Aim: Oxidative stress, heat shock protein (HSP70) and p38 mitogen-activated protein kinase (MAPK) are important functional cellular signals involved in the pathophysiology of cardiovascular diseases. This study investigated the effect of high environmental temperature (HET) and high salt diet (HSD) respectively and together on systemic oxidative stress, nitric oxide (NO), HSP70 and renal p38 MAPK. Methods: Thirty-two male Sprague-Dawley rats were divided into four groups with eight rats in each group: Control rats (C) fed a normal diet; salt-loaded rats (S) fed a HSD (8%NaCl); normal diet rats (H) exposed to HET (38.5 ± 0.5oC 4h daily for 8weeks); and salt-loaded rats (SH), fed a HSD and exposed to HET. Circulatory oxidative stress parameters (SOD: superoxide dismutase; GSH: glutathione; CAT: catalase; MDA: malondialdehyde), HSP70 and renal p38 MAPK were determined by colorimetric, enzyme-linked immunosorbent assay (ELISA) methods and immunohistochemistry (IHC) techniques respectively. Results: Plasma GSH concentration and CAT activity decreased significantly, with significant increase in MDA concentration in all the rat groups compared to control. However, MDA in SH rats was significantly higher than in either S or H rats. Circulatory HSP70 and NO were significantly raised in S and H rats but unchanged in SH rats compared to control. Conversely, renal expression of p38 MAPK was significantly increased in H and SH rats compared to control, but SH rats had significantly higher level than either S or H rats. SH rats also had weight gain slowing compared to control. Conclusion: Our findings indicate that prolonged exposure to HET and HSD intakes synergistically increased renal p38 MAPK and circulatory product of oxidative cellular damage without alteration in circulatory HSP70 and NO.

Aim: To investigate the clinical effect of the computer-aided sperm analyzers (CASA) by comparing the low sperm concentration semen samples evaluated by CASA with the sperm count performed on Makler Counting Chamber (MC) as a manual method. Methods: Semen samples were taken from184 patients coming to our clinic were evaluated with CASA (SQA-V Gold sperm analyzer, MES Medical Electronic Systems Ltd. Caesarea Industrial Park, IL 3088900, UK) and MC (Makler Counting Chamber, Sefi-Medical Instruments ltd., Haifa, Israel). Samples were divided into two groups as samples containing sperms and samples without sperms, according to the CASA results. Results: There was a very high correlation between the two measurement methods (rho = 0.982) and regression analysis formula was y=1.042x-0.104. No sperm was detected in CASA in any of the samples identified to have no sperm in MC. However, when patients who were identified with no sperm in their CASA measurements (n=51) were analyzed with MC, 29 patient samples (56.9%) had an average of 0.23±0.35 x106 /mL sperm. Conclusion: CASA’s used in routine semen analysis provide a great convenience in measuring sperm count, compared to manual methods and provide highly correlated results. Manual verification of samples can be recommended since the samples diagnosed with azoospermia provided different results with a manual method in our study.

Aim: To compare the effect of administration of 2 different doses of platelet rich plasma (PRP) and a single dose of hyaluronic acid (HA) preparation on pain and daily life activities of knee osteoarthritis (KOA) patients. Method: In this nonrandomized comparative study, three groups of patients who received either a single dose of intraarticular (IA) PRP (PRP1 group), three doses of IA PRP (PRP3 group), or single dose IA HA (HA group) were included. Assessments were before treatment, and in the 3rd week and 6th week after treatment (after the final injection). The pain-visual analog scale (VAS), Euro-Qol (EQ)-5D-3L, EQVAS, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used. Results: In the 3rd week, there were statistically significant differences between the PRP1-HA groups in all parameters except EQ5; between PRP3-HA groups in all parameters except EQ5 and WOMAC stiffness; and between PRP3-PRP1 groups in all parameters except EQVAS, WOMAC pain and WOMAC stiffness. In the 6th week, there were statistically significant differences between the PRP1- HA groups in all parameters except WOMAC stiffness; between PRP3-HA groups in all parameters; and between PRP3-PRP1 groups in all parameters except WOMAC pain. Conclusion: Intraarticular PRP injections (single or three doses) were found to be more beneficial in the short term in terms of pain and functional improvement than HA injection and administration of three consecutive doses of PRP may be more effective compared to single-dose PRP administration in KOA patients.

Aim: To compare our parameters as regards: i) cell count via two different automated cell count techniques, and ii) viability via automated trypan blue exclusion and 7-aminoactinomycin D (7-AAD) staining. Method: We used the trypan blue exclusion technique and an automated cell counter and for viability testing, and the trypan blue exclusion technique and the 7-AAD evaluation by flow cytometry. The trypan blue exclusion and the radio frequency techniques were used for automated cell counting. Flow cytometric analysis was performed by evaluating the yielded cellular products for 7-AAD uptake during the cell count of CD34+ cells. Results: The mean values for cell count were estimated as 3.44±1.22x106 /ml (range, 2.48- 5.71x106 /ml) and 4.14±1.94x106 /ml (range, 1.77-7.43x106/ml) for the trypan blue exclusion and radio frequency techniques, respectively. Additionally, the mean values for viability analyses via the automated trypan blue exclusion and 7-AAD were 93.38±6.09% (range, 79.00-98.00%) and 99.49±0.60% (range, 98.40-100.00%), respectively. Conclusions: Our study has responded to two fundamental questions: whether the results of both of the automated techniques for cell count correspond with each other, and whether the results of the automated viability assessment conform those of the 7-AAD technique during the manufacturing processes of cellular therapy products intended for clinical use. Even though we have the opportunity to use the hemocytometer in our laboratory setting, the automated trypan blue exclusion technique gives cell count results in concordance within the range of the expectations of our Quality Management System (QMS).

Aim: To investigate the co-existence of cholelithiasis in patients with gastrointestinal (GI) cancer both in preoperative and postoperative periods. Methods: We retrospectively analyzed the data of patients who underwent GI tract cancer surgery in the general surgery clinic of a university hospital between January 2013 and December 2019 for the presence of cholelithiasis in the preoperative and postoperative periods. Age, gender, tumor type and localization and presence of the cholelithiasis in the patients were determined. In addition, the cases were divided into two as upper GI tract and lower GI tract according to tumor location and the relationship with cholelithiasis was evaluated. Results: A total of 680 GI cancer patients were included in the study. Localization of GI cancers were; colon in 211 cases, rectum in 195 cases, gastric in 187 cases, periampullary region in 55 cases, and small intestine in 32 cases. In the preoperative period, 69 patients were associated with cholelithiasis. Thirty-one patients had accompanying cholelithiasis in the postoperative period. Coexistence of cholelithiasis according to cancer location was not statistically significant in the preoperative and postoperative periods. Conclusions: Our available data make it difficult to distinguish the roles of cholelithiasis on gastrointestinal cancers, because no statistically causal relationship was found between cholelithiasis and gastrointestinal cancers. However, the role of asymptomatic and symptomatic stones, which may or may not require cholecystectomy, in the development of GI tract cancers should not be ignored.

Aim: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Armed Forces Institute of Pathology (AFIP) criteria which is the basis of our study, is also known as Miettinen’s criterion is used in classification of GIST. Lymphocyte-monocyte ratio (LMR), and platelet lymphocyte ratio (PLR) have been shown as novel markers in chronic systemic inflammatory response, therefore, we aimed to study LMR levels of the subjects with moderate to high risk GIST and to compare to those in the subjects with low or very low risk GIST. Methods: Thirty GIST patients who underwent surgery were retrospectively evaluated. Patients were divided into two groups according to the AFIP risk scoring system: the first group (group 1) included very low and low risk patients and the second group (group 2) included moderate and high risk patients. Inflammatory indicators; LMR and PLR of the groups were compared. Results: LMR value was higher in Group 1 (5.25 ± 2.55) than the LMR of group 2 (2.92 ± 1.76). PLR value was significantly lower in group 1 (139.68) compared to the PLR of group 2 (185.04). Conclusion: We think that LMR is effective in identifying low and very low risk patients compared to AFIP. From this point of view, we suggest that LMR can identify high and medium risk patients by excluding low and very low risk patients and may be an independent risk factor in GIST scoring systems.

Aim: To evaluate the role of the diameter of the optic nerve sheath (ONSD) in the differential diagnosis of the central and peripheral vertigo in patients, who had applied with the complaints of vertigo. Method: Our study had a prospective design and 113 vertigo patients were included in the study. The demographic characteristics, vital signs, symptoms accompanying vertigo and findings of the imaging examinations were evaluated. Results: The median age of our patients was 43 years (IQR: 17) and 44.2 % of them were males. 19.5 % of the patients were diagnosed with central and 80.5 % with peripheral vertigo. In our study, the median ONSD was 4.88 mm (IQR=0.86) in patients with central vertigo and 4.65 mm (IQR=0.20) in patients with peripheral vertigo. The median value of ONSD in patients with central vertigo was significantly higher (p=0.030). In our study, the area under the curve was 0.654 (95 % CI=0.498- 0.810) and the sensitivity and specificity for the cut-off value of 4.65 mm were 68.2 % and 61.5 % respectively. Conclusion: We determined that ONSD was larger in patients with central vertigo. Further studies with larger subject size are needed on this topic.

Aim: To evaluate the sedation score response and salivary cortisol levels (SC) to premedication with sedative hydroxyzine in children with outpatient surgery and the relationships between the two. Methods: Eighty-seven ASA 1 classified patients (American Society of Anesthesiologists Classification 1, normal healthy patients), aged 4-13 years, were randomly and prospectively allocated into the study. Children having outpatient surgery (e.g. inguinal/abdominal surgery, circumcision) either did not have a premedication or received oral hydroxyzine (2 h before the surgery) as a sedative drug. All patients were evaluated for the level of sedation by Ramsay sedation score [RSS, from 1 (awake, anxious, restless or both) to 6 (asleep, exhibits no response)] by an independent anesthesiologist. Salivary samples taken during the assessment of sedation score were analyzed for cortisol levels. Results: SC increased significantly by increasing age (r=0.447; p0.05). Conclusion: The data suggest that salivary cortisol increases by increased age and provide evidence that sedation is associated with suppressed cortisol levels. Moreover, different types of surgery appear to be perceived as similar threats by the children.

The year 2020 is began with the declaration of a pandemic of novel coronavirus, which first occurred by the end of 2019 in Wuhan region of China. The novel virus infection is so called as Covid-19 or SARS Cov-2. The infection rapidly spread all over the world and changed the lives of millions. In this extended review, we aimed to discuss current and possible treatment strategies against SARS Cov-2 infection. Treatment options mentioned here include but not limited to chloroquine/hydroxychloroquine, favipiravir, remdesivir, lopinavir/ritonavir, umifenovir, steroids, cepharanthine, convalescent plasma, anticoagulants and monoclonal antibodies. In conclusion, mainstay of the SARS Cov-2 treatment is general measures such as patient isolation and supportive care. However, encouraging developments are being achieved in terms of discovery of an effective treatment and production of a potent vaccine.