Cc In Group Research Articles

Association of the miR-143 Gene rs353292 Polymorphism with Recurrent Pregnancy Loss in Caucasian Women: A Novel Finding in a Multifactorial Devastating Problem.

The purpose of this prospective case-control study is to investigate the correlation of the miR-143 gene rs353292 polymorphism in Caucasian women with recurrent pregnancy loss (RPL) compared to a matched control group with at least one live birth and without pregnancy losses. In total, 110 women with recurrent pregnancy losses and 95 control women were recruited. Peripheral blood was collected from all women, and the isolation of DNA was performed with Monarch Genomic DNA Purification. Polymerase chain reaction was applied to amplify the DNA sequence of the miR-143 gene promoter, carrying the polymorphism rs353292. The incidence of genotype CC in the RPL group was statistically significantly higher than in control group (p < 0.0001). Allele C (CT + CC) in the control group was found in 47.36%, and in the RPL group was found in 68.17% (p = 0.006). SNP rs353292 T>C was associated with increased risk of recurrent pregnancy loss. The calculated odds ratio for CT + CC vs. TT and for CC vs. TT were significant higher (p = 0.0028 and p < 0.0001, respectively). The study results suggest that the rs353292 polymorphism is associated with a statistically significant increase in RPL prevalence. The present study provides additional evidence in favor of a shared pathophysiological mechanism that contributes to both RPLs, potentially through inflammatory processes and epithelial-mesenchymal transition dysregulation.

The Role of Theory of Mind, Executive Functions, and Central Coherence in Reading Comprehension for Children with ASD and Typical Development.

Many children with autism spectrum disorders (ASD) have challenges in reading comprehension, especially when implicit information in narrative texts is involved. Three interrelated factors influencing reading comprehension have been proposed to explain these challenges: Theory of Mind - ToM; executive functions - EF; and central coherence - CC. This study investigated the differential contribution of these cognitive abilities to reading comprehension among cognitively able children with ASD compared to matched peers with typical development (TD).28 third-grade children with ASD and 28 third-grade children with TD participated in the study. Four measures were administered: ToM, CC, EF (working memory, planning, inhibitory control, cognitive flexibility), and reading comprehension. One-way ANOVAs were computed to examine group differences in cognitive characteristics (ToM, CC, EF) and reading comprehension. Regressions were performed to examine the contribution of cognitive characteristics (ToM, CC, EF) to reading comprehension abilities (explicit, implicit, and general score) in ASD and TD.The TD group outperformed the ASD group in ToM and various EF measures but not in CC or reading comprehension. Positive main effects were found for ToM, and EF measures (planning - 3rd level, inhibition, and cognitive flexibility), demonstrating their contribution to reading comprehension abilities in both groups. Interactions revealed positive main effects for EF planning and CC for the ASD group only, showing the contribution of EF planning and CC for better reading comprehension.Our findings suggest different processing mechanisms regarding reading comprehension in each group.

Percutaneous full-endoscopic transforaminal discectomy versus open microdiscectomy in the treatment of lumbar disc herniation: randomized controlled trial

BackgroundLumbar disc herniation is one of the most common degenerative spine conditions. In our center, the standard surgical technique for treatment of lumbar disc herniation is open microdiscectomy. The full-endoscopic transforaminal discectomy is done for selective cases of lumbar disc herniation under local anesthesia, achieving good results. This study aims to compare the clinical outcomes, operative data, and complications of the treatment of lumbar disc herniation with “percutaneous full-endoscopic transforaminal discectomy” (TED) and the gold standard “open microdiscectomy" (MD). This was a randomized controlled trial that included 65 patients with lumbar disc herniation: 32 in the TED group and 33 in the MD group.ResultsThere was no statistically significant difference between the two groups with regard to the visual analogue scale (VAS) for leg pain, the VAS for back pain, or the Oswestry Low Back Pain Disability Questionnaire (ODI) score at the end of the 1-year follow-up. The operative time in minutes was statistically shorter in the TED group, with a mean value of 50.38 (± 11.65) and 61.09 (± 12.32) in the MD group. The blood loss was 77.33 CC (± 23.14) in the TED group and 170 CC (± 56.06) in the MD group. The mean duration of hospital stay in days was statistically shorter in the TED group. Exposure to radiation in minutes was higher in the TED group: 1.09 (± 0.33) and 0.18 (± 0.08) in the TED group and MD group, respectively. There was no statistically significant difference in the rate of complications.ConclusionTED showed superiority over MD with regard to blood loss, operative time and shorter hospital stays, but with increased radiation exposure. There was no difference in clinical outcomes regarding VAS for leg and back pain and ODI score at 1 year follow-up with no significant difference in complications.

“Floating ball sign” in the diagnostic imaging of mature ovarian teratomas in children

The “floating ball sign” (FBS) is a rarely described visual phenomenon found in mature ovarian teratoma imaging. It is characterized by the presence of movable, spherical areas within the cystic component of a tumor. Such visualization is possible both in cross-sectional imaging and ultrasonography. To evaluate the incidence of FBS in the pediatric population with regard to patients’ age and tumor size. This is a retrospective study of pediatric patients operated on in a tertiary pediatric surgical center between January 2009 and December 2022 due to mature ovarian teratoma; the medical records were reviewed for the age at diagnosis, recurrences, tumor size, and their characteristics in preoperative imaging. Eighty-three patients (mean age 14, range 0–17) out of 91 met the inclusion criteria for the analysis. Eighty-seven operations on 90 ovaries were performed. Preoperatively 38 patients underwent CT, 13 MRI, and 39 received only the ultrasound examination. The FBS was identified in preoperative imaging diagnostics in 3 (3.3%) girls (14, 16 and 17 years of age). The average largest tumor dimension and volume were 142 mm and 1268 cc in the FBS group, and 73 mm and 252 cc in the remaining group, respectively. FBS tumors usually reach large sizes. Although the sign is rare in children, there are no scientific reports of its occurrence in the first life decade. Color flow mapping and cross-sectional imaging play a pertinent role in distinguishing this uncommon pattern from a malignant mass and enable the selection of an appropriate surgical approach.

(445) A Full Bladder Is Not Needed To Grade Male Stress Incontinence For Prosthesis Patient Selection

Abstract Introduction Stress urinary incontinence (SUI) resulting from prostate surgery can have devastating consequences in men’s quality of life. Patient selection is crucial for successful treatment of SUI with urethral sling or artificial urinary sphincter (AUS). The ideal SUI evaluation tool for determining severity and guiding surgical treatment remains unknown. The Male Stress Incontinence Grading Scale (MSIGS) uses a standing cough test to provide a simple, non-invasive assessment of post-prostatectomy SUI severity, and can facilitate procedure selection. However, uncertainty remains as to whether MSIGS underestimates SUI severity if performed with insufficiently full bladder, increasing the risk of treatment failure. Objective We present our sling and AUS outcomes using the MSIGS for selection. We assessed bladder fullness with random bladder scans (BS) at the time of evaluation to determine if emptier bladder carries increased risk of failure. Methods We conducted a retrospective chart review of male patients undergoing sling and AUS placement. MSIGS and BS were documented at initial evaluation. Additional collected data included age, pads per day (PPD) pre- and post-surgery, post-operative MSIGS, and need for revision or conversion. Success and failure groups were defined as the post-operative use of ≤1 PPD or &amp;gt;1 PPD, respectively. Descriptive and comparative statistics were performed using SAS software. Results From April 2017 to September 2021, 40 male patients underwent sling and 43 naïve AUS placement. Average age was 71.9 for slings and 70.3 for AUS. 80/83 had prior prostatic surgery. Average follow up was 12.5 months. 34/40 slings had complete SUI resolution or reduction of pad use to no more than one PPD vs 40/43 of AUS (85 vs 93%, p=0.4). 4 sling patients (10%) had persistence or recurrence of SUI, of whichone patient underwent AUS placement. MSIGS scores were similar between sling success (83% patients grade 0, 3% grade 1, 14% grade 2) and failure groups (67% grade 0, 33% grade 1). 73% of AUS patient mostly had MSIGS scores 3 or 4. BS was available for 35 sling and 25 AUS patients. Average was 18.5cc in the sling failure group (range 17-161) and 38cc in the sling success, (17-161), with 32% of success patients having a BS of 0cc, and 80% of &amp;lt;60cc. Average BS for AUS patients was 45cc (14-224). 10 patients with BS 0 and 7 patients with BS&amp;lt;30cc demonstrated MSIGS 4 on exam. Conclusions MSIGS is a non-invasive, reliable test to assess SUI severity. Our preliminary data suggests that a full bladder at time of assessment is not necessary to accurately select patients for male sling vs AUS, with high rate of success and patient satisfaction. Disclosure No

Association of Androgen-Receptor Gene Mutations with the Copy Number of Androgen-Receptor Silk Protein A Complex and Glutathione-S-Transferases T1 and M1 in Prostate Cancer Patients.

The purpose of our work was to explore the association of mutations in the androgen receptor gene and copy numbers of the androgen-receptor silk protein A complex with glutathione-S-transferases T1 and M1 in prostate cancer patients. Eighty-five patients with PC and 85 healthy controls were included in the study. Fasting peripheral venous blood was collected, whole blood genomic DNA was extracted, and AR gene-receptor genotype was detected by a high-resolution melting curve analysis detection technology. Expression levels of androgen receptor (AR) and filamin protein A (FlnA) were detected by Western blotting. RT-PCR was used to detect the copy number of T1 and M1 glutathione-S-transferases. The wild-type androgen receptor gene rs5918762 is of TT type. The frequencies of CC and TC genes in the prostate cancer group were significantly higher than those in the normal control group (P < 0.05). Compared with TT-type PC patients, PC patients with TC-type and CC-type had higher expression levels of sex hormone receptor silk protein A complex and higher copy numbers of GSTT1 and GSTM1 (P < 0.05). Androgen-receptor gene mutation (T ⟶ C) was significantly positively correlated with the expression level of androgen-receptor silk protein A complex and the copy number of GSTT1 and GSTM1. Androgen-receptor gene polymorphisms were significantly associated with expression levels of androgen receptor complex A and silk proteins, and copy numbers of T1 and M1 glutathione-S-transferases. A combination of four factors can be used to identify prostate cancer susceptibility and disease progression.

Correlation Analysis between c.1365-13T>C and c.406C>T Single Nucleotide Polymorphism and the Risk of G6PD Deficiency

To investigate the possible association between c.1365-13T>C, c.406C>T polymorphism and G6PD deficiency in the population of Guangxi by the methods of case-control study. Meanwhile to investigate the mutation frequency of these two gene loci in population of Guangxi. The activity levels of G6PD and c.1365-13T>C, c.406C>T polymorphism were detected in 417 patients with G6PD deficiency and 295 healthy controls. The correlation between genotypes, alleles and G6PD activity levels was analyzed using statistical methods, and the haplotype frequencies at the two loci was analyzed using online SHEsis software. The frequencies of CC genotype (P=0.001, OR=2.684) and C allele (P=0.002, OR=1.681) of c.1365-13T>C in patients with G6PD deficiency were significant lower than those in the controls, the frequency of dominant model TT+TC vs CC（P=0.001, OR=2.694） in the G6PD deficiency group was higher than that in the control group, and the differences were statistically significant. The differences of genotype and allele frequencies in c.406C>T between G6PD deficiency patients and controls had no statistical significance (all P>0.05). Haplotype analysis showed that there were significant correlations between C-C, T-C haplotypes and G6PD expression levels. In G6PD deficiency group, patients with c.1365-13T>C TC genotype had higher levels of G6PD activity, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) compared with patients with TT genogype, but the values of red cell distribution width-coefficient of variation (RDW-CV) was lower than those in TT genotype patients, and the differences were statistically significant (P<0.05). While patients with c.1365-13T>C CC genotype had lower levels of G6PD activity compared with patients with TT genogype, but the values of MCV and MCH were higher than those in TT genotype patients (P<0.05). The average values of hematocrit(HCT), MCV, MCH and red blood cell distribution width-standard deviation (RDW-SD) in patients with c. 406C> T TT genotype were significantly higher than those in patients with c. 406C> T CC genotype.(all P<0.05). The association between G6PD c.1365-13T>C and the activity levels of G6PD is statistically significant, which is worth further study.

Efficacy of Oxytocin in Reducing Blood Loss During Abdominal Myomectomy

Introduction: The drug of choice for preventing postpartum uterine atony and bleeding is oxytocin. Myomectomy is a procedure that may result in substantial bleeding. In about 20% women, transfusion of blood may be required during abdominal myomectomy. The objective was to compare the frequency of patients who needed blood transfusions with and without oxytocin during abdominal myomectomy. Place and duration of study: This was a randomized controlled trial carried out at the Department of Obstetrics and Gynecology of Sharif Medical Complex Lahore from 10th May 2018 to 10th November 2018. Material &amp; Methods: 108 patients having intramural uterine fibroid &gt; 5 cm in size, requiring planned elective open abdominal myomectomy were included and equally divided in both oxytocin and non-oxytocin groups(n=54). 30 IU oxytocin infusion (in 500 ml normal saline) / 120 milliliter per hour were administered during myomectomy, starting after administration of general anesthesia and completing just prior to surgery in patients of oxytocin group. An infusion of pure normal saline was administered at the same amount in the patients of non-oxytocin group. Blood loss was estimated and need for blood transfusion was determined in both the groups. Data was analyzed using SPSS version 24. P-value&lt;0.05 was considered significant. Results: Patients age ranged from 35 to 45 years with mean age of 40.481± 1.84 years in Oxytocin group while 40.425± 2.68 years in Non-Oxytocin group. Mean blood loss was 290.463±120.91 cc in Oxytocin group and 424.981±106.21 cc in Non-Oxytocin group. Need for blood transfusion was seen in 7.4% patients in Oxytocin group as compared to 25.9% in Non-Oxytocin group (p=0.009). Conclusion: Our study concludes that to reduce loss of blood during abdominal myomectomy, infusion of intra- operative oxytocin may be efficient and safe. To confirm these results, more studies with varied dosages and protocols are required.

Analysis of polymorphisms in recurrent pregnancy loss: Factor V Leiden G1691A, Factor II G20210A, MTHFR C677T and Factor V H1299R

The distribution of factor V Leiden G1691A, factor II G20210A, MTHFR C677T, and factor V H1299R polymorphisms known to predispose to thrombophilia in 215 cases and 40 controls admitted with indication of recurrent pregnancy loss (RPL) was investigated. Genotyping was performed by melting curve analysis using simultaneous PCR (RT-PCR). There was no difference between genotype and allele frequencies in the case and control groups in terms of the polymorphisms examined (p>0.05). In the genotype distribution of the Factor V gene G1691A polymorphism, 12.6% GA in the case group and 90.0% GG (wild) genotypes in the control group were found to be higher than the other genotypes. In the genotype distribution of the factor II gene G20210A polymorphism, the GG (wild) genotype was found to be higher in 94.5% and 97.5%, respectively, in the case group and control group than the other genotypes. In the genotype distribution of MTHFR gene C677T polymorphism, 43.7% CC (wild) in the case group and 40.0% CT genotype in the control group were found to be higher than the other genotypes. In the genotype distribution of the factor V gene A4070G polymorphism, 87.4% AA (wild) in the case group and 80% AA (wild) genotype in the control group were found to be higher than the other genotypes. However, the frequency of risk allele A for factor V Leiden G1691A (6.8% and 5%), the frequency of risk allele A for factor II gene G20210A (3% and 1.2%), MTHFR gene C677T were determined in the case and control groups. The frequency of the T allele (35.9% and 42.5%), which is the risk allele for A4070G, and the frequency of the G allele (6.5% and 16.6%), which is the risk allele for the factor V gene A4070G, were determined. When our study results were evaluated, no relationship was found between RPL and factor V Leiden G1691A, factor II G20210A, MTHFR C677T, and factor V A4070G polymorphisms.

A Randomized Controlled Trial of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with Two Anorganic Bovine Bone Materials Covered by Titanium Meshes.

The aim of this study is to compare two low-temperature sintered anorganic bovine bone materials (ABBMs), Bio-Oss (Geistlich, Wolhusen, Switzerland) and A-Oss (Osstem, Seoul, Korea), for GBR in dehiscence defects. A single implant was placed simultaneously with GBR in the buccal or bucco-proximal osseous defect by double-layering of inner allograft and outer ABBM, covered by a preformed ultrafine titanium mesh and an absorbable collagen membrane. Grafted volume changes were evaluated by cone-beam computed tomography, taken preoperatively (T0), immediately after implant surgery (T1), after re-entry surgery (T2), and after delivery of the final restoration (T3). The density of the regenerated bone was assessed by measuring the probing depth on the buccal mid-center of the mesh after removing the mesh at T2. Postoperative sequelae were also recorded. Grafted volume shrinkage of 46.0% (0.78 ± 0.37 cc) and 40.8% (0.79 ± 0.33 cc) in the Bio-Oss group (8 patients) and A-Oss group (8 patients), respectively, was observed at T3 (p < 0.001). There were no significant differences in grafted volume changes according to time periods or bone density between the two groups. Despite postoperative mesh exposure (3 patients), premature removal of these exposed meshes and additional grafting was not necessary, and all implants were functional over the 1-year follow-up period. Both ABBMs with titanium meshes showed no significant difference in the quantity and density of the regenerated bone after GBR for peri-implant defects.

Contemporary management of prostatic abscess: Our experience.

Introduction:Prostatic abscess is a serious urological problem that needs immediate attention due to its high morbidity and mortality in absence of appropriate treatment. The objective of our study is to evaluate the efficacy and safety of various modalities of management of prostatic abscess: medical management (MM), transrectal ultrasound-guided aspiration (TRUS-GA), and transurethral deroofing (TU-DRMethods:This retrospective study was done in a tertiary care center after taking approval from the institutional review board. Conservative management was done by oral or parenteral medications. Transrectal ultrasound GAs were performed under local anesthesia with an 18-gauge two-part needle. Collapse of cavity was seen in “real time” on TRUS. TU-DR of the prostate was done by 26 French continuous irrigation monopolar resectoscopes. The aspirated pus was sent for microbiological investigation.Results:TRUS-guided aspiration was performed in 20 patients, TU-DR in five patients, and conservative management in 15 patients. The mean volume of abscess aspirated by TRUS guidance was 13 cc (range 8–50 cc) with single-time aspiration in 85% of cases. Re-aspiration was done in 3 patients. The mean volume of abscess was 33.2 cc (range: 25–40 cc) in TU-DR group and 1.2 cc (range 0.5–2.0 cc) in the MM group. The predominant organism isolated was Escherichia coli (48%). Clinical improvement was seen in 97.5% of cases.Conclusion:We suggest TRUS-GA for symptomatic patients with abscess size more than 2 cc and TU-DR if TRUS-GA fails or is contraindicated.

Comparison of the Results and Complications of Crush-Clamp and Ultrasonic Dissection Surgery Techniques in Hepatectomy in Patients with Hepatic Mass

Inroduction: Perioperative hemorrhage and postoperative bile leakage are important complications of hepatectomy. various methods to reduce intraoperative bleeding during liver transection have been reported. We designed a randomized clinical trial to compare crush clamp method and ultrasound dissection in liver transection. Materials and Method: Twenty patient experienced hepatectomy with the crush clamp method. The ultrasonic dissection group consisted of twenty patients. The surgical outcome including: duration of the surgery, bleeding, P.C request, after operation bile leakage, hospital stay and hepatic failure are evaluated and compared. Results: Mean blood loss was 247 cc in crush clamp group and 232 in ultrasonic dissection group. Blood loss in ultrasonic method was lower but the difference did not reach significant level. Duration of surgery was almost identical. but duration of transection in crush clamp group was shorter than ultrasonic dissection group. That mean the crush clamp method is faster. Acidosis and hepatic failure were rare and difference was not significant. There were not cases with infection and bile leakage. Conclusion: Post-operative complications did not different in two groups. but duration of transection in crush clamp was shorter than ultrasonic dissection method and blood loss was almost identical. because ultrasonic dissection is an equipment dependent procedure and more expensive therefore we trend to perform liver transection with crush clamp method. Keywords: Hepatectomy, Crush clamp method, Ultrasonic dissection, Hepatic mass, hepatobiliary surgery, Adenocarcinoma

The effects of rectal suppositories of Plantago major and Anetheum Graveolens on postpartum hemorrhage: A randomized triple blinded clinical trial

Introductionpostpartum hemorrhage (PPH) is a known emergency in midwifery and is one of the most common causes of maternal mortality. This study sought to investigate the effectiveness of rectal suppositories of Plantago major and Anethum graveolens (Dill) on the PPH. MethodA randomized triple blinded clinical trial was performed on 105 pregnant women who were eligible for the study and admitted to the vaginal delivery unit to Umm-al-Banin Hospital in Mashhad in 2018. Individuals were divided using random assignment into three 35-individual groups, namely Plantago major, Dill, and control groups. Measures were taken according to the hospital routine and participants received an infusion of 30 units of oxytocin after the infant birth. Intervention groups received the first dose of a rectal suppository of Plantago major 120 mg and rectal suppository of dill 290 mg immediately after removal of the placenta and embryonic membranes and uterine massage, and then the next doses were placed every half hour to 5 doses. The PPH was measured by weighing the blood bags and pads 4 h after labor. FindingsAverage bleeding rate at the end of the first 4 h after delivery was 306.2 ± 11.2 cc in the control group, 282.4 ± 9.6 cc in the Dill group, and 253.5 ± 14.2 cc in the Plantago group; there was a statistically significant difference (P = 0.001). ConclusionThe results demonstrated that rectal suppositories of Dill and Plantago are both effective for decreasing PPH, but Plantago rectal suppository can more effectively reduce PPH.

VEGF Inhibition Reduces Intracranial Edema Following SRS of Brain Metastases From Renal Cell Carcinoma

Optimal control of brain metastases (BM) from renal cell carcinoma (RCC) with stereotactic radiosurgery (SRS) is critical as tyrosine kinase inhibitors (TKI) and immunotherapy has significantly prolonged overall survival (OS), emphasizing the importance of minimizing potential morbidity from treatment-associated edema. Clinically, we have observed that RCC BM-associated edema seems to be less prominent when VEGF-targeted agents (VEGFi) such as axitinib are administered contemporaneously with SRS. We therefore investigated the role of VEGFi in intracranial edema reduction in pts treated with SRS.We conducted a single institution retrospective analysis of all clear cell or unknown RCC pts with BM treated with SRS from 2013 onwards. We excluded non-clear cell RCC, lack of post-SRS imaging, and failure to complete SRS. The SRS plus VEGFi cohort was defined as VEGFi within 6 months of SRS. Volumetric data was obtained from SRS plans, edema was contoured on MR Brain T2 Flair, and paired t-test was performed. Multivariate analysis for OS performed with the Cox proportional hazards model.We identified 38 pts who received 78 courses of SRS + VEGFi and 18 pts who received 29 courses of SRS alone. For the SRS + VEGFi and SRS groups, median OS was 4.1y and 6.0y, median SRS dose was 21 Gy and 27 Gy with comparable pre-SRS steroid use of 52% and 57% (HR 0.51, P = 0.200) and baseline neurologic symptoms 50% and 74% (HR 0.943, P = 0.904), respectively. Among the SRS + VEGFi group, the mean intact tumor volume decreased from pre-SRS 1.89cc to 0.42cc at 6m post-SRS, compared to a decrease from 1.82cc to 1.28cc in the SRS group. Edema volume decreased from 17.65cc to 3.28cc in the SRS + VEGFi group with an increase from pre-SRS 5.78cc to 6.39cc at 6mo post-SRS in the SRS alone group (95% CI -3.67, 1.15, P = 0.154).Despite similar pre-SRS steroid use and increased edema volume, VEGFi appeared to improve post-SRS edema with a notable reduction of neurological symptoms. Our data suggest VEGFi may offer symptomatic benefit for significant peritumoral edema even without overt disease progression, and that re-challenge or continuation of VEGFi with SRS should be considered in such patients.

MDR1 C3435T POLYMORPHISM: A PRELIMINARY STUDY ON ITS RELATIONSHIP WITH THE RISK OF COLORECTAL CANCER

Objective: Colorectal carcinoma (CRC) is the third most frequent cancer in the world and a heterogenious disease which aroze from one or a combination of different genetic mechanisms. The multiple drug resistance-1 (MDR1) gene which encodes P-glycoprotein (P-gp) plays a part in the bioavailability of drugs and cell toxicity. In the current study, we aimed to investigate the possible relation between the MDR1 gene C3435T polymorphism and CRC risk in the Turkish population. Material and Methods: Forty three patients (26 men, 17 women) with CRC and 48 healthy controls (34 men, 14 women) were included in the study. The MDR1 C3435T genotypes were determined by the Restriction Fragment Length Polymorphism (RFLP) method. Results: Statistical significance was obtained in terms of genotype distributions of MDR1 C3435T genotypes between study groups. The frequencies of MDR1 C3435T CC, TT and CT genotypes in the CRC patient group were found as 16.3%, 32.6% and 51.2%, respectively. The frequency of the homozygous TT genotype was found as 32.6% in CRC patients while it was identified as 14.6% in controls (p=0.04; OR=2.82, 95% CI: 1.01-7.87). When the patients were compared with the healthy population, TT genotype carriers of MDR1 C3435T polymorphism were found at 2.8-fold (p&lt;0.05 ) increased risk for the development of CRC. Conclusion: Our results show that the MDR1 C3435T polymorphism might be one of the genetic risk factors for CRC development in the Turkish population.

The SNP rs13118928, rs1828591 and rs10519717 in the HHIP Gene are not Associated on COPD Susceptibility in Male Javanese Smokers

Background: Hedgehog Interacting Protein (HHIP) gene polymorphisms have an association on COPDhas been carried out in Europe and Asia but in Indonesia there is still very limited study on this type andthe largest ethnic group in Indonesia is the Javanese. Objective: To analyze the association between theHHIP gene polymorphism and the incidence of COPD in male Javanese smokers in Lampung, Indonesia.Method: In a case-control study in Javanese male smokers, three single nucleotide polymorphism (SNPs)in the HHIP gene were analyzed by Sanger sequencing method. There were 110 participants in this studywhich were divided into 2 groups, such as COPD group (55 participants) and control group (55 participants).Three SNPs in the gene (rs13118928, rs1828591 and rs10519717) were selected for genotyping. Genotypedistributions were compared between patients and controls. The statistical analysis was carried out with theSPSS program with a chi-square test. Result: The genotypic frequency of the HHIP gene sequence at theSNP position rs1828591, such as AA (52.72%), GG (3.63%) and AG (43.63%) in COPD group, while inthe control group such as AA (38.18%), GG (9.09%) and GG (52.72%; p &gt; 0.05). The genotypic frequencyof the HHIP gene sequence at the SNP position rs13118928 consisted of AA (47.27%) and AG (53.72%)in the control group, while the COPD group consisted of AA (52.72%), GG (1.81%) and AG (45.45%; p&gt; 0.05). The genotypic frequency of the HHIP gene sequence at the SNP position rs10519717 consistedof TT (34.54%), CC (14.56%) and CT (50.90%) in COPD group, while controls group consisted of TT(23.63%), CC (16.37%) and CT (60.00%; p &gt; 0.05). The genotypic analysis of Three SNPs in HHIP genewere observed but showed no significant difference between case and control groups. Conclusion: Singlenucleotidevariants in the HHIP gene are not associated with COPD susceptibility in Javanese male smokers.

Is salvage surgery for large vestibular schwannomas after failed gamma knife radiosurgery more challenging?

In order to verify whether a previous gamma knife surgery (GKS) treatment could influence the oncological and functional outcome in large vestibular schwannoma (VS) surgery, we have compared group of patients operated on for large VS after failed GKS to a group of genuine VS that underwent the same functional nerve-sparing resection technique regimen in the same period. Single center retrospective cohort study of 23 consecutive GKS failure and 170 genuine VS patients operated on between April 2003 and March 2019. After resection, patients were allocated to a Wait-&-rescan or an upfront GKS policy. At last follow-up examination, the facial nerve function was good (House-Brackmann grades I or II) in 95% of the GKS failure and 84% of the genuine VS patients (p = .25). The median volume of tumor residue was .56cc in the GKS failure group and .62cc in the genuine VS group (p = .70). Tumor control was achieved in 91% and 83% of cases with a mean follow-up of 74 and 63months in the GKS failure and the genuine VS populations, respectively. The 1-, 5-, and 7-year progression-free survival were 100%, 95%, and 85% respectively in the GKS failure group and 97%, 80%, and 81% in the genuine VS group (p = .27). Despite significant modifications of the microsurgical environment associated to salvage surgery after GKS failure, a functional nerve-sparing resection is an effective strategy to optimize the results on facial nerve function, with similar long-term tumor control to those observed in the genuine VS population.

Effect of Vitamin C on Blood Loss during FESS in Patients with chronic rhinosinusitis

Introduction: In this study we assessed the effect of vitamin C on blood loss during endoscopic sinus surgery. Materials and methods: In this double-blind clinical trial study 91 patients suffered from chronic rhinosinusitis with nasal polyposis undergoing endoscopic sinus surgery involved. Patients in the case group (group A) received 3 g of vitamin C in 500 cc of normal saline intravenously over a half hour at the beginning of the surgery. Patients in the control group (group B) received the same volume of normal saline under similar condition. Ultimately, intraoperative blood loss, surgery duration, and the quality of surgical field were assessed. Results: The mean of blood loss was 211.47 cc in group A and it was 281.52 cc in group B, indicating a significant difference between two groups (p value= 0.03). The quality of surgical field, according to Boezaart scale, was also significantly better in group A (p value= 0.016). However, no significant difference was observed between groups in terms of surgeon’s satisfaction score. Conclusion: According to the results, we can conclude that preoperative administration of vitamin C could improve surgical field and reduce blood loss during endoscopic sinus surgery.

An Integrated Management Paradigm for Skull Base Chordoma Based on Clinical and Molecular Characteristics

Objective Previous work categorized skull base chordoma (SBC) into three genetic risk groups based on 1p36 and homozygous 9p21(p16) deletions, accounting for a wide variability in prognosis (A = low-risk, B = intermediate-risk, C = high-risk). However, it remains unclear how these groups could guide management. Study Design By integrating surgical outcome and adjuvant radiation (AdjXRT) information with genetic data on 152 tumors, we sought to develop an evidence-based management algorithm for SBC. Results Gross total resections (GTRs) were associated with improved progression free survival (PFS) in all genetic groups. For Group C tumors, GTR and AdjXRT independently contributed to PFS (multivariate Cox proportional hazard ratio [HR] = 0.14, p = 0.002, and HR = 0.40, p = 0.047, respectively). For Group B tumors, AdjXRT improved outcomes only when GTR was not feasible (log-rank p = 0.008), but not following GTR (log-rank p = 0.54). However, 24 of 25 Group A tumors underwent GTR, and AdjXRT for these did not confer any benefit (log-Rank p = 0.285). The high GTR rates in Group A could be explained by smaller tumor sizes (mean = 0.98cc/4.08cc/4.92cc for Group A/B/C, respectively, p = 0.031) and lack of invasiveness. Group A tumors were also more frequently diagnosed in young people ( p = 0.002) as asymptomatic lesions ( p = 0.001), suggesting that they could be precursors to tumors in higher risk groups. Conclusion Genotypic grouping by 1p36 and homozygous 9p21(p16) deletions can predict prognosis in SBC and guide management. GTR remains the cornerstone of SBC treatment and can be sufficient without AdjXRT in low and intermediate risk tumors. Low-risk tumors are associated with a less invasive phenotype, which makes them more amenable to GTR.

Frequency of Growth Differentiation Factor 5 rs143383 and asporin D-repeat polymorphisms in patients with hand and knee osteoarthritis in Kurdistan province, Iran.

Osteoarthritis (OA) is the most common chronic joint disorder, resulting from the breakdown of joint cartilage. It occurs in the knees, hands, and hips, leading to pain, stiffness, inflammation, and swelling. In this study, 100 hand and knee OA patients, meeting the American College of Rheumatology criteria were included in the case group, and 100 healthy individuals were allocated to the control group. Blood samples were collected from the participants. After DNA extraction, genotyping was carried out for GDF5 rs143383 C/T polymorphism by allele-specific polymerase chain reaction (ASPCR) and for D-repeat alleles of asporin (ASPN) by conventional PCR assay. The results showed that the frequency of the D14 allele of ASPN was significantly higher than other alleles in the case group (P=.0001). Also, the frequency of the D14 allele among women was significantly higher than in men (P=.004). Moreover, the frequency of the TT allele in GDF5 rs143383 C/T polymorphism was significantly higher than the CC and CT alleles in the case group, compared with the control group (P=.001). A significant difference was found between the TT allele and other alleles in female and male patients compared with the control group (P=.02). The D14 allele of the ASPN gene and TT allele of the GDF5 gene (rs143383+104T/C) are associated with hand and knee OA in the Kurdish population, indicating that these alleles could be risk factors for OA, at least in our populations.