Production of secondary metabolites using tissue culture-based biotechnological applications.

Plants are the sources of many bioactive secondary metabolites which are present in plant organs including leaves, stems, roots, and flowers. Although they provide advantages to the plants in many cases, they are not necessary for metabolisms related to growth, development, and reproduction. They are specific to plant species and are precursor substances, which can be modified for generations of various compounds in different plant species. Secondary metabolites are used in many industries, including dye, food processing and cosmetic industries, and in agricultural control as well as being used as pharmaceutical raw materials by humans. For this reason, the demand is high; therefore, they are needed to be obtained in large volumes and the large productions can be achieved using biotechnological methods in addition to production, being done with classical methods. For this, plant biotechnology can be put in action through using different methods. The most important of these methods include tissue culture and gene transfer. The genetically modified plants are agriculturally more productive and are commercially more effective and are valuable tools for industrial and medical purposes as well as being the sources of many secondary metabolites of therapeutic importance. With plant tissue culture applications, which are also the first step in obtaining transgenic plants with having desirable characteristics, it is possible to produce specific secondary metabolites in large-scale through using whole plants or using specific tissues of these plants in laboratory conditions. Currently, many studies are going on this subject, and some of them receiving attention are found to be taken place in plant biotechnology and having promising applications. In this work, particularly benefits of secondary metabolites, and their productions through tissue culture-based biotechnological applications are discussed using literature with presence of current studies.

Forecasting contamination in an ecosystem based on a network model.

This paper aims to predict heavy metal pollution based on ecological factors with a new approach, using artificial neural networks (ANNs), by significantly removing typical obstacles like time-consuming laboratory procedures and high implementation costs. Pollution prediction is crucial for the safety of all living things, for sustainable development, and for policymakers to make the right decisions. This study focuses on predicting heavy metal contamination in an ecosystem at a significantly lower cost because pollution assessment still primarily relies on conventional methods, which are recognized to have disadvantages. To accomplish this, the data collected for 800 plant and soil materials have been utilized in the production of an ANN. This research is the first to use an ANN to predict pollution very accurately and has found the network models to be very suitable systemic tools for modelling in pollution data analysis. The findings appear are promising to be very illuminating and pioneering for scientists, conservationists, and governments to swiftly and optimally develop their appropriate work programs to leave a functioning ecosystem for all living things. It has been observed that the relative errors calculated for each of the polluting heavy metals for training, testing, and holdout data are significantly low.

Investigation of water-soil-plant relationships based on hazardous and macro-micro element concentrations on Orontes River, Türkiye.

Arundo donax and Phragmites australis were examined in 4 different periods (June and October for 2 years), heavy metal and mineral element accumulations in plants were evaluated, and water-soil-plant relationships were revealed. Element distributions, bioaccumulation factors (BAF) and translocation factors (TF) in different parts of the investigated plant species were also determined. BAFs of elements calculated by using the concentration values in underground parts and sediment samples were between 1.02 and 4.96. While the highest TF was determined as 8.07 for Zn between washed leaf and stem in A. donax, the lowest TF was determined as 0.05 for Fe between stem and underground part. Corresponding highest and lowest TFs for P. australis were 11.80 for Cu between washed leaf and stem, and 0.02 for Fe between stem and underground part, respectively. The results were supported by MANOVA statistical analyzes. Additionally, the macro-micro elements and heavy metal accumulation levels in the parts of the Orontes River ecosystem were significantly higher in the fall periods compared to the spring periods. Our research revealed that the versatile accumulation properties and high accumulation ability of A. donax for Cd, Cr, and Ni and of P. australis for Cd, Co, Cu, Ni, Pb, and Zn.

The Orontes River passes through the regions of three different countries with high population density and developed economies. This study presents the current state of the relationship between the element types and their concentrations in the sediments in the Orontes River ecosystem and the ecophysiological parameters of the river. In this study, the focus was on the Türkiye-Hatay region of the Orontes River, the water-soil-plant relationship in this region was revealed in detail, and valuable data were compiled for researchers who will conduct research on the river ecophysiology.

An investigation on environmental pollution due to essential heavy metals: a prediction model through multilayer perceptrons.

This research is to predict heavy metal levels in plants, particularly in Robinia pseudoacacia L., and soils using an effective artificial intelligence approach with some ecological parameters, thereby significantly eliminating common defects such as high cost and seriously tedious and time-consuming laboratory procedures. In this respect, the artificial neural network (ANN) is employed to estimate the concentrations of essential heavy metals such as Fe, Mn and Ni, depending on the Cu and Zn concentrations of plant and soil samples collected from five different locations. The derived relative errors for the constructed ANN model have been computed within the ranges 0.041-0.051, 0.017-0.025, and 0.026-0.029 for the training, testing and holdout data regarding Fe, Mn, and Ni, respectively. In addition, it has been realized that the relative errors could be diminished up to 0.007 for Fe, 0.014 for Mn and 0.022 for Ni by considering the Cu, Zn, location and plant parts as independent variables during the analysis. The results produced seem instructive and pioneering for environmentalists and scientists to design optimal study programs to leave a livable ecosystem.

The levels of essential heavy metals, Fe, Mn, Ni, based on Zn and Cu in plant and soil samples have been predicted through an AI-based prediction model, a class of feedforward artificial neural networks (ANNs) with a multilayer perceptron (MLP). Thereby common drawbacks such as high cost and severely time-consuming laboratory procedures have been significantly eradicated. In the evaluation of different pollution levels at locations, it has been shown that the ANN method can overcome several disadvantages of analytical element analyzers to monitor the amounts of heavy metals such as Fe, Mn, and Ni in soil and plants.

Diagnostic accuracy of sentinel node biopsy in non-endometrioid, high-grade and/or deep myoinvasive endometrial cancer: A Turkish gynecologic oncology group study (TRSGO-SLN-006).

INTRODUCTION: This study aimed to evaluate the diagnostic accuracy of the sentinel lymph node (SLN) mapping algorithm in high-risk endometrial cancer patients. METHODS: Two hundred forty-four patients with non-endometrioid histology, grade 3 endometrioid tumors and/or tumors with deep myometrial invasion were enrolled in this retrospective, multicentric study. After removal of SLNs, all patients underwent pelvic ± paraaortic lymphadenectomy. Operations were performed via laparotomy, laparoscopy or robotic surgery. Indocyanine green (ICG) and methylene blue (MB) were used as tracers. SLN detection rate, sensitivity, negative predictive value (NPV) and false-negative rate (FNR) were calculated. RESULTS: Surgeries were performed via laparotomy in 132 (54.1%) patients and 152 (62.3%) underwent both bilateral pelvic and paraaortic lymphadenectomy. At least 1 SLN was detected in 222 (91%) patients. Fifty-five (22.5%) patients had lymphatic metastasis and 45 patients had at least 1 metastatic SLN. Lymphatic metastases were detected by side-specific lymphadenectomy in 8 patients and 2 patients had isolated paraaortic metastasis. Overall sensitivity, NPV and FNR of SLN biopsy were 81.8%, 95% and 18.2%, respectively. By applying SLN algorithm steps, sensitivity and NPV improved to 96.4% and 98.9%, respectively. For grade 3 tumors, sensitivity, NPV and FNR of the SLN algorithm were 97.1%, 98.9% and 2.9%. CONCLUSION: SLN algorithm had high diagnostic accuracy in high-risk endometrial cancer. All pelvic metastases were detected by the SLN algorithm and the isolated paraaortic metastasis rate was ignorable. But long-term survival studies are necessary before this approach becomes standard of care.

Multidimensional Scaling of the Mineral Nutrient Status and Health Risk Assessment of Commonly Consumed Fruity Vegetables Marketed in Kyrgyzstan.

Intensive production of fruits and vegetables causes heavy metal accumulation. Consumption of this kind of foodstuff is a growing concern of the modern world with the additional distress of the supply of enough foodstuffs. To contribute to this global purpose, this research aimed to find out the mineral nutrient and heavy metal concentrations of commonly consumed fruity vegetables in Kyrgyzstan. Totally, ten different fruity type vegetables were collected from five different large bazaars of Kyrgyzstan. From these, 20 samples, including washed/unwashed rinds of vegetables, were quantified in terms of their B, Ca, Cd, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, and Zn contents by using inductively coupled plasma-optical emission spectrometry (ICP-OES). The concentrations of the fruity vegetables were found in the following range: B (1.392-25.816), Ca (92.814-4095.466), Cd (0.007-0.086), Cr (0.009-0.919), Cu (0.351-8.351), Fe (4.429-126.873), K (920.124-10,135.995), Mg (61.973-879.085), Mn (1.113-78.938), Na (36.132-266.475), Ni (0.039-1.215), Pb (0.081-2.906), and Zn (1.653-87.107) (mg kg-1). It was determined that red capia pepper was the vegetable having the highest daily nutritional value according to evaluation done in our study. Taking into account of the HI values, all of the vegetables analyzed were determined to be lower than the limit value of 1 that falls into acceptable limits in terms of being safe. Peppers demonstrated the highest variation in terms of the elemental content. The high Cr content rendered hot pepper risky for consumption by both genders regarding with CR, and in terms of CR, it has been observed that nickel contents being found in vegetables including tomatoes pose a moderate risk for consumption. Quite lower risk was detected in red/Brandy-wine tomatoes, eggplants, and cucumber for both genders. As most striking result in our study, the Brandy-wine type tomato was found to be healthiest (as well as safest) and nutritious vegetable looking from the viewpoint of consumption in Kyrgyzstan.

Lemna minor, a hyperaccumulator shows elevated levels of Cd accumulation and genomic template stability in binary application of Cd and Ni: a physiological and genetic approach.

In this study, to determine whether having potential to be used as hyperaccumulator for Cd and Ni, numerous experiments were designed for conducting assessments for physiological and genotoxic changes along with defining possible alterations on mineral nutrient status of Lemna minor L. by applying Cd-Ni binary treatments (0, 100, 200 and 400 µM). Our study revealed that there were increases in the concentrations of B, Cr, Fe, K, Mg, and Mn whereas decreases were noticed in the concentrations of Na and Zn and the levels of Ca were inversely proportional to Cd-Ni applications showing tendency to increase at the low concentration and to decrease at the high concentration. Randomly Amplified Polymorphic DNA (RAPD) and Inter Simple Sequence Repeat (ISSR) analyses revealed that rather than band losses and new band formations, mostly intensity changes in the band profiles, and low polymorphism and high genomic template stability (GTS) were observed. Although, to date, L. minor was defined as an efficient hyperaccumulator/potential accumulator or competent phytoremedial agent by researchers. Our research revealed that L. minor showing high accumulation capability for Cd and having low polymorphism rate and high genomic template stability is a versatile hyperaccumulator, especially for Cd; therefore, highly recommended by us for decontamination of water polluted with Cd. NOVELTY STATEMENTMany studies have been focused on the effects of individual metal ions. However, heavy metal contaminants usually exist as their mixtures in natural aquatic environments. Especially, Cd and Ni coexist in industrial wastes.In this study, the accumulation properties of Lemna minor for both Cd and Ni were investigated and the effects of Cd and Ni on the bioaccumulation of B, Ca, Cu, Fe, Mg, K, Mn, Na, Pb and Zn in L. minor were also determined. This study furthermore aimed to assess the genotoxic effects of Cd and Ni found in being extended concentrations on DNA using the Randomly Amplified Polymorphic DNA-Polymerase Chain Reaction (RAPD-PCR) method.

Impact of cytoreductive surgery on survival of patients with low-grade serous ovarian carcinoma: A multicentric study of Turkish Society of Gynecologic Oncology (TRSGO-OvCa-001).

BACKGROUND AND OBJECTIVES: The aim of this study was to analyze the factors affecting recurrence-free (RFS) and overall survival (OS) rates of women diagnosed with low-grade serous ovarian cancer (LGSOC). METHODS: Databases from 13 participating centers in Turkey were searched retrospectively for women who had been treated for stage I-IV LGSOC between 1997 and 2018. RESULTS: Overall 191 eligible women were included. The median age at diagnosis was 49 years (range, 21-84 years). One hundred seventy-five (92%) patients underwent primary cytoreductive surgery. Complete and optimal cytoreduction was achieved in 148 (77.5%) and 33 (17.3%) patients, respectively. The median follow-up period was 44 months (range, 2-208 months). Multivariate analysis showed the presence of endometriosis (p = .012), lymphovascular space invasion (LVSI) (p = .022), any residual disease (p = .023), and the International Federation of Gynecology and Obstetrics (FIGO) stage II-IV disease (p = .045) were negatively correlated with RFS while the only presence of residual disease (p = .002) and FIGO stage II-IV disease (p = .003) significantly decreased OS. CONCLUSIONS: The maximal surgical effort is warranted for complete cytoreduction as achieving no residual disease is the single most important variable affecting the survival of patients with LGSOC. The prognostic role of LVSI and endometriosis should be evaluated by further studies as both of these parameters significantly affected RFS.

High-grade endometrial stromal sarcoma versus undifferentiated uterine sarcoma: a Turkish uterine sarcoma group study-001.

OBJECTIVE: Prognostic factors associated with high-grade endometrial stromal sarcoma (HGESS) and undifferentiated uterine sarcoma (UUS) have not been distinctly determined due to the repetitive changes in the World Health Organization (WHO) classification. We aimed to compare clinicopathologic features and outcomes of patients with HGESS with those of patients with UUS. METHODS: A multi-institutional, retrospective, cohort study was conducted including 71 patients, who underwent surgery at 13 centers from 2008 to 2017. An experienced gynecopathologist from each institution re-evaluated the slides of their own cases according to the WHO2014 classification. Factors associated with refractory/progressive disease, recurrence or death were examined using logistic regression analyses. Kaplan-Meier method and log-rank test were used for survival comparisons. RESULTS: The median disease-free survival (DFS) for HGESS and UUS was 12 months and 6 months, respectively. While the median overall survival was not reached in HGESS group, it was 22 months in the UUS group. Kaplan-Meier analyses revealed that patients with UUS had a significantly poorer DFS than those with HGESS (p = 0.016), although OS did not differ between the groups (p = 0.135). Lymphovascular-space involvement (LVSI) was the sole significant factor associated with progression, recurrence or death for HGESS (Hazard ratio: 9.353, 95% confidence interval: 2.539-34.457, p = 0.001), whereas no significant independent factor was found for UUS. CONCLUSIONS: UUS has a more aggressive behavior than HGESS. While no significant predictor of prognosis was found for UUS, LVSI is the sole independent prognostic factor for HGESS, with patients 9.3 times more likely to experience refractory/progressive disease, recurrence or death.

Morcellation in gynecology: short review and suggestions from Turkish Society of Minimally Invasive Gynecologic Oncology

Morcellation allows the removal of a large uterus and fibroids through small incisions with minimally invasive surgery. It helps to prevent the complications associated with large incisions in both hysterectomy and myomectomy operations. Currently, there is much debate regarding the use of power morcellation in laparoscopic hysterectomy and myomectomy, mainly due to the risk of peritoneal dissemination of undiagnosed uterine sarcomas. Unfortunately, there is no valid pre-operative diagnostic method that can differentiate sarcomas from myomas, and the currently available scientific literature regarding morcellation is insufficient. As the Turkish Society of Minimally Invasive Gynecological Oncology, we present our consensus opinion and suggestions for the preoperative evaluation and morcellation of fibroids, in line with the recent literature.

Environment-Based Impairment in Mineral Nutrient Status and Heavy Metal Contents of Commonly Consumed Leafy Vegetables Marketed in Kyrgyzstan: a Case Study for Health Risk Assessment.

Leafy vegetables are important components of the human diet for providing mineral nutrients. However, due to the tendency of metal accumulation, metal contents of leafy vegetables need not only to be determined but also estimated health risk for revealing possible health effects on humans. The aims of this study are (I) to examine comprehensive concentrations of trace/heavy metals along with some macroelements including Ca, Cd, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, and Zn in selected leafy vegetables from Kyrgyzstan; (II) to assess recommended dietary allowances (RDA); and (III) to evaluate hazard quotient (HQ) and carcinogenic risk estimation with associated vegetable consumption. For this purpose, B, Ca, Cd, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, and Zn elements were quantified, utilizing an ICP-OES instrument, in 18 samples belonging to 12 different groups of leafy vegetables including celery, Chinese parsley, dill, garden sorrel, lettuce, parsley, purple basil, spinach, and white-red-napa cabbage collected from different bazaars of Kyrgyzstan. Average elemental contents of the analyzed vegetables were determined (in mg kg-1) as follows: B (3.21-64.79), Ca (852.51-17,183.20), Cd (0.015-0.09), Cu (6.08-63.47), Fe (116.52-768.66), K (2347.04-17,305.42), Mg (136.34-1261.11), Na (54.75-526.42), Ni (0.09-1.3), Pb (1.91-9.54), and Zn (29.49-314.93). Estimated daily intake, recommended daily allowance, hazard quotients, and carcinogenic risk values of the vegetables were calculated with the help of these results. In considering HQ values, Chinese cabbage was determined to be safe for the consumption of both genders whereas parsley to be safe for only males. Based on the carcinogenic risk calculation, most of the vegetables examined in this study were categorized as moderately risky. It was inferred from the given results that airborne pollution has impaired/increased the mineral contents of vegetables for both genders. The findings obtained from this study were compared with international standards and will contribute to the data available on a global scale.

Can risk groups accurately predict non-sentinel lymph node metastasis in sentinel lymph node-positive endometrial cancer patients? A Turkish Gynecologic Oncology Group Study (TRSGO-SLN-004).

BACKGROUND AND OBJECTIVES: The purpose of this study was to find out the risk factors associated with non-sentinel lymph node metastasis and determine the incidence of non-sentinel lymph node metastasis according to risk groups in sentinel lymph node (SLN)-positive endometrial cancer patients. METHODS: Patients who underwent at least bilateral pelvic lymphadenectomy after SLN mapping were retrospectively analyzed. Patients were categorized into low, intermediate, high-intermediate, and high-risk groups defined by ESMO-ESGO-ESTRO. RESULTS: Out of 395 eligible patients, 42 patients had SLN metastasis and 16 (38.1%) of them also had non-SLN metastasis. Size of SLN metastasis was the only factor associated with non-SLN metastasis (p = .012) as 13/22 patients with macrometastasis, 2/10 with micrometastasis and 1/10 with isolated tumor cells (ITCs) had non-SLN metastasis. Although all 4 metastases (1.8%) among the low-risk group were limited to SLNs, the non-SLN involvement rate in the high-risk group was 42.9% and all of these were seen in patients with macrometastatic SLNs. CONCLUSIONS: Non-SLN metastasis was more frequent in higher-risk groups and the risk of non-SLN metastasis increased with the size of SLN metastasis. Proceeding to complete lymphadenectomy when SLN is metastatic should further be studied as the effect of leaving metastatic non-SLNs in-situ is not known.

Management of gynecological cancers in the COVID-19 era: a survey from Turkey

Objective: This study aimed to investigate how gynecologic oncologists modified their patient management during Coronavirus disease-2019 (COVID-19) in Turkey. Material and Methods: An online survey was sent to gynecologic oncology specialists and fellows in Turkey. It included management questions about strategies for newly diagnosed or recurrent endometrial, cervical, ovarian and vulvar cancer during the pandemic. Participants were asked if treatment of these cancers can be delayed or not and, if yes, the duration of delay. Results: 32.9% of surgeons prescribed oral or intrauterine progesterone for early stage, low-grade endometrial cancer. Conversely, 65.7% and 45.7% of the most surgeons did not change their management for early stage high-grade and advanced stage endometrial cancers respectively, as they perform surgery. 58% and 67.1% of the surgeons continued to prefer standard surgical treatment for microinvasive and early stage cervical cancers, respectively. Radiotherapy was preferred administered with hypofractionated doses for locally advanced cervical cancer (57.1%). While 67.1% of surgeons operated early stage ovarian cancer patients, 50% administered neoadjuvant chemotherapy (NACT) to all advanced stage ovarian cancers and 50% administered more cycles of NACT in preference to interval debulking surgery. 93.7% of the surgeons responded that treatment should not be delayed beyond eight weeks. Conclusion: Most Turkish gynecologic oncologists modified their management of gynecologic cancers due to the COVID-19 pandemic. While chemotherapy was preferred for ovarian cancer, postponement of the surgery, with or without non-surgical options, was considered for early stage, low-grade endometrial cancer. Treatment of gynecologic cancers should be decided on a case by case basis, taking into account local COVID-19 infection rates and availability of health facilities. Prognosis is also an important consideration if delay is contemplated. Standard treatment and normal time-frames should be used if possible. If not, a postponement for a maximum of eight weeks or referral to another center were acceptable alternatives.

Coexistence of uterine adenomyosis is not associated with a better prognosis in endometrioid-type endometrial cancer.

BACKGROUND: Prognostic value of accompanying adenomyosis in endometrial cancer is the subject of interest due to their common etiology and co-occurrence frequency. However, it is still unclear whether adenomyosis has a role in the prognosis of endometrial cancer. AIMS: The aim of this study was to determine the effects of adenomyosis on the prognosis of patients with endometrial cancer. METHODS: In this study, medical records of 552 patients with endometrioid endometrial cancer who underwent surgery between 2007 and 2017 were retrospectively reviewed. The patients were divided into two groups based on the presence or absence of adenomyosis, and these two groups were compared in terms of the clinicopathological factors and survival outcomes of patients. RESULTS: Of these patients, 103 (18.7%) had adenomyosis, and the remaining 449 (81.3%) did not. The endometrial cancer patients with adenomyosis exhibited earlier stages (p < 0.001), lower tumor grades (p < 0.001), tumor sizes ≤ 2 cm (p = 0.002), myometrial invasion < 50% (p < 0.001), and negative lymphovascular space invasion (p < 0.001). The 5-year overall survival rate was comparable between the adenomyosis and non-adenomyosis groups (95 vs. 89.1%, respectively; p = 0.085). The presence of adenomyosis was significantly associated with a higher 5-year disease-free survival rate (95.1 vs. 87.9%; p = 0.047), but adenomyosis did not remain as a prognostic factor in multivariate analysis. CONCLUSION: The results of our study showed that the endometrioid endometrial cancer patients with adenomyosis are significantly associated with smaller tumor sizes, less myometrial invasion, lower tumor grades, less lymphovascular space invasion, and earlier FIGO stages. Nevertheless, adenomyosis was not found to be an independent prognostic factor for endometrioid endometrial cancer.

Effect of Mg doping on morphology, photocatalytic activity and related biological properties of Zn1-xMgxO nanoparticles.

The objective of this study is to synthesize ZnO and Mg doped ZnO (Zn1-xMgxO) nanoparticles via the sol-gel method, and characterize their structures and to investigate their biological properties such as antibacterial activity and hemolytic potential.Nanoparticles (NPs) were synthesized by the sol-gel method using zinc acetate dihydrate (Zn(CH3COO)2.2H2O) and magnesium acetate tetrahydrate (Mg(CH3COO)2.4H2O) as precursors. Methanol and monoethanolamine were used as solvent and sol stabilizer, respectively. Structural and morphological characterizations of Zn1-xMgxO nanoparticles were studied by using XRD and SEM-EDX, respectively. Photocatalytic activities of ZnO and selected Mg-doped ZnO (Zn1-xMgxO) nanoparticles were investigated by degradation of methylene blue (MeB). Results indicated that Mg doping (both 10% and 30%) to the ZnO nanoparticles enhanced the photocatalytic activity and a little amount of Zn0.90 Mg0.10 O photocatalyst (1.0 mg/mL) degraded MeB with 99% efficiency after 24 h of irradiation under ambient visible light. Antibacterial activity of nanoparticles versus Escherichia coli ( E. coli ) was determined by the standard plate count method. Hemolytic activities of the NPs were studied by hemolysis tests using human erythrocytes. XRD data proved that the average particle size of nanoparticles was around 30 nm. Moreover, the XRD results indicatedthat the patterns of Mg doped ZnO nanoparticles related to ZnO hexagonal wurtzite structure had no secondary phase for x ≤ 0.2 concentration. For 0 ≤ x ≤ 0.02, NPs showed a concentration dependent antibacterial activity against E. coli . While Zn0.90Mg0.10 O totally inhibited the growth of E. coli , upper and lower dopant concentrations did not show antibacterial activity.

Is It Possible to Develop a Prediction Model for Lymphovascular Space Invasion in Endometrioid Endometrial Cancer?

OBJECTIVE: The purpose of this retrospective study was to define a risk index that would serve as a surrogate marker of lymphovascular space invasion (LVSI) in women with endometrioid endometrial cancer (EC). MATERIALS AND METHODS: Final pathology reports of 498 women who underwent surgery with curative intent for endometrioid EC between January 2008 and June 2018 were retrospectively reviewed. Logistic regression was used to investigate clinicopathologic factors associated with positive LVSI status. Independent risk factors for LVSI were used to build a risk model and "risk of LVSI index" was defined as "tumor grade×primary tumor diameter×percentage of myometrium involved." The scores used in the "risk of LVSI index" were weighted according to the odds ratios assigned for each variable. The risk of LVSI index was noted for each patient. The diagnostic performance of the model was expressed as sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. RESULTS: According to the "risk of LVSI index," presence of LVSI was correctly estimated in 89 of 104 LVSI-positive women at a cutoff of 161.0 (sensitivity 85.5%, specificity 79.4%, negative predictive value 95.4%, positive predictive value 52.3%, positive likelihood ratio 4.15, negative likelihood ratio 0.18). The area under curve of the receiver-operating characteristics was 0.90 (95% confidence interval, 0.87-0.93) at this cutoff. CONCLUSIONS: It seems possible to predict the presence of LVSI in women with endometrioid EC when the "risk of LVSI index" is calculated. However, external validation of this model is warranted.

Pretreatment of simvastatin on liver trace element levels during endotoxemia.

There are a number of studies investigating anti-inflammatory effects of simvastatin in patients with sepsis and animal models. There are a few studies which investigated effect of simvastatin on elements in sepsis. In the present study, the impact of pretreatment with simvastatin on element levels was evaluated in liver during endotoxemia. Rats were divided into control, LPS, simvastatin, and simvastatin + LPS. The histopathologic examination of the liver was performed using hematoxylin and eosin. Selenium, zinc, iron, manganese, magnesium, and copper were analyzed using inductively coupled plasma - optical emission spectroscopy. In the LPS, the hepatocyte cell structure was damaged. In the simvastatin + LPS, hepatocyte, and sinusoidal cord damage were partially smaller than LPS. Levels of selenium, and copper significantly decreased in both of LPS and simvastatin + LPS. In the LPS group, iron was found to increase. In the simvastatin + LPS, zinc was increased. Simvastatin partially smaller liver damage by increasing zinc levels during endotoxemia.

Heavy Metal Levels and Mineral Nutrient Status in Different Parts of Various Medicinal Plants Collected from Eastern Mediterranean Region of Turkey.

Medicinal plants have been used for treatment of many diseases since the ancient times with traditional knowledge being transferred from generation to generation. However, in recent years, many natural habitats have been contaminated due to increased anthropogenic activities. Plants which are exposed to heavy metal toxicity may experience several serious problems. Furthermore, the inclusion of these plants into the food chain poses a threat to human health as well. Additionally, presence of heavy metals directly effect mineral nutrition and consequently the food quality. The aim of this study herewith is to determine the heavy metal content and mineral nutrient status of some medicinal plants to have insight on their health repercussions on plants and humans. The concentrations of Al, B, Ca, Cd, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb and Zn in commonly used parts (root, rhizome, seed, resin, gall, fruit) especially for remedial purposes of 17 medicinal plants collected from Turkey were analyzed by ICP-OES. The measured values for concentrations from lowest to highest were (in mg kg-1) 30.983-368.877 for Al, 13.845-186.015 for B, 1335.699-11213.951 for Ca, 0.016-0.653 for Cd, 0.379-30.708 for Cr, 23.838-90.444 for Cu, 78.960-1228.845 for Fe, 1035.948-6393.491 for K, 83.193-2252.031 for Mg, 12.111-362.570 for Mn, 278.464-1968.775 for Na, 1.945-35.732 for Ni, 0.796-17.162 for Pb and 166.910-395.252 for Zn. Overall, heavy metal concentrations in medicinal plants collected nearby industrial regions, mining and farming sites, were found to be in slightly higher levels. This shows us that it is of crucial importance that the areas where medicinal plants are collected are clean especially by means of heavy metals for the reason that these plants can cause more harm than the benefits they may provide if they are contaminated.

SATEN III-Splitting Adjuvant Treatment of stage III ENdometrial cancers: an international, multicenter study.

INTRODUCTION: The purposes of this study were to compare adjuvant treatment modalities and to determine prognostic factors in stage III endometrioid endometrial cancer (EC). METHODS: SATEN III was a retrospective study involving 13 centers from 10 countries. Patients who had been operated on between 1998 and 2018 and diagnosed with stage III endometrioid EC were analyzed. RESULTS: A total of 990 women were identified; 317 with stage IIIA, 18 with stage IIIB, and 655 with stage IIIC diseases. The median follow-up was 42 months. The 5-year disease-free survival (DFS) of patients with stage III EC by adjuvant treatment modality was 68.5% for radiotherapy (RT), 54.6% for chemotherapy (CT), and 69.4% for chemoradiation (CRT) (p=0.11). The 5-year overall survival (OS) for those patients was 75.6% for RT, 75% for CT, and 80.7% for CRT (p=0.48). For patients with stage IIIA disease treated by RT versus CT versus CRT, the 5-year OS rates were 75.6%, 75.0%, and 80.7%, respectively (p=0.48). Negative peritoneal cytology (HR: 0.45, 95% CI: 0.23 to 0.86; p=0.02) and performance of lymphadenectomy (HR: 0.33, 95% CI: 0.16 to 0.77, p=0.001) were independent predictors for improved OS for stage IIIA EC. For women with stage IIIC EC treated by RT, CT, and CRT, the 5-year OS rates were 78.9%, 67.0%, and 69.8%, respectively (p=0.08). Independent prognostic factors for better OS for stage IIIC disease were age <60 (HR: 0.50, 95%CI: 0.36 to 0.69, p<0.001), grade 1 or 2 disease (HR: 0.59, 95% CI: 0.37 to 0.94, p=0.014; and HR: 0.65, 95%CI: 0.46 to 0.91, p=0.014, respectively), absence of cervical stromal involvement (HR: 063, 95% CI: 0.46 to 0.86, p=0.004) and performance of para-aortic lymphadenectomy (HR: 0.52, 95% CI: 0.35 to 0.72, p<0.001). DISCUSSION: Although not statistically significant, CRT seemed to be a better adjuvant treatment option for stage IIIA endometrioid EC. Systematic lymphadenectomy seemed to improve survival outcomes in stage III endometrioid EC.