Antalya Education Research Articles

The role of High Mobility Group Box 1 (HMGB1) in colorectal cancer

BackgroundHMGB1, the most important member of the high mobility group box protein family, is a nuclear protein with different functions in the cell; it has a role in cancer progression, angiogenesis, invasion, and metastasis development. We studied the expression of HMGB1 and whether it is a prognostic factor in colorectal carcinoma.Material/MethodsThe study included 110 cases that were histopathologically diagnosed with colorectal carcinoma from the tissue samples acquired by surgical resection and biopsy in Antalya Education and Research Hospital between 2008 and 2012. HMGB1 expression was examined via immunohistochemical method.ResultsHMGB1 expression was evaluated as negative in 32 (44.4%) of the patients and as positive in 40 (55.6%) patients. There was no relation between the HMGB1 expression and sex, age, tumor invasion depth, and histological type. However, a significant relation was detected between the HMGB1 expression and lymph node status, metastasis status, and stage (p:<0.001, p:<0.001, p:<0.001, respectively). Similar results were obtained for the relations between the HMGB1 and histological grade, perineural invasion, lymphovascular invasion, and lymphocytic response (p<0.001, p<0.001, p<0.001, and p<0.001, respectively).ConclusionsThe results of our study demonstrate that HMGB1 overexpression has a significant role in tumor progression (especially migration of tumor cells) and tumor ability to metastasize in colorectal cancers; thus, it corroborates the idea that it might be an important prognostic factor.

Recurrent spontaneous ovarian hyperstimulation secondary to hypothyroidism in an adolescent girl

Ovarian hyperstimulation syndrome (OHSS) is characterized by ovarian enlargement due to multiple ovarian cysts and a fluid shift into the extravascular space [1]. Some forms of OHSS have reportedly occurred during spontaneous pregnancy such as multiple pregnancies and associated conditions including, hypothyroidism, polycystic ovary syndrome, and follicle-stimulating hormone receptor (FSHr) mutations [2–4]. This report describes a case of recurrent OHSS associated with hypothyroidism in an adolescent girl with a non-remarkable family history and normal FSHr. An 18-year-old adolescent girl was admitted to our hospital with symptoms of abdominal pain and distension. Transabdominal ultrasonography (USG) showed mild ascites and bilateral ovarian multilocular cysts extending into the midabdomen. The results of blood counts and electrolyte analyses were normal. The hormonal evaluation revealed undetectable human chorionic gonadotropin (hCG), normal follicle-stimulating hormone (FSH) (6.5 IU/L) and luteinizing hormone (LH) (9.2 IU/L), high estradiol (E2) (4.000 mIU/mL) and thyroid-stimulating hormone (TSH) (100 lU/mL; normal range 0.47–5 lU/mL), and low free thyroxine (4.5 pmol/L; normal range 11–24 pmol/L). Abdominal magnetic resonance imaging (MRI) showed massively enlarged bilateral multicystic structures of presumable bilateral ovarian origin extending into the midabdomen (Fig. 1). Pituitary MRI was normal. Conservative medical management comprising was considered due to the presence of moderate spontaneous OHSS. Oral thyroxine (levothyroxine at 100 lg/day) was instituted on the basis of hypothyroidism. Abdominal symptoms were relieved with the beginning of menstruation within 2 weeks. Four months later, the patient presented to our center with similar symptoms. USG findings were similar to bilateral multilocular cysts in both ovaries and mild ascites. Serum hormonal analysis revealed a higher E2 level (10.000 mIU/mL) with a high TSH (20 lU/mL) and normal free thyroxine (15 pmol/L). Blood counts and electrolyte analyses were normal. Observation and supportive medical treatment was considered. The patient was discharged after 10 days with complete resolution of all clinical symptoms. Oral thyroxine reached a dose of 200 lg/day. Hormonal tests for thyroid function were normal 2 months after her second admission and the ovarian cysts completely regressed after 6 months. Bidirectional DNA sequencing of the FSHr gene was performed by PCR amplification to rule out FSHr abnormality in this case. No differences in the DNA sequence in the 10 exons were observed between the wild-type FSHr gene and those obtained from the patient. The exact mechanism underlying the relationship between OHSS and hypothyroidism is not clearly understood. One explanation of this rare association is that TSH has weak FSH activity on mutated FSHr, causing ovarian stimulation [5]. Another explanation is based on the release of FSH and LH by low levels of thyroid hormones, in addition to the targeted activation of TSH release. This seemed to be the cause in our case as FSHr sequencing was normal. In the literature, all the reported recurrent form of O. Erol (&) H. Ayik A. U. Derbent Department of Obstetrics and Gynecology, Antalya Research and Education Hospital, 07050 Antalya, Turkey e-mail: dronurerol@hotmail.com

Complementary and alternative medicine use in children with thalassaemia

The aims of this study were to: (1) determine the types of complementary and alternative medicine use among children with thalassaemia as reported by parents and (2) describe sociodemographic and medical factors associated with the use of such treatments in families residing in southern Turkey. Thalassaemia is one of the most common human genetic diseases. Despite the therapeutic efforts, patients will encounter a variety of physical and psychological problems. Therefore, the use of complementary and alternative medicines among children thalassaemia is becoming increasingly popular. This is a descriptive study of complementary and alternative medicine. This study was conducted in the Hematology Outpatient Clinic at Akdeniz University Hospital and in the Thalassemia Centre at Ministry of Health Antalya Education and Research Hospital, Antalya, Turkey, between January 2010-December 2010. Parents of 97 paediatric patients, among 125 parents who applied to the haematology outpatient clinic and thalassaemia centre between these dates, agreed to take part in the study with whom contact could be made were included. Data were collected by using a questionnaire. The proportion of parents who reported using one or more of the complementary and alternative medicine methods was 82·5%. Of these parents, 61·8% were using prayer/spiritual practice, 47·4% were using nutritional supplements and 35·1% were using animal materials. It was determined that a significant portion of the parents using complementary and alternative medicine use it to treat their children's health problems, they were informed about complementary and alternative medicine by their paediatricians and family elders, and they have discussed the use of complementary and alternative medicine with healthcare professionals. To sustain medical treatment and prognosis of thalassaemia, it is important for nurses to consult with their patients and parents regarding the use and potential risks of some complementary and alternative medicine.

Cosmetic Results of Wedge Resection of Nail Matrix (Winograd Technique) in the Treatment of Ingrown Toenail

The purpose of this retrospective study is to evaluate the cosmetic results of wedge resection of the nail matrix (Winograd technique) in the treatment of ingrown toenail. This study retrospectively reviewed medical charts of 68 patients with 75 ingrown toenails who underwent surgical correction with the Winograd technique between January, 2008, and December, 2009, at the Orthopaedics and Traumatology Department, Antalya Education and Research Hospital. For the final follow-up, patients were contacted by telephone and completed a telephone questionnaire. Recurrence, cosmetic results, and satisfaction of the patients were the major outcome measures. There was recurrence in 9 patients (13.2%). The mean recurrence time was 6.7 months (range = 2-12 months). All recurrences involved the lateral border of the toenail. Cosmetic ratings were statistically lower in female patients (P = .005). The reasons for poor and acceptable cosmetic results were proximal-incision scar and narrowing of the nail plate. Wedge resection of nail matrix has a considerably high recurrence rate. Furthermore, narrowing of the nail plate is a disadvantage of this procedure. All patients should be informed about the possibility of recurrence and disfigurement in their toenails (narrow nail plate). Particularly, female patients who care about the cosmesis may be dissatisfied with this surgical technique.

P01-457 - Evaluation of self-esteem with internalized stigmatization in the patients with mentally illness

IntroductionInternalized stigmatization means a internalized reaction in the person with mentally illness as a answer against the people reject and discrimination.ObjectiveThe peoples with mentally illness believe that most people reject and devalue people with mental illnesses, they may suffer a number of negative outcomes, such as demoralization, lowered self-esteem.AimThe aim of our study was to identify the relationship between the factors effecting the internalized stigmatization and self-esteem among patients with mentally illness.MethodsIn this study, we measured the prevalence of internalized stigma among 115 outpatients referring to the Psychiatry Service of Antalya Education and Research Hospital between 2009–2010 using Rosenberg Self-Esteem(SE) Scale, the Internalized Stigma of Mental Illness(ISMI) Scale, and Personel Datasheet.ResultsOf the patients, 53.9% had middle level of SE and the 22.00–70.00 ranging of ISMI, 30.4% of the patients were found to be 21–30 years-old. We found the increase of ISMI when SE was decreased in both of gender(p = 0.01, r = -0.67) and it was also found to be decreased of ISMI when the education level was increased in the patients(p = 0.004,r = -0.27). Recurrent hospitalization of the patients increased their ISMI points(p = 0.014, r = 0.23). There was no statistical relation between the living place of the patients and their ISMI points(p = 0.523).ConclusionsOur results suggest that some factors effected internalized stigma and showed the relationship between the internalized stigmatization and self-esteem among patients with mentally illness. To decrease and prevent internalized stigmatization, a specific education should be provided to patients, families and society by health professionals.