycles with 3, 4, 5 and 6 oocytes (14.2, 17.2, 18.5, 17.6%, respectively, P=0.810). CONCLUSIONS: AFC and the number of oocytes retrieved are important prognostic factors in an ICSI cycle with testicular sperm in women ?40years, yielding significantly diminished LBRs with<8 antral follicles and/or<7 oocytes retrieved.

The influence of sperm parameters on the outcome of intracytoplasmic sperm injection-embryo transfer cycle in poor responder women under 35 years of age.

To evaluate the influence of sperm parameters on the outcome of intracytopiasmic sperm injection (ICSI) cycies in poor responaer women under the age of 35 years in a retrospective analysis in a fertility center. MATERIALS AND METHODS: A total of 432 poor responder women who underwent ICSI cycles were evaluated. The interventions included ICSI and microdissection testicular sperm extraction (m-TESE). Main outcome measures included fertilization, cleavage, clinical pregnancy, and delivery rates. RESULTS: Patients were di- vided into four groups according to the sperm parameters and the source of sperm; testicular spermatozoa obtained from men with azoospermia (group 1; n=26), severe oligoasthenoteratozoospermia (OAT) (group 2; n=35), OAT (group 3; n=104), and normal semen analysis (group 4; n=267). Average age of the women, antral follicle count, FSH level, male age, number of previous ICSI cycles, duration of infertility, and the maximal endometrial thickness were similar among the groups. In group 1, the fertilization rate was lower than those in all other groups. Cleavage, clinical pregnancy, and delivery rates were similar among the groups. CONCLUSIONS: Neither sperm parameters nor the source of spermatozoa affects delivery rate through ICSI in poor responder women < 35-years-old.

Total Thyroidectomy for Management of Benign Multinodular Goitre in an Endemic Region: Review of 620 Case.

INTRODUCTION: The aim of this study was to evaluate the safety and efficiency of total thyroidectomy (TT) when performed by an experienced surgeon in benign multinodular goitre (BMNG) in an endemic region. MATERIAL AND METHODS: A total of six hundred and twenty consecutive patients, who underwent a total thyroidectomy for BMNG between July 2004 and May 2012, were reviewed in this study. RESULTS: Of the one hundred and nine men and 511 women examined, the mean ± SD (standard deviation) ages were 48 ± 14 in men (range: 19-79) and 51 ± 16 in women (range: 18-84 years). The annual mean number of operation was 80 ± 14 (range: 68-86). The mean operation time lasted 64 ± 12 minutes (range: 48-95). About 2.3 ± 0.4 (range: 1-4) parathyroid glands were observed during thyroidectomy. Parathyroid auto transplantation was performed in seventy-eight patients (12.5%). Patient-stay in hospital was approximately 2.3 ± 0.3 days (range: 1-5). TT was performed in all patients as the primary operation. Pathologic findings revealed BMNG in four hundred and seventy (75.8%) cases, papillary carcinoma in 66 (10.3%), thyroiditis in 59 (9.5%), follicular carcinoma in 10 (1.6%), follicular adenoma in 5 (0.8%), and thyroid lymphoma in 3 cases (0.5%). Postoperatively, bilateral recurrent laryngeal nerve (RLN) injury was seen in one case (0.3%) and unilateral RLN injury in 5 (0.8%) cases. Three months later, only three cases (0.5%) were permanent. The histological diagnosis in all patients with permanent RLN injury was thyroiditis. Transient hypoparathyroidism was found in forty-eight cases (7.8%), three of which (0.5%) were permanent. Four cases were re-operated due to re-bleeding (0.6%). Seroma developed in three cases (0.5%) and wound infection in two (0.3%). CONCLUSION: TT can be performed safely by an experienced surgeon with a minimal risk in a high volume hospital.

Living related kidney transplantation in Libya: a single center experience.

OBJECTIVE: The aim of this study was to establish a successful living related kidney transplantation program in Libya and to bring down health care costs in management of patients with end-stage renal disease. PATIENTS AND METHODS: Since the transplantation program was launched on August 17, 2004, 135 patients have been transplanted up to August 17, 2007. The donors and recipients were screened prior to transplantation. Our immunosuppressive protocol was cyclosporine-based. Both donors and recipients were followed in the transplant outpatient clinic. RESULTS: Among 135 accepted pairs, 133 cases (98.5%) were genetically related donors and recipients and 2 cases were emotionally related. Mean donor age was 37 +/- 9.5 years (range, 18-56 years). Recipient age was significantly lower, namely, 37 +/- 13.6 years (range, 7-67 years). Among the recipients, 95 (70.4%) were males and 40 (29.6%) females, while among the donors, 102 (75.6%) were males and 33 (24.4%) females. The most common donor-recipient relationship was brother-to-brother. There was no early or late surgical mortality among donors. Delayed graft function was observed in 3 patients (2.2%), acute rejection in 6 (4.4%), and posttransplantation infections in 8 (5.9%). Urinary tract infections were diagnosed in 6 patients (4.4%) and pneumonia in 3 (2.2%). Postsurgical complications included ureteric kink in 2 patients (1.5%) and an anastomotic urine leak in 4 (3.0%). At 36 months, graft survival was observed in 130 patients (96.3%) and patient survival in 126 (93.3%). CONCLUSION: The Libyan National Organ Transplant Program has been successful with results comparable to international levels.

Clinical features and natural course of Behçet's disease in 661 cases: a multicentre study.

BACKGROUND: Behçet's disease (BD) is a systemic inflammatory disease with unpredictable exacerbations and remissions. The natural course of BD is not fully known. OBJECTIVES: We aimed retrospectively to determine the occurrence of the symptoms in chronological order. We also evaluated the influence of the treatment and follow-up on the clinical severity and tried to identify the factors determining severe organ involvement. METHODS: Six hundred and sixty-one patients were involved in this multicentre study. The symptoms of the disease were recorded retrospectively in the time order of the manifestations in each patient. RESULTS: Oral ulcers were the most common manifestation (100%), followed by genital ulcers (85.3%), papulopustular lesions (55.4%), erythema nodosum (44.2%), skin pathergy reaction (37.8%), and articular (33.4%) and ocular involvement (29.2%). Oral ulcers were the most common onset manifestation (88.7%). The mean +/- SD duration between the onset symptom and the fulfilment of diagnostic criteria was calculated to be 4.3 +/- 5.7 years. The clinical severity score was significantly increased in the noncompliant treatment group compared with the compliant group with the passage of time (P < 0.001). The frequency of ocular involvement and genital ulcers was significantly higher in patients whose disease onset was at < 40 years. Genital ulcers, ocular involvement, papulopustular lesions, thrombophlebitis and skin pathergy reaction were found to be significantly more frequent in males. CONCLUSIONS: Mucocutaneous lesions are the hallmarks of the disease, and especially oral ulcers precede other manifestations. The increase in clinical severity score is more pronounced in patients without regular treatment and follow-up. Male sex and a younger age at onset are associated with more severe disease.

Triterpenes from Campanula lactiflora.

One new triterpene compound, 3beta-acetoxylup-20(30)-en-29-al and two known 3-acetylptiloepoxide and 3beta-acetoxylup-20(29)-ene were isolated for the first time from the leaves of Campanula lactiflora and their structures were deduced by high field 1D and 2D 400 MHz NMR, EI-MS and (+) LC-MS/MS spectra.

A case report; trilobular spleen?

During dissection course a spleen with a pyramidal extremity was noted. Literature reviewed and this rare case has been presented.

A new method of artificial bone modeling for medical education.

We have developed an artificial bone modeling method by using negative cast technique. As we decided to use this material in medical student training, we insisted on producing a long-standing and not expensive material therefore we chose a polyester resin.

The measurements of some anthropometric landmarks of the mandible; a preliminary anatomical study.

In this study, the morphometric measurements were done on human cadaver mandibles including ramus height and width, angle between ramus and corpus, the relation between foramen mentale and teeth. The aim of this study was to establish some standards with the achieved results in order to expand these studies in some reconstructive surgical areas. As a result, the standard measurements were established under the heads of short and long ramus, acute and obtuse angle mandibles.

Comparison of four different types of osteotomes for lateral osteotomy: a cadaver study.

In this study, four different types of osteotomes were compared in lateral osteotomy of cosmetic rhinoplasty. For this purpose, 32 halves of 16 cadavers were used. Fracture line and mucosal injuries were evaluated. Statistical analyses were made to find out if there is any relation between the type of osteotomes and the extent of injury. At the same time bone thickness was measured on the osteotomy line. Wide osteotomes have shown more mucosal injuries which is statistically significant. Bone thickness does not exceed 3 mm at any point on the osteotomy lines.