Harika Gozukara Bag

Leukapheresis in acute myeloid leukemia patients with hyperleukocytosis: A single center experience

Hyperleukocytosis is defined as WBC count above 100,000/mm(3) in peripheral blood. Increased WBC count leads to leukocyte aggregation, increased blood viscosity, and consequently results in stasis in small blood vessels. Ultimate neurological, pulmonary, gastrointestinal complications, coagulopathy, and tumor lysis syndrome cause increase in morbidity and mortality. Leukapheresis is a treatment modality used for hyperleukocytosis. In patients presenting with hyperleukocytosis the indications for leukapheresis were accepted as having symptoms of leukostasis and prophylactic. Indications for leukapheresis in prophylactic group evaluated according to WBC count. We report a single center experience about leukapheresis in managing 31 AML patients with hyperleukocytosis. In addition to demographic characteristics, disease-related clinical and laboratory findings of the patients were recorded. Survival rates were also calculated. Ten patients were female. The most common of AML subtype was AML-M2. The median number of leukapheresis per patient was 2 and totally 60 leukapheresis cycles were performed in all patients. There was a significant decrease in WBC count and LDH level after leukapheresis as compared with the baseline values (p < 0.05). Early and total mortality were 16.1% and 58.0%, respectively. Alive and died patients were evaluated according to baseline WBC, LDH; increased WBC count and LDH level were found in died patients (p < 0.05). According to leukapheresis indications, patients were divided into two groups: 14 patients in symptomatic leukostasis, 17 patients in prophylaxis. No statistically significant differences were noted between both groups in leukapheresis effectiveness, mean survival time, early and total mortality rate (p > 0.05). None of our patients suffered serious side effects and tumor lysis syndrome during or after apheresis. Leukapheresis is an effective and safe approach to reduce WBC counts in patients with AML with hyperleukocytosis. Further evidence-based data obtained from larger sample sizes are required to better understand the impact of prophylaxis leukapheresis on early and total mortality of AML patients with hyperleukocytosis.

Hepatoprotective effects of crocin on biochemical and histopathological alterations following acrylamide-induced liver injury in Wistar rats

The objective of the present study is the treatment of oxidative damage caused by acrylamide induced oxidative stress in rats with the administration of a strong antioxidant, namely crocin. High acrylamide (AA) levels have genotoxic, carcinogenic and neurotoxic effects on living organisms. In the present study, 40 Wistar rats were randomly divided into four equal groups. These groups were control, acrylamide (25mg/kg), crocin (50mg/kg), acrylamide+crocin (25mg/kg acrylamide and 50mg/kg crocin) groups. At the end of the application, biochemical and histological variations were examined in liver and blood samples. It was observed that acrylamide administration significantly decreased liver GSH and TAS levels when compared to the control group. On the contrary, it was also observed that AST, ALT, ALP, SOD and CAT activities and TOS and MDA levels increased as a result of acrylamide administration. Histopathological examinations demonstrated inflammatory cell infiltration, hepatocellular necrosis and hemorrhage areas in AA group liver sections. Furthermore, intracytoplasmic vacuolization was detected in hepatocytes. After crocin treatment, it was observed that GSH and TAS levels increased while AST, ALT, ALP, SOD and CAT activities and TOS and MDA levels decreased. Significant decreases were observed in inflammatory cell infiltration and vascular congestion in liver sections and intracytoplasmic vacuolization in hepatocytes after the crocin treatment, while no hepatocellular necrosis and hemorrhages were observed. In the present study, it was demonstrated that crocin treatment removed acrylamide induced liver damage due to the strong antioxidant properties of crocin.

The effect of bulk-fill flowable composites on the fracture resistance and cuspal deflection of endodontically treated premolars

The aim of this study was to evaluate the effect of bulk-fill flowable composites on cuspal deflection and fracture resistance of endodontically treated teeth. Forty-two maxillary premolars were subjected to endodontic treatment followed by the preparation of mesioocclusodistal cavities. Teeth were divided into six groups according to restorative materials as follows: Group 1: Clearfil Majesty Flow and Clearfil Majesty Posterior; Group 2: Venus Bulk Fill and Clearfil Majesty Posterior; Group 3: Clearfil Majesty Posterior; Group 4: Vertise Flow and Clearfil Majesty Posterior; Group 5: SDR and Clearfil Majesty Posterior; and Group 6: x-tra base and Clearfil Majesty Posterior. A single-step self-etch adhesive (OptiBond All-in-One) was applied to all groups, except Group 4. The cavities were restored with a centripetal incremental insertion technique and flowable composites using a 2-mm-thick base material, except for Group 3. The distance between cusp tips was measured before and after the cavity preparations, after the restorations, and after thermal cyclus with a digital micrometer. After measuring, each tooth was subjected to compressive loading with a stainless steel ball (4 mm diameter) perpendicular to the occlusal surface with a crosshead speed of 1 mm/min, and mean loads necessary to fracture were recorded in Newtons. The data were statistically analyzed by Kruskal–Wallis test. No statistically significant differences were found between groups in fracture strength or cuspal deflections (p > 0.05). Bulk-fill flowable composite bases did not change the cuspal deflection or fracture resistance of endodontically treated teeth, compared with that of a conventional flowable base and conventional resin composite.

Biochemical investigation of the toxic effects of acrylamide administration during pregnancy on the liver of mother and fetus and the protective role of vitamin E

Abstract Objectives: To investigate the toxic effects occurring in the liver tissues of the pregnant rats and the fetuses, which are administered acrylamide and vitamin E as a protector during pregnancy. Materials and methods: This research was conducted with the permission of Laboratory Animals Ethical Board of Inonu University Faculty of Medicine. Forty rats, of which their pregnancy is validated via vaginal smear, were distributed into five different groups. On the 20th day of pregnancy, pregnant rats and fetuses are decapitated. Malondialdehyde (MDA), reduced glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS) and xanthine oxidase (XO) levels were measured in the liver samples taken from mother and fetuses. Results: It was detected that acrylamide administered during pregnancy increased MDA, TOS, XO levels statistically significantly and decreased the GSH level (p ≤ 0.05) in the pregnant rat liver tissue when compared to all other groups. In the vitamin E administered group; GSH, TAS levels significantly increased statistically and TOS and XO levels dropped to levels of the control group (p ≤ 0.05), in comparison to all other groups. Among all groups, no biochemical changes were observed in the fetus liver tissue (p > 0.05). Conclusion: The liver of pregnant rats functions as a protective pre-filter by detoxifying acrylamide effectively and the acrylamide that reaches fetus liver is detoxified by the cytochrome P-450 system of the fetus liver. To be able to figure out the biochemical mechanism, more advanced studies are needed.

Leukapheresis Treatment in Elderly Acute Leukemia Patients With Hyperleukocytosis: A Single Center Experience

Leukapheresis is an invasive treatment modality used for hyperleukocytosis. Various drugs and fluids are used during the leukapheresis. Aging itself and associated factors such as increased comorbidity, decreased tolerance to drugs, increased drug toxicity give rise to the application of other treatment modalities in elderly patients. Treatment of acute leukemia in the elderly differs from young patients. Consequently, we assumed that outcome, effectiveness, and side effects of leukapheresis treatment used for acute leukemia patients with hyperleukocytosis may be different in elderly compared to younger patients.

Effect of crocin on oxidative stress in recovery from single bout of swimming exercise in rats.

Physical exercise could cause muscle and tissue damage due to increase in the formation of free oxygen radicals during exercise. The aim of the present study was to investigate the effect of crocin on parameters associated with oxidative stress in recovery from acute swimming exercise in rats. Rats were divided into eight groups; Normal Control (NC: untreated and did not swim), Crocin Control (CC: received crocin and did not swim), Exercise-1 (Exe-1: untreated and swam), Exercise-24 (Exe-24: untreated and swam), Exercise-48 (Exe-48: untreated and swam), Exercise+Crocin-1 (Exe-Cro-1: received crocin and swam), Exercise+Crocin-24 (Exe-Cro-24: received crocin and swam), Exercise+Crocin-48 (Exe-Cro-48: received crocin and swam). AST, ALP, LDH, CK, XO enzymes levels increased after swimming in untreated and crocin-treated groups, but there was a less increase in crocin-treated groups. The highest MDA levels in serum were determined in Exe-1 compared with all other groups. There was significant difference between control and exercise groups in MDA level (p = 0.033). In contrast, there was significant difference between control and exercise groups in GSH level (p < 0.001). In addition, crocin given to swimming rats significantly increased GSH levels (p < 0.05) and decreased MDA levels when compared with untreated exercise groups. In conclusion, crocin is able to protect liver and skeletal muscle tissue against exercise-induced oxidative damage by preventing reactive oxygen species (ROS) production.

Saffron (its active constituent, crocin) supplementation attenuates lipid peroxidation and protects against tissue injury.

The aim of the current study was to investigate the outcomes in a rat model of an acute swimming exercise induced oxidative stress in brain, kidney, liver, skeletal and cardiac muscles using supplementation with crocin. Rats were divided into the eight groups; Normal Control (NC: Untreated and did not swim), Crocin Control (CC: Received crocin and did not swim), Exercise-1 (E-1: Untreated and swam), Exercise-24 (E-24: Untreated and swam), Exercise-48 (E-48: Untreated and swam), Exercise+Crocin-1 (EC-1: Received crocin and swam), Exercise+Crocin-24 (EC-24: Received crocin and swam), Exercise+Crocin-48 (EC-48: Received crocin and swam). The malondialdehyde (MDA) and xanthine oxidase (XO) enzymes levels increased after swimming in untreated and crocin treated groups, but there was a lower increase in crocin treated groups. The highest MDA levels in all tissues were observed in E-1 compared to all other groups. There were significant differences between control and exercise groups in MDA levels of tissues (p < 0.001). In contrast, there were significant differences between control and exercise groups in glutathione (GSH) levels of tissues.In addition, the crocin supplementation significantly increased GSH levels and decreased MDA and XO enzyme levels when compared to untreated exercise groups. Crocin can protect the tissues against exercise induced oxidative stress by enhancing antioxidant activity (Tab. 3, Fig. 1, Ref. 37).

Acrylamide applied during pregnancy causes the neurotoxic effect by lowering BDNF levels in the fetal brain

OBJECTIVES The aim of this study is to elucidate the possible mechanism of neurotoxic effect of acrylamide (AA) applied during pregnancy on fetal brain development and to show the effect of N-acetylcysteine (NAC) on AA toxicity. MATERIALS AND METHODS Four groups were formed with 9 pregnant rats each as control (C), acrylamide (AA), N-acetylcysteine (NAC), acrylamide plus N-acetylcysteine (AA plus NAC) groups. Caesarian section was implemented on the 20th day of pregnancy. Malondialdehyde (MDA), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT) and Brain-derived neurotrophic factor (BDNF) levels were analyzed and histopathologic examinations were performed in brain tissues of the fetuses. RESULTS Our data indicated that AA caused necrotic death and hemorrhagic damages in fetal brain tissue with decreasing BNDF levels and increasing oxidative stress. N-acetylcysteine prevented the toxic effects of its on fetal brain (p < 0.05). CONCLUSION Our study indicated that acrylamide has toxic effects in the fetal brain and N-acetylcysteine prevents its toxic effect.

Migraine and associated comorbidities are three times more frequent in children with ADHD and their mothers

OBJECTIVE Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents. METHODS In a multi-center, cross-sectional, familial association study using case-control design, treatment naïve children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender-matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly. RESULTS 117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p < 0.001). CONCLUSION Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands.

The Effect of Two Bulk Fill Resin Composites on Microleakage in Endodontically Treated Teeth

Purpose: To evaluate the effect of two bulk fill resin composites on microleakage in endodontically treated Class II restorations. Materials and Methods: Twenty-four non-carious molars were selected and randomly divided into three groups (n = 8). The Class II cavity preparations were made with the cervical margin 1 mm below the cementum-enamel junction, and endodontic treatment was performed using a resin-based sealer and gutta-percha points. In Group 1 (Control), resin composite (G-aenial Posterior; GC Corp., Tokyo, Japan) was applied to the interproximal wall, and then restorative material was applied incrementally. In Group 2, resin composite was applied to the interproximal wall, followed by a 4- mm-layer of a bulk fill flowable composite (x-tra base; Voco, GmbH, Cuxhaven, Germany) and the remaining occlusal part of the cavity was filled with resin composite. In Group 3, resin composite was applied to the interproximal wall, followed by a 4mm layer of a bulk fill fiber-reinforced composite (everX Posterior; GC Corp., Tokyo, Japan), and the remaining occlusal part of the cavity was filled with a resin composite. The restorations were then subjected to 500 thermal cycles, each with a dwell time of 20 seconds at 5 and 55 o C. The adaptation at the cervical margin was evaluated by dye penetration, and one tooth was used to evaluate the restorative material interface using SEM. The data were statistically analyzed using the Kruskal Wallis test (p < 0.05). Results: No significant difference in dye penetration was found between the control and the experimental groups. Microleakage was significantly higher on enamel margins compared with the dentin margins for all of the groups. Conclusion: The use of bulk fill restorative materials under resin composites does not affect the sealing ability of restorations.