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Labiaplasty revision surgery with using clitoral hood flap: A case-cohort study
(Springer, 2024) Şahin, Eda Adeviye; Ağlamış, Özgür; Şahin, Hanifi; Ozan Şahin, Elif; Yılmaz Ergani, Seval
Background: The demand for labia minora reduction surgery has increased due to aesthetic preferences and discomfort caused by labial hypertrophy. This study aims to share experiences with labial reconstruction using clitoral hood flaps in patients who underwent aggressive trim labiaplasty. Methods: Twenty-eight patients who had previously undergone only labiaplasty surgery were included in this study. Surgical techniques focused on preserving blood supply and achieving symmetry. Postoperative care included hospitalization, wound care training, and regular follow-up visits. Complications were monitored and managed as needed. Results: All 28 patients, comprising 23 bilateral and 5 unilateral labiaplasty cases, underwent revision surgery using 49 clitoral hood flaps. Complications occurred in 6 cases, including suture dehiscence, flap necrosis, and infection, all of which were effectively managed. All flaps maintained their viability, and high patient satisfaction was reported. Conclusion: Clitoral hood flap reconstruction following aggressive trim labiaplasty is a viable technique with minimal complications and high patient satisfaction. Further multicenter, long-term studies are necessary to validate these findings and improve surgical outcomes. Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Distribution of branches of anterior choroidal artery in the uncus: An anatomical study
(Springer, 2024) Kaçur, İdil; Nteli Chatzioglou, Gkionoul; Nas, Emine; Şahan, Orhun; Kale, Ayşin; Çakır, Halit; Coşkun, Osman; Gayretli, Özcan
The aim of our study was to examine the relationship between uncus and uncal branches of anterior choroidal artery (AChA) and to observe the morphological and morphometric features of these branches. 124 hemispheres from 62 fresh cadavers were included in the study. Measurement of the length of AChA and the distances of the uncal branches to the origin of AChA were measured by ImageJ software. Morphological variations of uncal branches originating from AChA were observed. The length of AChA was found as mean 26.24 ± 4.34 mm. It was determined that the average distance of these uncal branches arising from the AChA was 13.48 ± 7.31 mm. In 4 out of 124 AChAs, no branches were observed. 594 branches originating from 120 were detected. 130/594 branches appeared to be terminal branches. AChAs of 80/120 hemispheres have been reported to have uncal branches. Thirty of 130 uncal branches were observed to originate as the first branch of AChA. It was found that uncal branches may originate from AChA with a variability between 1 and 4. When evaluated according to the origin of each branch from the AChA, it was observed that the uncal branches originated from the midpoint of the AChA on average. Also, in 64 hemispheres, morophological variations were detected regarding the origin of uncal branches. We believe that the morphological and morphometric data we obtained from the uncal branches of the AChA are of clinical importance in terms of understanding this complex region and minimizing errors in surgical procedures.
RNA splicing aberrations in hereditary cancer: Insights from Turkish patients
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Kılıç, Seda; Şükrüoğlu Erdoğan, Özge; Tuncer, Şeref Buğra; Çelik Demirbaş, Betül; Yalnız Kayım, Zübeyde; Yazıcı, Hülya
The process of RNA splicing is fundamental in contributing to proteomic diversity and regulating gene expression. Dysregulation of splicing is associated with various human disorders, including cancer. Through functional studies, this study sought to examine the potential impact of seven variants within six inherited cancer-related genes on RNA splicing patterns in Turkish cancer patients. Upon detecting variants using Next-Generation Sequencing (NGS), we used Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and Sanger sequencing to elucidate the effects of these variants on splicing. Three of the seven variants demonstrated no discernible effect on RNA, while four exhibited pathogenic characteristics. Specifically, the variants APC c.532-1G>A rs1554072547, BRCA1c.4358-3A>G rs1567779966, BRCA2c.7436-1G>C rs81002830 and MSH3c.1897- 1G>A rs1744149615 were identified as pathogenic, while the variants BLMc.4076+4T>G rs183176301, RB1c.2489+2T>C rs1555294636 and RB1c.1050-2A>G rs? were found to be benign from a splicing perspective. These findings highlight the importance of verifying the precise consequences of splice site variants through experimental analysis, given their potential implications for genetic disorders and cancer predisposition. This research contributes to the understanding of splice-site variants in inherited cancer predisposition, particularly among Turkish cancer patients. It emphasizes the necessity for further exploration into the mechanisms and functional consequences of alternative splicing for potential therapeutic interventions in cancer.
Autologous ovarian tissue transplantation: Preoperative assessment and preparation of the patient
(Wolters Kluwer Health, 2024) Turan, Volkan; Öktem, Özgür
Importance: Ovarian tissue cryopreservation (OTC) is an innovative and established fertility preservation method. More than 150 live births have been reported worldwide to date with the use of this strategy. OTC is one of the options to preserve fertility in prepubertal girls and for women who have time constraints and/or contraindications for ovarian stimulation for oocyte/embryo freezing before cancer treatment. The success rate of the ovarian tissue transplantation (OTT) depends on many interrelated factors. Therefore, preoperative evaluation and preparation of the candidate patients for the procedure are of paramount importance. Objective: In this review, our aim was to provide a guide for the clinicians, which demonstrates step-by-step assessment and preparation of the patients and ovarian tissue samples for transplantation. Evidence Acquisition: We searched for published articles in the PubMed database containing key words, such as OTT, OTC, preoperative assessment, primordial follicle density, and cancer, in the English-language literature until May 2024. We did not include abstracts or conference proceedings. Results: OTT is still a developing method as an effective fertility preservation approach. It is essential to perform a thorough preoperative evaluation of the patient to improve the success rates of transplantation. Conclusions and Relevance: Preoperative evaluation and preparation of women for ovarian transplantation surgery should include safety management to prevent reimplantation of malignant cells, transplanting ovarian tissue with minimum follicle loss and the decision of the best transfer site.
Non‑cirrhotic portal fbrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and management
(Springer Nature, 2024) Shukla, Akash; Rockey, Don C.; Kamath, Patrick S.; Kleiner, David E.; Singh, Ankita; Vaidya, Arun; Koshy, Abraham; Goel, Ashish; Dökmeci, A. Kadir; Meena, Babulal; Philips, Cyriac Abby; Sharma, Chhagan Bihari; Örmeci, Necati; Sarin, Shiv Kumar
Since the Asian Pacific Association for the Study of the Liver (APASL) published guidelines on non-cirrhotic portal fibrosis/idiopathic portal hypertension in 2007, there has been a surge in new information, especially with the introduction of the term porto-sinusoidal vascular disorder (PSVD). Non-cirrhotic intra-hepatic causes of portal hypertension include disorders with a clearly identifiable etiology, such as schistosomiasis, as well as disorders with an unclear etiology such as non-cirrhotic portal fibrosis (NCPF), also termed idiopathic portal hypertension (IPH). This entity is being increasingly recognized as being associated with systemic disease and drug therapy, especially cancer therapy. An international working group with extensive expertise in portal hypertension was assigned with formulating consensus guidelines to clarify the definition, diagnosis, histological features, natural history, and management of NCPF/IPH, especially in the context of PSVD. The guidelines were prepared based on evidence from existing published literature. Whenever there was paucity of evidence, expert opinion was included after detailed deliberation. The goal of this manuscript, therefore, is to enhance the current understanding and help create global consensus on the issues surrounding NCPF/IPH.
Comparison of the effects of four laser wavelengths on Medication-Related Osteonecrosis of the Jaw (MRONJ) in a murine model: An in vivo photobiomodulation study
(Ivyspring International Publisher, 2024) Ayhan, Mustafa; Gedik, Betül; Kalelioğlu, Ekrem Emir; Kundakçıoğlu, Abdulsamet; Küçükgergin, Canan; Turgut, Cevat Tuğrul; Kocaelli, Hümeyra; Alatlı, Fatma Canan; İşsever, Halim; Ademoğlu, Evin; Yaltırık, Mehmet
Background: This study aims to investigate the effectiveness of lasers at various wavelengths in treating medication-related osteonecrosis of the jaw (MRONJ) using biochemical, clinical scoring, micro CT analysis, and histopathological methods. The study follows the ARRIVE guidelines to ensure robust and transparent research. Methods: In our study, there were 6 groups, including one SHAM group, one CONTROL group, and four experimental groups, with 8 rats in each individual group. Each rat received antiresorptive drug intraperitoneally for 4 weeks and then had the left second molar in the mandible extracted. All animals were sacrificed at the end of the 12th week. In the experimental groups, lasers at wavelengths of 405nm, 445nm, 660nm, and 808nm were applied to the animals. Parameters such as serum vitamin D levels, bone density and bone volume at the extraction site, new bone formation, dead bone count, inflammatory cell count, and epithelial regeneration were examined. Additionally, clinical scoring was conducted after sacrifice. The laser parameters included power density, area, time, fluence, and mode (continuous wave), and the light was administered using a fiber with a Gaussian profile. Statistical analyses were performed with the NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package program. The results were evaluated at the p<0.05 significance level. Results: According to the results obtained from our study, new bone formation in all experimental groups was significantly higher than in the SHAM and CONTROL groups. Furthermore, the 660nm and 808nm wavelengths increased serum vitamin D levels significantly. The most successful outcomes were observed in clinical scoring, dead bone count, epithelial cell regeneration, and bone density in the 660nm and 808nm wavelength groups. Conclusions: The combined use of lasers at 660nm and 808nm wavelengths may yield successful results in treating MRONJ.
The effect of rapamycin treatment on mouse ovarian follicle development in dehydroepiandrosterone-induced polycystic ovary syndrome mouse model
(Zygote, 2024) Yıldırım, Ecem; Önel, Tuğçe; Aguş, Sami; Günalan, Elif; Yılmaz, Bayram; Aydın, Mehmet Şerif; Yaba, Aylin
Polycystic ovary syndrome (PCOS) is a complex reproductive and endocrine disorder affecting 5–10% of women of reproductive age, but the pathophysiology of PCOS still remains unknown. Here, the aim of our study was to analyze the effects of rapamycin treatment that may regulate impaired hormonal levels and folliculogenesis in dehydroepiandrosterone (DHEA)-treated PCOS mouse. We hypothesized that rapamycin may ameliorate the negative effects of PCOS in DHEA-induced PCOS mouse model. The target of rapamycin (TOR) gene product is a serine/threonine kinase that has been implicated in the control of cell growth, proliferation and autophagy, and rapamycin is a potent inhibitor of mTORC1 pathway. In this study, for the first time, mTORC1 and activation products are presented at protein and mRNA levels after rapamycin treatment in DHEA-induced PCOS mouse ovary. We showed that rapamycin treatment may regulate follicular development, hormonal levels and provide ovulation in DHEA-induced PCOS mouse. Additionally, we assessed decreased primordial follicle reserve, increased number of primary and secondary follicles, corpus luteum structure forms again after 10 days of rapamycin treatment. This study presented here suggests rapamycin treatment regulates hormonal phenotype and folliculogenesis in the ovary and also mTOR signalling pathway in granulosa cells of DHEA-induced PCOS mouse ovary which may have potential to attenuate understanding the mechanism of dominant follicle selection and anovulatory infertility.
Perceived social support and depression, anxiety and stress in pregnant women diagnosed with foetal anomaly
(John Wiley & Sons, 2024) Mecdi Kaydırak, Meltem; Balkan, Elif; Bacak, Nilgül; Kızoğlu, Filiz
Aim: To examine the relationship between perceived social support level and depression, anxiety and stress in pregnant women diagnosed with foetal anomaly. Design/Methods: This descriptive and correlational study was conducted in an advanced prenatal evaluation unit of a university hospital between December 2021 and May 2022. The study data collected from 131 pregnant women through a personal information form, depression, anxiety and stress scale (DASS-42) and multidimensional scale of perceived social support (MSPSS). Results: Most of the pregnant women were in the second trimester of pregnancy, and more than half had been advised by a healthcare professional to terminate their pregnancy. Overall, the pregnant women reported moderate levels of social support, while their depression, anxiety and stress levels varied. There was a weak negative correlation between perceived social support from family, friends and multidimensional sources with stress, but the effect rate was low. Conclusion: Most pregnant women diagnosed with foetal anomaly have normal levels of depression, stress and anxiety. There is a weak negative correlation between perceived social support and stress, with family and friend support affecting stress levels at a low rate. Professional support should be provided, and both the woman's mental health and social support mechanisms must be evaluated. Impact: This study highlights the importance of social support in managing stress among pregnant women with foetal anomalies. While most women had normal levels of depression, anxiety and stress, increased social support from family and friends was shown to reduce stress. The findings underscore the need for healthcare professionals to assess and strengthen mental health and social support systems in this vulnerable population, informing interventions to improve psychosocial outcomes. Reporting Method: This descriptive and correlational study adhered to the CONSORT guidelines for reporting non-randomised trials. Patient or Public Contribution: No patient or public contribution.
Investigating leptin gene variants and methylation status in relation to breastfeeding and preventing obesity
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Kılıç, Ayşe; Pehlivan, Sacide; Varkal, Mehmet Ali; Tuncel, Fatima Ceren; Kandemir, İbrahim; Özçetin, Mustafa; Poyrazoğlu, Şükran; Kardelen, Aslı Derya; Özdemir, İrem; Yıldız, İsmail
Objective: We investigated whether the results of leptin gene (LEP) 2548G/A (rs7799039) and leptin receptor gene (LEPR) 668 A/G (rs1137101) variants, as well as the methylation analysis of CpG regions at nucleotides −31 and −51 of the LEP gene, showed any differences between breastfed and non-breastfed children in this study. Materials and Methods: The cross-sectional study included 100 children aged 2–5 years who were attending nursery and kindergarten and had been accepted to the Department of General Paediatrics. Infants who were exclusively breastfed for the first six months after birth constituted the study group, and those who were not only breastfeed constituted the control group. Methylation percentages at CpG islands of the LEP gene were compared between exclusively breastfed and non-exclusively breastfed infants, and the statistical significance was analyzed by looking for changes in LEP −31 and −51 nt methylation and LEP 2548G/A ve LEPR 668 A/G variants. Results: Both groups were compared by feeding, and the association of LEPR and LEP gene polymorphisms and −51 nt and −31 nt methylations were analyzed. There were no significant differences between the groups regarding genotype and allele frequency for the LEPR 668 A/G, LEP 2548 G/A gene variant, −31 nt methylation, and −51 nt methylation status. Similarly, there was no significant difference in genotype and allele frequency for the LEPR 668 A/G gene variant in terms of duration of exclusive breastfeeding, total breastfeeding, body mass index, family obesity, and satiety status. However, maternal support from family elders and physical activity increased the 51 nt methylation, but this methylation was not significantly affected by BMI, age, or satiety status. Conclusions: Maternal support from family elders and physical activity were associated with increased 51 nt methylation, but this methylation was not significantly affected by BMI, age, or satiety status. However, there are not enough studies in this area to reach a definitive conclusion, and further research is needed.
Effect of obesity and NAFLD on leukocyte telomere length and hTERT gene MNS16A VNTR variant
(Springer Nature, 2024) Kandemir, İbrahim; Yetim Şahin, Aylin; Oyacı, Yasemin; Khudiyeva, Shahri; Şahin, Memduh; Aksakal, Melike Tuğrul; Pehlivan, Mustafa; Baş, Firdevs; Pehlivan, Sacide
It is known that telomere length (TL) (evaluated with T/S ratio) is shortened in the presence of obesity. In this study, we aimed to investigate how obesity in adolescents and non-alcoholic liver disease (NAFLD) within the obese group affect TL and the clinical significance of the human telomerase reverse transcriptase (hTERT) gene MNS16A VNTR variant in terms of NAFLD. Adolescents with exogenous obesity and healthy controls (aged 10-19 years) who applied to our adolescent outpatient clinic between May-October 2023 were included in this study. We performed upper abdominal ultrasonography to investigate the presence of NAFLD in adolescents with obesity and divided into two groups: those without hepatosteatosis (obese NAFLD (-)) and those with hepatosteatosis (obese NAFLD (+)). We recorded body weight, height, waist circumference, and blood pressure measurements and measured the T/S ratio (telomere sequence copy number/gene single copy number) by the Quantitative Polymerase Chain Reaction method. The groups were compared using frequentist and Bayesian methods. Eighty-three obese adolescents [63 NAFLD(+) 20 NAFLD(-)] and 69 lean controls were included in the study. Pairwise comparisons revealed that T/S ratio was significantly lower in the obese NAFLD (-) group than the obese NAFLD (+) and the control group (p = 0.025, p = 0.007, respectively). T/S ratio was lower in the LL allele group than in the other alleles (p = 0.022) and slightly higher in the obese group with metabolic syndrome compared to the obese group without metabolic syndrome (p = 0.072). hTERT-MNS16A-VNTR gene variant LL allele had a negative correlation with T/S ratio among the obese adolescent group. Patients with LL alleles had higher ALT, GGT, HOMA-IR, and ALT/AST. Diastolic blood pressure had a significant correlation with the T/S ratio. The T/S ratio was shorter in the obese adolescent group compared to healthy ones but was higher in the NAFLD (+) obese compared to the NAFLD (-) obese. ALT level and ALT/AST ratio were higher, T/S ratio was lower in the hTERT MNS16A VNTR variant LL allele group among obese adolescents. In addition, there was a significant correlation between the T/S ratio and diastolic blood pressure in obese adolescents.
Superficial siderosis: A case report of underdiagnosed disorder
(Springer Nature, 2024) Talibov, Tural; İnci, Meltem; Barburoğlu, Mehmet; Sencer, Altay; Çoban, Oğuzhan
Superficial siderosis (SS) is caused by subpial hemosiderin deposition due to chronic low-grade bleeding into the subarachnoid space. Dural tears are the most common etiology. Slowly progressive gait ataxia and hearing impairment are common clinical manifestations. Brain magnetic resonance imaging (MRI) shows linear superficial hypointensity on the T2 weighted images and gradient echo. The therapeutic approach is surgical repair of the bleeding source. The patient presented with progressive hearing loss and ataxia. Neurological examination revealed bilateral hearing loss, nystagmus, dysarthria, brisk deep tendon reflexes, and severe ataxia. Brain MRI showed linear superficial siderosis in the cerebrum, cerebellum, and brain stem. Spinal MRI showed ventral epidural cerebrospinal fluid (CSF) collection and disc-osteophyte complex. Six months after the surgical repair of the dural defect, the patient's neurological examination demonstrated improvement in ataxia and dysarthria. The patient was able to walk without any assistance. Surgical repair of the underlying bleeding source may be beneficial in preventing the progression and improving the symptoms of superficial siderosis SS. This case suggests that SS symptoms are potentially reversible by surgical treatment of the underlying spinal CSF leak after a long disease course.
Anatomical and morphometric features of the profunda brachii artery
(Medrang, 2024) Şanlıtürk, Yüsra Nur; Zeybek, Nurşen; Gayretli, Özcan; Öztürk, Adnan
When the literature is examined, studies evaluating the profunda brachii artery (PBA) are limited as most studies only investigate the artery’s origin. In 44 upper extremities belonging to 24 human anatomical specimens, single and double PBAs were observed in 39 and five cases, respectively. In cases with a single PBA, the origin was the brachial artery (BA) in 35 cases and the posterior circumflex humeral artery in four cases. In cases with double PBAs, the artery’s origin was the BA. Morphometric measurements of single and double arteries originating from the first branch BA were evaluated separately and compared according to sex and side. Our study, in which the PBA was examined morphologically and morphometrically, contributes to the literature anatomically and radiologically in treating humerus fractures and lateral arm-flap applications by surgeons.
Clinical significance of coronary artery tortuosity in chronic coronary syndrome & stable angina: Insights from gensini scores
(Kare Publishing, 2024) Özyaşar, Mehmet; Doğduş, Mustafa; Yılmaz, Ahmet; Altıntaş, Mehmet Sait; Yetkin, Ertan
OBJECTIVE This study investigated the clinical significance of coronary artery tortuosity (CAT) in chronic coronary syndrome (CCS) by using Gensini scores. METHODS The retrospective single-center study involved 388 patients undergoing coronary angiography for chest pain, excluding those with acute coronary syndromes or prior coronary interventions. Demographic, clinical, and angiographic data were collected and categorized based on the presence or absence of CAT. Categorical variables were analyzed using appropriate statistical tests, with significance set at p < 0.05. RESULTS Analysis of 388 patients revealed that CAT was associated with older age (p <0.001), female gender (p <0.001), lower smoking (19.3% vs. 29.6%, p=0.025), and hypertension (53.5% vs. 38.7%, p=0.05). There was a slightly higher, nearly significant, prevalence of diabetes in the CAT group (22.8% vs. 14.5%, p=0.051). Furthermore, CAT correlated with diastolic dysfunction (p=0.04) and inversely with coronary atherosclerosis severity, as indicated by lower Gensini scores correlating with higher CAT scores (p=0.039 and p=0.049, respectively). Univariate analysis confirmed CAT's association with older age (p <0,001), female gender (p <0,001), hypertension (p=0,004), diabetes (p=0,039), diastolic dysfunction (p=0,003), and Gensini score (p=0,012). Multivariate analysis further identified significant correlations with age (p=0,001), female gender (p <0,001), and Gensini score (p=0,049). CONCLUSIONS Our findings indicate that older age and female gender predict CAT development in CCS patients. The lower Gensini scores associated with CAT may possibly be due to a reduced atherosclerotic plaque burden in these patients. Further research into this relationship could inform the development of treatment and management strategies for coronary atherosclerosis.
The course of the phrenic nerve in the neck region and its relationship with adjacent anatomical structures in the thoracic inlet
(Springer, 2024) Yıldız, Nilay; Nteli Chatzioglou, Gkionoul; Coşkun, Osman; Kale, Ayşin; Gayretli, Özcan
Pupose: This study aims to reveal the relationship of the phrenic nerve (PhN) with its neighboring structures in the lower neck region more comprehensively than previous studies and to minimize nerve damage by enabling invasive procedures in this region to be performed with high accuracy. Methods: Forty-one heminecks were evaluated. The relationship between the PhN and the anterior scalene muscle (ASM), internal thoracic artery (ITA), branches of subclavian artery (SA) and subclavian vein (SV) was examined. Results: It was observed that the PhN was located medial to the ASM in all cases. The distances were higher in male cadavers. The PhN was found to enter the thorax lateral to the ITA in 15/41 and medial to it in 25/41 sides. In 17/41 cases, the closest SA branch to the PhN was the thyrocervical trunk (TT) and in 24 cases the ITA. The PhN was located behind the SV in 38 cases and in front of it in 2 cases.The accessory PhN was found in 4/41 sides. There was no significant difference in morphometric findings between genders (p > 0.05). However, significant differences were observed between the parameters (p < 0.05). Conclusion: The anatomy and variations of the PhN are of great importance in surgical interventions and invasive procedures in the neck region. The study provides important information to reduce the risk of damage to the PhN in surgical procedures. In addition, knowledge of the anatomical variations of the nerve may contribute to more successful results in nerve grafting and other surgical applications.
Overcoming barriers to cervical cancer prevention inAfghanistan: The imperative for an HPV vaccination andscreening program
(Wiley, 2024) Sadat, Rowaida; Saçıntı, Koray Görkem; Topçu, Elif Göknur; Saeed, Saeeda
The critical situation of cervical cancer screening and human papillo-mavirus (HPV) vaccination in Afghanistan demands urgent attention,especially in view of the ongoing political unrest and humanitarianchallenges faced by the country. Recent data underscore the urgentneed for immediate action to address this pressing issue.
Managing CDH1 cancer risks in a child: Complex decision making in a family with hereditary diffuse gastric cancer
(Wiley, 2024) Ağaoğlu, Nihat Buğra; Hatırnaz Ng, Özden; Zemheri, İtir Ebru; Ünal, Büşra; Gerenli, Nelgin; Tosun, İlkay; Yazıcı, Hülya; Özbek, Uğur; Kamihara, Junne; Rana, Huma Q.
Germline pathogenic variants (PVs) in CDH1 cause hereditary diffuse gastric cancer. The management of CDH1 cases with a positive family history includes total prophylactic gastrectomy or intensive surveillance. In this study, we report a 16-year-old boy with intramucosal gastric signet ring cells in the setting of a germline CDH1 PV and a family history of early-onset gastric cancer. The approach to managing both the proband and their 9-year-old sister, who also had the CDH1 PV, presented a challenge to both clinicians and the family. Herein, we present the complexities of managing gastric cancer risk when a CDH1 PV is identified in childhood in the setting of a family history of early-onset gastric cancer.
Therapeutic effects of mesenchymal stem cell conditioned medium in rat varicocele model
(Korean Society for Sexual Medicine and Andrology, 2024) Şerefoğlu, Ege Can; Kolbaşı, Bircan; Bülbül, Muhammet Volkan; Karabulut, Seda; Çakıcı, Çağrı; Gündoğdu Özdemir, Reyhan Zeynep; Keskin, İlknur
Purpose: This study aimed to examine the therapeutic effects of injection of conditioned medium of adipose-derived mesen chymal stem cells (ADMSC-CM) in a surgically created varicocele model in comparison with varicocelectomy. Materials and Methods: Twenty-eight male Wistar Albino rats were randomly divided into four groups: sham group, varico cele group, varicocelectomy group, and ADMSC-CM injection group. Sperm parameters were analyzed in samples taken from the epididymis after treatment. Malondialdehyde and superoxide dismutase (SOD) levels in blood samples were exam ined by biochemical analysis. The testicular tissues were stained with hematoxylin-eosin for histological examination (John sen’s Score). Additionally, Western Blot analyzes were performed to detect Claudin-11 levels, the functional protein of the blood-testis barrier, in testicular tissues. Results: Varicocelectomy and ADMSC-CM treatments significantly improved mean sperm parameters (concentration, pro gressive motility, motility, normal sperm morphology) (p≤0.05 for all). Both treatment groups had increased SOD levels along with a decrease in malondialdehyde levels (p≤0.05 for all). No significant difference was observed between the ADMSC CM group and the varicocelectomy group in preserving normal testicular histology according to Johnsen’s Score (p=0.114). Levels of Claudin-11 were significantly higher in the varicocelectomy and ADMSC-CM groups compared to the varicocele group (p≤0.05 for all). Conclusions: The therapeutic effects of ADMSC-CM in varicocele model may involve secretion of anti-inflammatory and re generative factors from ADMSC. ADMSC-CM injection appears to be a promising new strategy in the treatment of varicocel
The Homeostasis-Enrichment-Plasticity (HEP®) approach for premature infants with developmental risks: A pre-post feasibility study
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Balıkçı, Aymen; May-Benson, Teresa A.; Sırma, Gamze Çağla; Kardaş, Ayten; Demirbaş, Duygu; Arıcikul Balıkçı, Ayşe Firdevs; İlbay, Gül; Sözen, Hatice Gülhan; Beaudry-Bellefeuille, Isabelle
Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4–10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers’ use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.
Trends and regional differences for fertil ity preservation procedures in women with breast cancer
(Elsevier, 2024) Turan, Volkan; Bedoschi, Giuliano; Lee, Dong-Yun; Barbosa, Caio Parente; Oliveira, Renato de; Saçıntı, Koray Görkem; Sönmezer, Murat; Lambertini, Matteo; Massarotti, Claudia; Schaub, Amelia; Wang, Erica; Gayete-Lafuente, Sonia; Dunlop, Cheryl; Anderson, Richard A.; Bang, Heejung; Oktay, Kutluk H.
Introduction : Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation (FP) referral. Embryo, oocyte, or ovarian tissue cryopreservation are established FP modalities in women with breast cancer but there are few data on their uptake over time. In this study our aim was to determine the regional time trends and utility differences for fertility preservation methods of reproductive tissue cryopreservation. Methods : This multicenter study included 1,623 women diagnosed with breast cancer from seven tertiary centers in six countries (Brazil, Italy, Scotland, South Korea, Turkey, USA). Participant centers provided the details of FP cryopreservation approaches broken down annually from 2012 to 2021. Women with newly diagnosed breast cancer, aged 18-45 years who were referred for FP at participating centers and had normal ovarian function at the time were included. Results : We found a mean increase of 7% per year (p=0.002, adjusting for centers) in the number of women referred for FP. Of those who were referred (n=1623), a mean 38.7% underwent FP (n=629), with a range of 12% in South Korea) to 95% in Brazil. The number of women undergoing ovarian stimulation for FP continually increased until 2021, with oocyte cryopreservation being the most common procedure throughout the study period (p=0.014 for time trend). The proportion of random start ovarian stimulation cycles increased each year from 58.3% in 2012 to 86.8% in 2021, (p=0.005 for time trend, and p=0.04 for 2012 vs. 2021). Conclusions : The utility of FP has steadily increased for young women with breast cancer over the last decade, although regional differences significantly influence FP practices. The findings of our study could have value for policy making in FP care for young women with breast cancer at the local, regional, or global level. Micro abstract Breast cancer is the most common malignancy in women of reproductive age and chemotherapy protocols impair fertility, frequently necessitating fertility preservation referral. The utility of fertility preservation has steadily increased for young women with breast cancer over the last decade, although regional differences significantly influence fertility preservation practices.
Clinical implications of aberrant anatomy of the common hepatic duct in liver surgery: a systematic review and meta‑analysis
(Springer, 2024) Valenzuela‑Fuenzalida, Juan José; Avalos‑Díaz, Constanza; Droguett‑Utreras, Antonia; Guerra‑Loyola, Javier; Nova‑Baeza, Pablo; Orellana‑Donoso, Mathias; Suazo‑Santibañez, Alejandra; Oyanedel‑Amaro, Gustavo; Sanchis‑Gimeno, Juan; Bruna‑Mejias, Alejandro; Nteli Chatzioglou, Gkionoul
Introduction: Knowledge of anatomical variants that affect the hepatic duct (HD) are of particular clinical relevance during hepatobiliary surgical procedures. More specifically, the aberrant anatomy of the common HD is the most common anatomical variation affecting the biliary tree. Below, we describe different classifications of anatomical variants that affect this canal. According to Huang's classification, variations are determined depending on the insertion of the right posterior hepatic duct (RPHD). Materials and methods: Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases were investigated until January 2024. The methodological quality was assessed with an anatomical studies assurance tool (AQUA). Pooled prevalence was estimated using a random effects model. For the subgroup analysis, Student's T-test was used. Results: The prevalence rate of aberrant hepatic duct (AHD) was 15% (confidence interval [CI] of 7-22%). The first subgroup had cadavers and images. For the cadavers, the prevalence was 15.83% (CI: 11.22-18.3%), while the images had a prevalence of 22.06% (CI: 18.12-25.33%). This subgroup analysis showed no statistically significant difference between these groups (p = 0.127). The second subgroup comprised the continents where the included studies were from. In this subgroup, no statistically significant differences were found (p = 0.613). Finally, regarding the right or left laterality of the HD variant, there were no statistically significant differences (p = 0.089). Conclusion: A AHD corresponds to a finding that can occur in a significant percentage of our society, which could be an accidental discovery during surgeries or present asymptomatically throughout life and be a cadaveric discovery later. We believe it is important for surgeons to have prior knowledge of the possible variants of HD to prevent possible complications during and after surgery.

Güncel Gönderiler