Abstract Breast cancer is the leading cause of cancer-related deaths in women throughout the world. Research on natural anti-cancer products from plants has gained traction. Salvia L. species and their derivatives are rare in Turkey and have suggested for their potential anti-cancer effects. The aim of this study is to assess the potential cytotoxic/apoptotic activities of methanol extract of Salvia candidissima Vahl. subsp. candidissima (SCE) on MCF-7 and MDA-MB-231 breast cancer cells. A GCxGC-TOF/MS system and a dual stage commercial thermal desorption injector were used to determine the chemical components of SCE. MTT and ATP viability tests were used to investigate the anti-growth activity. The apoptosis-inducing effect was assessed using a fluorescence staining method. Caspase-cleaved keratin 18 (ccK18, M30-antigen) levels measured by M30-CytoDeath ELISA Kit. The results showed that SCE suppressed the survival of the MCF-7 and MDA-MB-231 breast cancer cells in a dose-dependent manner, based on the findings of both MTT and ATP cell viability tests and pyknotic cell nuclei were observed via fluorescent staining in both cell lines after 48 h of treatment. The treatment group had greater levels of caspase-cleaved keratin 18 in the MCF-7 cells than the untreated group. These results showed that SCE triggers apoptosis, causes cell death in MCF-7 and MDA-MB-231 cell lines. SCE may become promising therapeutic strategy in the treatment of breast cancer with further in vitro and in vivo studies.

Abstract Background Coronary artery disease (CAD) due to myocardial ischemia causes permanent loss of heart tissue. Objectives We aimed to demonstrate the possible damage to the myocardium at the molecular level through the mechanisms of autophagy and apoptosis in coronary bypass surgery patients. Methods One group was administered a Custodiol cardioplegia solution, and the other group was administered a Blood cardioplegia solution. Two myocardial samples were collected from each patient during the operation, just before cardiac arrest and after the aortic cross-clamp was released. The expressions of autophagy and apoptosis markers were evaluated. The level of statistical significance adopted was 5%. Results The expression of the BECLIN gene was significant in the myocardial tissues in the BC group (p=0.0078). CASPASE 3, 8, and 9 gene expression levels were significantly lower in the CC group. Postoperative TnT levels were significantly different between the groups (p=0.0072). CASPASE 8 and CASPASE 9 gene expressions were similar before and after aortic cross-clamping (p=0.8552, p=0.8891). In the CC group, CASPASE 3, CASPASE 8, and CASPASE 9 gene expression levels were not found to be significantly different in tissue samples taken after aortic cross-clamping (p=0.7354, p=0.0758, p=0.4128, respectively). Conclusions With our findings, we believe that CC and BC solutions do not have a significant difference in terms of myocardial protection during bypass operations.

Resumo Fundamento A doença arterial coronariana (DAC) devido à isquemia miocárdica causa perda permanente de tecido cardíaco. Objetivos Nosso objetivo foi demonstrar o possível dano ao miocárdio em nível molecular através dos mecanismos de autofagia e apoptose em pacientes submetidos à cirurgia de revascularização miocárdica. Métodos Um grupo recebeu uma solução de cardioplegia Custodiol e o outro grupo uma solução de cardioplegia sanguínea. Duas amostras miocárdicas foram coletadas de cada paciente durante a operação, imediatamente antes da parada cardíaca e após a liberação do pinçamento aórtico. Foram avaliadas as expressões de marcadores de autofagia e apoptose. O nível de significância estatística adotado foi de 5%. Resultados A expressão do gene BECLIN foi significativa nos tecidos miocárdicos do grupo CS (p=0,0078). Os níveis de expressão dos genes CASPASE 3, 8 e 9 foram significativamente menores no grupo CC. Os níveis pós-operatórios de TnT foram significativamente diferentes entre os grupos (p=0,0072). As expressões dos genes CASPASE 8 e CASPASE 9 foram semelhantes antes e depois do pinçamento aórtico (p=0,8552, p=0,8891). No grupo CC, os níveis de expressão gênica de CASPASE 3, CASPASE 8 e CASPASE 9 não foram significativamente diferentes em amostras de tecido coletadas após pinçamento aórtico (p=0,7354, p=0,0758, p=0,4128, respectivamente). Conclusões Com nossos achados, acreditamos que as soluções CC e CS não apresentam diferença significativa em termos de proteção miocárdica durante as operações de by-pass.

Abstract As a direct consequence of understanding the importance of the relationship between health and food, the interest in healthy recipes has increased. In the present study, wheat flour was used to replace chia seed (CS) in the cracker formulation (control) at levels of 10, 20, and 30% (w/w) and fat content was reduced by 25, 50, and 75% for the production of low-fat crackers. The physicochemical, textural, sensorial properties of the crackers were investigated. It was determined that CS had high a dietary fiber (38.7%), protein (21.78%), and fat (28.69%) content. The cracker sample containing 25% fat and 30% chia seed had the highest amounts of protein (14.49%) and dietary fiber (16.70%). CS could provide positive effects on health in terms of its high fiber content and low carbohydrate value. Six different fatty acids (FAs) were determined in the cracker samples. By reducing fat and increasing chia seed amount; oleic, linoleic, α-linolenic increased compared to the control sample, whereas the palmitic acid amount decreased significantly. According to the sensorial evaluation, the crackers were acceptable. It was also determined that CS was a suitable supplementation for low-fat products.

SUMMARY OBJECTIVE: Exercise is a nonpharmacological supportive therapy which has been specifically identified to reduce postoperative complications or adverse events of cancer or treatments. Although there are few studies combining resistance and aerobic exercise in cancer survivors, exercise programs are very rare in different places in the literature. This study aims to investigate the effects of mixed-type exercise in different venues on weight, body mass index, fatigue, and quality of life in cancer survivors. METHODS: This is a descriptive, intervention study. Participants were included in the study, and the exercise process was between January and November 2019. The exercise group consisted of 32 patients who had just completed their breast cancer treatment and did not have distant metastases, and they applied a mixed exercise program including resistance at home and aerobic exercise in the fitness center for 12 weeks. The patients with breast cancer in the control group (30 patients) did not receive any exercise program. RESULTS: Subjective feelings of fatigue and decrease in concentration, motivation, and physical activity significantly decreased after exercise (p<0.001, p<0.001, p=0.006, p=0.008, and p<0.001, respectively) in the study group. The results also showed that physical health, general health status, and emotional and social health status significantly increased with the exercise program (p<0.001, p<0.001, p=0.004, and p=0.003, respectively). CONCLUSION: Our results show that a mixed (fitness center and home) 12-week exercise program provides an improvement in general health and reduces the side effects of the treatments and fatigue in patients with breast cancer. For a good prognostic process after medical treatment, exercise can be recommended in every accessible area.

Abstract The function of gene body DNA methylation in alternative splicing, and its relation to disease pathogenesis is not fully elucidated. The gene for familial Mediterranean fever (MEFV) encodes the pyrin protein and contains a 998 bp CpG island, covering the second exon, which is differentially methylated in FMF patients compared to healthy controls. Our further observation of increased exon 2-spliced MEFV transcript in leukocytes of FMF patients provoked us to test the role of exon methylation in alternative splicing using inflammatory cell culture models. First, in vitro exon methylation triggered an increased level of exon 2 exclusion using a splicing cassette in a promyelocytic leukemia cell line (HL-60). HL-60 cells subjected to methylating and demethylating agents, as well as cells differentiated to neutrophil-like cells, exhibited different levels of spliced/unspliced transcripts. We observed increased levels of spliced transcripts in neutrophil-like (p = 0.0005), activated (p = 0.0034) and methylated cells (p < 0.0001), whereas decreased levels in demethylated cells (p = 0.0126) compared to control untreated HL-60 cells. We also showed that the protein isoform of pyrin lacking the exon 2 has an adverse subcellular localization in neutrophil-like cells. Therefore, it remains in the cytoplasm rather than the nucleus. This may point to an epigenetic involvement in an important inflammatory gene.

Vascular structures are in greater danger during lumbar surgery. The purpose of this study is to describe the morphology of the inferior vena cava (IVC) related to the lumbar vertebra and aortic bifurcation (AB) and assessing the role of demographic values in these relations to decrease the risk of complications in the surgical interventions. The study was performed on Multidetector Computed Tomography (MDCT) images of 100 male and 100 female cases with an age range from 50 to 84 years. The morphometric values of the IVC obtained from the coronal, sagittal and the axial reformatted images were measured and compared with the demographic values. The distance from the IVC to the 1st lumbar vertebra (L1) and 2nd lumbar vertebra (L2) were measured as (26.5 mm and 18.1 mm) in males and (21.1 mm and 14.2 mm) in females with a high level of significance between genders; the distance from the IVC to the iliocaval confluence (IC), 3rd lumbar vertebra (L3) and 4rd lumbar vertebra (L4) were measured as (6.5 mm, 10.5 mm and 6.9 mm) in males and (4.9 mm, 9.1 mm and 5.5 mm) in females with significance between genders. The level of the IC was detected 46 % of males, 39 % of females at the level of lower third of L4. The vertical distance between the IC and the AB was measured and negative correlation between genders based on age was detected. Demographic values are important to consider the relationship of the IVC, the lumbar vertebra and the AB. The IVC was located further from the lumbar vertebra in males compared to females. Age increase played role in the approaching of the AB and the IC to each other in both gender and the IC to the promontory level in males.

RESUMO Introdução A espondilite anquilosante (EA) é uma doença reumática inflamatória crônica caracterizada pela inflamação da pelve e da coluna vertebral, que resulta em uma restrição na mobilidade da coluna vertebral. Em decorrência da postura alterada e da dor inflamatória noturna, os distúrbios do sono são passíveis de ocorrer em pacientes com EA. Objetivo Determinar as diferenças entre os pacientes com EA e controles saudáveis na qualidade do sono, bem como avaliar a relação entre a qualidade do sono e a atividade da doença. Método Para avaliar a qualidade do sono, 55 pacientes com EA (40 homens, 15 mulheres, idade média 43 ± 1 anos) que preencheram os critérios modificados de Nova York e 55 controles comparáveis (40 homens, 15 mulheres, idade média 42 ± 9 anos) preencheram o questionário Índice de Qualidade do Sono de Pittsburgh (PSQI). A atividade da doença foi avaliada pelo Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Resultados A espondilite anquilosante se correlacionou significativamente com a qualidade de sono prejudicada de acordo com os escores totais do PSQI (p = 0,001). Foram encontradas diferenças significativas entre os pacientes com EA e controles saudáveis nos domínios do PSQI, incluindo "qualidade subjetiva do sono" (p = 0,010), "duração do sono" (p = 0,011), "eficiência do sono habitual" (p = 0,034), "distúrbios do sono" (p = 0,003) e "disfunção diurna" (p = 0,009), mas não na "latência do sono" e no "uso de medicação para dormir". Houve uma correlação positiva entre as pontuações do BASDAI e do PSQI (r = 0,612, p = 0,001). Conclusão Verificou-se que os distúrbios do sono foram significativamente maiores em pacientes com EA em comparação com os controles. Os pacientes com doença ativa apresentaram pior qualidade de sono. Além disso, a atividade da doença esteve correlacionada com a pontuação da maior parte das subescalas do PSQI. A investigação da qualidade do sono deve ser uma ferramenta usada na avaliação de pacientes com EA.

ABSTRACT Introduction Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease characterized by the inflammation of the pelvis and spine that results in a restriction in the mobility of the spine. Due to the altered posture and nocturnal inflammatory pain, sleep disturbances are likely to occur in patients with AS. Objective This cross-sectional study aimed at determining the differences between the patients with AS and healthy controls in sleep quality, as well as assessing the relationship between the sleep quality and disease activity. Method In order to assess sleep quality, fifty-five patients with AS (40 men, 15 women; mean age, 43 ± 1 yrs) who fulfilled the modified New York criteria and fifty-five comparable controls (40 men, 15 women; mean age, 42 ± 9 yrs) completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The disease activity was assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Results Ankylosing spondylitis was associated with a significantly impaired sleep quality according to the total PSQI scores (p = 0.001). Significant differences were found between the patients with AS and healthy controls in PSQI domains, including "subjective sleep quality" (p = 0. 010), "sleep duration" (p = 0. 011), "habitual sleep efficiency" (p = 0. 034), "sleep disturbances" (p = 0. 003) and "daytime dysfunction" (p = 0. 009) but not in "sleep latency", "use of sleep medication". There was a significant positive correlation between the BASDAI and PSQI scores (r = 0.612, p = 0.001). Conclusion In the current study, we found that the sleep disturbances were significantly higher in patients with AS in comparison to controls. Patients with active disease had worse sleep quality. In addition, disease activity was correlated with the scores of most of the PSQI subscales. Sleep quality assessment should be a tool for evaluating patients with AS.

Objective The aim of this study was to evaluate the capability and the reliability of diffusion-weighted imaging (DWI) in the changes of kidneys occurring after extracorporeal shock wave lithotripsy (ESWL) treatment for renal stones. Materials and Methods A total of 32 patients who underwent ESWL treatment for renal stone disease between June and December 2011 were enrolled in this prospective study. Color Doppler ultrasonography (CDUS) and DWI were performed before and within 24 hours after ESWL. DWI was obtained with b factors of 0, 500 and 1000 s/mm2 at 1.5 T MRI. Each of Resistive index (RI) and ADC values were calculated from the three regions of renal upper, middle and lower zones for both of the affected and contralateral kidneys. Paired sample t test was used for statistical analyses. Results After ESWL, the treated kidneys had statistically significant lower ADC values in all different regions compared with previous renal images. The best discriminative parameter was signal intensity with a b value of 1000 s/mm2. The changes of DWI after ESWL were noteworthy in the middle of the treated kidney (p<0.01). There were no significant difference between RI values in all regions of treated and contralateral kidneys before and after treatment with ESWL (p>0.05). Conclusion DWI is a valuable technique enables the detection of changes in DWI after ESWL treatment that may provide useful information in prediction of renal damage by shock waves, even CDUS is normal.

Uma mulher de 49 anos de idade, com perda visual aguda de seu olho esquerdo, que teve diagnóstico de carcinoma endotelial de pâncreas há dois meses, foi examinada em nossa clínica. Suas acuidades visuais eram 20/20 no olho direito e 20/200 no olho esquerdo. O exame de fundo de olho e a angiofluoresceinografia mostraram massa solitária sub-retiniana bilateral. Múltiplas metástases do pulmão, pleura, fígado, baço e nódulos linfáticos abdominais foram detectados no diagnóstico inicial. A paciente foi submetida a quimioterapia durante o tempo que os sintomas visuais foram observados. Nenhum tratamento adicional foi oferecido por causa da extensão da doença e problemas de saúde em geral. Embora o carcinoma endotelial de pâncreas normalmente se espalhe para órgãos abdominais e pulmões, este pode ser uma causa rara de metástases de coroide.

A 49-year-old woman with acute loss of vision in her left eye was examined in our clinic. Two months before arriving at out clinic, she was diagnosed with pancreatic endothelial carcinoma. Her visual acuities were 20/20 for the right and 20/200 for the left eye. Fundus examination and fundus fluorescein angiography showed bilateral subretinal solitary mass. Multiple metastases to lung, pleura, liver, spleen, and abdominal lymph nodes were detected during the initial diagnosis. The patient underwent chemotherapy during the period when the visual symptoms were observed. No additional treatment was offered because of the extent of the disease and poor general health. Although pancreatic endothelial carcinoma usually spreads to the abdominal visceral organs and lungs, choroidal metastases are rarely observed.