Eraslan, Ersen; Tanyeli, Ayhan; Güler, Mustafa Can; Özbek Bilgin, Aslı; Ekinci Akdemir, Fazile Nur; Polat, Elif; Çomakli, Selim; Kurt, Nezahat; Bal Taştan, Tuğba

Background/aim: Obesity impairs male fertility through metabolic dysfunction, oxidative stress, and disruption of the hypothalamic– pituitary–testicular (HPT) axis. Adropin (ADR), a peptide hormone whose circulating levels are reduced in obesity, plays emerging roles in metabolic homeostasis; however, its involvement in reproductive endocrine regulation remains unclear. The present study was conducted in healthy, nonobese male rats and aimed to investigate the neuroendocrine and testicular effects of exogenous ADR administration, focusing on circulating reproductive hormones, hypothalamic regulatory peptides, and testicular antioxidant pathways. Materials and methods: Thirty-two male Wistar rats were randomized into control, sham, low-dose ADR (4 μg/kg/day), and high-dose ADR (40 μg/kg/day) groups and treated for 10 days. An enzyme-linked immunosorbent assay (ELISA) was used to measure circulating gonadotropins, testosterone, inhibin B, and activin A. Hypothalamic gonadotropin-releasing hormone (GnRH) and kisspeptin expression, and testicular superoxide dismutase 1 (SOD1) localization were assessed by immunohistochemistry. Brain and testis morphology were examined histologically. Results: High-dose ADR administration was associated with increased hypothalamic GnRH and kisspeptin expression, accompanied by reduced circulating LH levels, while FSH concentrations remained unchanged. Testosterone and inhibin B levels were higher, whereas activin A levels were lower, in the high-dose ADR group compared with controls. ADR administration was also associated with enhanced testicular SOD1 immunoreactivity and dose-dependent reductions in body weight. No overt histopathological alterations were observed in the cerebral cortex or testicular tissue. Conclusion: In healthy, nonobese male rats, exogenous ADR administration was associated with changes in central neuroendocrine markers and testicular antioxidant responses without overt histopathological alterations. These findings do not demonstrate improvements in fertility but suggest that ADR may be involved in pathways linking metabolic signals with reproductive endocrine regulation. The potential relevance of these observations to obesity-associated male reproductive dysfunction remains hypothesis-generating and requires confirmation in appropriate disease models and functional reproductive studies.

Mertoğlu, Cuma; Örek, Yaprak Şule; Albayrak, Bülent; Arslan, Yusuf Kemal; Çoban, Abdulkadir

Background/aim: Nonalcoholic fatty liver disease (NAFLD) is a metabolic disease that is commonly observed in individuals with obesity. The present study investigates the irisin and adropin levels of sera in preobese or obese adults with NAFLD. Materials and methods: Included in the study were 89 patients who were categorized into four groups: Group 1: 25 normal-weight individuals without NAFLD (Control group); Group 2: 17 preobese or obese individuals without NAFLD; Group 3: 24 preobese or obese individuals with Grade 1 NAFLD; and Group 4: 23 preobese or obese individuals with Grade 2–3 NAFLD. The demographic details of all participants were recorded. Abdominal ultrasonography and anthropometric assessments were conducted. Serum adropin and irisin levels were determined using the Enzyme-Linked Immunosorbent Assay (ELISA) method. Results: Serum adropin and irisin levels were lower in Groups 3 and 4 than in Group 1 (between the all groups; p = 0.006, p = 0.001, respectively), but were comparable between Groups 3 and 4. Furthermore, the atherogenic index of Group 1 was lower than that of Group 4 (p < 0.001). Among the hemogram parameters, the red cell distribution width value was higher in Group 3 than in Group 1 (p = 0.031). Conclusion: Serum adropin and irisin levels decrease in the presence of NAFLD, regardless of disease severity, which may play a role in the development and exacerbation of NAFLD in preobese and obese individuals.

Korkmaz, Levent; Alan, Cumali; Topal, İsmail; Tayfur, Mahir; Bozkurt, Ali Seydi; Gürsul, Cebrail; Baştuğ, Osman

Background/aim: Preterm births cause fetuses to be born without completing the development of their organs. Due to this undesirable situation, it is the pulmonary tissue which has to be most exposed to harmful effects of extrauterine environment. Early disappearance of the prophylactic and constructive effects of amniotic fluid (AF) on developing tissues, such as pulmonary tissue, facilitates the formation of pulmonary morbidities resulting from oxygen. Setting out from this knowledge, we wanted, in addition to assessing the beneficent effects of AF on pulmonary tissue, to study the importance of AF in morbidities of this tissue thought to originate from oxygen. Materials and methods: In this experimental study, while the study group was made up of the fetuses of pregnant rats exposed to hyperbaric oxygen, (hyperoxic pregnant rat fetuses-HPRF), the control group was formed of the fetuses of the rats pregnant in the usual room setting (normoxic pregnant rat fetuses-NPRF). The pulmonary and hepatic tissues taken from the fetuses of these pregnant rats on the 21st day of their pregnancy were compared biochemically and histologically. For biochemical assessment, total glutathione (tGSH), catalase (CAT), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α) values and for histopathological assessment, apoptosis, alveolar wall count (AWC), vena centralis count (VCC) were included. Results: Statistical significance was found in the pulmonary tissue values of tGSH on behalf of NPRF, and MDA on behalf of HPRF (p < 0.05). In liver tissue, statistical significance was detected in tGSH and CAT values in favor of NPRF and in MDA, and TNF-α values in favor of HPRF (p < 0.05). Conclusion: Our study has demonstrated that AF protects the pulmonary tissue from the harmful effects of oxygen in the intrauterine period. In addition, our data have suggested that the pulmonary tissue’s being deprived of the useful effects of AF owing to premature birth may be an important trigger in the occurrence of the pulmonary morbidities thought to result from oxygen.

Küpeli, Ali; Bulut, Eser; Ünver, Edhem; Danişan, Gürkan

Background/aim: This study aims to investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Materials and methods: Between October 2020 and January 2021, 62 patients with gastric wall fat halo sign and 62 controls were evaluated with thorax CT. Patient’s height, weight, body mass index (BMI), sex, age, comorbidities, laboratory parameters, diameters of cardiac axes, aorta and pulmonary artery; aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.124). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long cardiac axes and a higher cardiothoracic ratio (CTR) than the control group (p < 0.001). Additionally, the calcium scores of the ascending, arcus, and descending aortas and the coronary arteries were significantly higher detected in patients group (p < 0.001). Patient group had significantly higher lipid profile, frequencies of diabetes mellitus (DM) and hypertension (HT) than control group (p<0.026). Conclusion: Patients with a gastric wall fat halo may show higher cardiovascular risk because of increased visceral fat tissue, vascular diameters, CTR, heart sizes, presence of DM, HT, increased lipid profile and calcium scores.

Türkoğlu, M. Erhan; Gülmez, Ahmet; Elbir, Çağirı; Şahin, Ömer Selçuk; Hanalioğlu, Şahin; Dinç, Samet; Tönge, Çağhan; Kalan, Mehmet

Background/aim: Cervical spondylotic myelopathy (CSM) develops as a result of compression of the spinal cord in the cervical region. Early diagnosis and surgical treatment can limit the progression of symptoms. Various surgical approaches and strategies have been described in the literature. This study aims to evaluate the clinical and radiological results of open-door laminoplasty for the treatment of CSM. Materials and methods: In this study, we retrospectively analyzed the patients who underwent expansive open-door laminoplasty secured with titanium miniplates. Thirty-four patients with CSM who were followed up postoperatively for more than 12 months were included in the study. The modified Japanese Orthopaedic Association (mJOA) score was used to assess the degree of myelopathy. We evaluated cervical sagittal alignment with C2–C7 Cobb angle, the ambulatory status with the Nurick grade, and measured postoperative neck pain with the visual analogue scale (VAS). Results: Themeanm JOA score was 11 (range 6–15) preoperatively, and 13.5 (range 9–16) postoperatively with an average 55% recovery rate (range 0–75) (p < 0.001). Themean–Nurick grade was 2 (range 1–3) preoperatively and 1 (range 0–3) postoperatively (p < 0.001). The median cervical lordotic angle increased from 7.5 ° preoperatively to 12.5 ° postoperatively (p = 0.044). K-line (+) patients› mean mJOA scores significantly increased from 10.8 ± 1.7 to 13.3 ± 1.7 postoperatively (p < 0.001). The mean preoperative VAS reduced from 2.66 ± 1.4 to 1.59 ± 1.4 postoperatively (p < 0.001). Conclusion: Open-door laminoplasty technique is an effective surgical procedure that can be used safely to treat cervical spondylotic myelopathy. Our findings suggest that it can limit the progression of symptoms and alter the poor prognosis in CSM.

Gökharman, Dilek; Aydin, Sonay; Paltun, Salih; Fatihoğlu, Erdem; Şahiner, Şafak; Koşar, Pınar Nercis

Background/aim: Synthetic cannabinoids (SCs) are full agonists of both cannabinoid receptors. Conventional magnetic resonance imaging (MRI) findings of SC users are mainly defined as diffusion restriction and T2/FLAIR hyperintensity. Diffusion tensor imaging (DTI) studies examining SC users have shown contradictory results. The aim of this study was to define white matter (WM) changes of SC users using DTI. Materials and methods: The study included 22 patients with a history of using SC for 5–37 months, and 22 healthy, age and sex-matched control subjects. A total of 41 diffusion gradient directions were used in the acquisition of diffusion imaging data. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) values were obtained. ROIs were placed on WM areas of normal appearance. Results: In the SC users, significantly lower FA values were determined in the left temporal lobe (216.2 ± 58.9 vs. 263 ± 27.4; P = 0.002) and right hippocampus (224.5 ± 61.5 vs. 255 ± 24.3; P = 0.040). The ADC values of the hippocampus and temporal lobe were significantly higher than those of the control group on both the left and right sides. Conclusion: The SC use causes WM microstructural changes, especially in the hippocampus and temporal lobes. DTI is a useful tool to reveal WM changes in SC addicts and can be used earlier than conventional MRI.

Ateş, Ömer Faruk; Taydaş, Onur; Kara, Ahmet Burak; Göktepeli, Mehmet; Özdemir, Mustafa

Background/aim: An ultrasound-guided liver mass biopsy is a method frequently used in determining the diagnosis and treatment plan. The aim of this study was to evaluate the potential new predictors of bleeding based on ultrasonographic features in liver mass biopsies, which are frequently applied in routine clinical practice. Materials and methods: The images and data of patients aged over 18 years, who underwent an imaging-guided percutaneous liver mass biopsy between January 2018 and December 2019 with various indications, were retrospectively reviewed. Liver size, liver steatosis status, parenchyma appearance, and mass vascularity on Doppler ultrasonography before the procedure, and hemoglobin (Hb) values before and after the procedure were recorded. Results: A total of 176 patients were included in the study. Ninety-six patients were male (54.5%) and 80 were female (45.5%). The mean age of the patients was 64 ± 12.3 years. The mean hemoglobin values of the patients were 11.5 ± 1.9 gr/dL before the procedure and 11.4 ± 1.5 gr/dL after the procedure. While 144 of the patients had less than 10% hemoglobin decrease (81.8%), 32 had more than 10% decrease (8.2%). In 56 patients, a heterogeneous and coarse granular pattern was observed in the liver parenchyma (31.8%). The decrease in the Hb rate was significantly higher in patients with heterogeneous and coarse granular liver parenchyma (8.7%) than in patients with normal parenchyma (6.6%) (P = 0.036). Conclusion: In our study, it was shown for the first time in the literature that the ultrasonographic appearance of the liver (heterogeneous and coarse granular parenchyma) may also be one of the parameters that can help to predict the risk of bleeding.

Küpeli, Ali; Bulut, Eser; Cansu, Ayşegül; Güner, Ali; Soytürk, Mehmet; Danişan, Gürkan

Background/aim: This study aimed to investigate the relationship between the iodine concentration (IC) of perigastric fat tissue as assessed by dual-energy computed tomography (DECT) and serosal invasion of gastric cancer. Materials and methods: A total of 41 patients underwent preoperative staging evaluation for gastric cancer using DECT between July 2015 and March 2018. Patients were divided into 2 groups based on pathology results: Serosal invasion (stage T4a) and intact serosa (stages T1–T3). Cutoff values, the diagnostic efficacy of IC in the perigastric fat tissue, and the perigastric fat tissue/tumor (P/T) ratio were determined. Results: Among the 41 patients, 22 had stage T4a gastric cancer and 19 patients had gastric cancer with a stage lower than T4a. The mean IC of perigastric fat tissue and the P/T ratio were significantly higher in patients with serosal invasion than in those with intact serosa (P < 0.001). During the arterial phase, the area under the curve (AUC) was 0.915 and 0.854 for the IC of perigastric fat tissue and the P/T ratio, respectively. During the venous phase, the AUC was 0.890 and 0.876 for the IC of perigastric fat tissue and the P/T ratio, respectively. Conclusion: The IC in the perigastric fat tissue seems to be a reliable indicator for serosal invasion of gastric cancer.

Pazarci, Özhan; Doğan, Halef Okan; Kilinç, Seyran; Çamurcu, Yalkın

Background/aim: Fracture healing is a complex physiological process that involves a well-orchestrated series of biological events. The mammalian target of rapamycin (mTOR) and sestrin 1 (SESN 1) play a central role in cell metabolism, proliferation, and survival. The aim of our study is to present serum mTOR and SESN 1 levels by comparing patients with or without bone fractures. It is also a guide for further research on the roles of these proteins in fracture healing. Materials and methods: A total of 34 patients (10 females, 24 males) with bone fractures and 32 controls (10 females, 22 males) participated in this study. After collecting serum venous blood samples, the quantitative sandwich ELISA technique was used for the determination of serum mTOR and SESN 1 levels. Results: The mean serum mTOR level was significantly higher in the fracture group compared to the control group (P = 0.001). However, SESN 1 levels did not significantly differ between groups (P = 0.913). Conclusion: We found that serum mTOR levels increased on the first day after fracture compared to the control group. However, we obtained no significant difference between groups in terms of SESN 1 levels. This study may guide further clinical studies investigating the potential role of mTOR signaling in the bone healing process.

Çöbden, Adem; Çamurcu, Yalkın; Çöbden, Serap Bulut; Sofu, Hakan; Üçpunar, Hanifi; Sevencan, Ahmet; Demirel, Hüseyin

Background/aim: The aim of this study was to investigate postoperative audiometric threshold shifts in patients who underwent primary total knee arthroplasty (TKA) using gentamicin-loaded bone cement (GLBC) in comparison with the ones who underwent TKA without GLBC. Materials and methods: Forty patients (gentamicin group) who underwent primary TKA using GLBC and 29 patients (control group) who underwent primary TKA using standard bone cement were included in this prospective case-control study. Baseline pure-tone audiometric evaluation was performed preoperatively and repeated at the postoperative third day for all patients. Control audiometric evaluation was performed weekly for patients who were diagnosed with ototoxicity according to audiometric threshold shifts. Results: Ototoxicity was diagnosed in 8 of 40 patients (20%) in the gentamicin group according to postoperative audiometric threshold shifts, whereas no ototoxicity was observed in the control group. Patients who were diagnosed with ototoxicity had no permanent audiometric threshold shifts in follow-up audiometric evaluation and these patients had no clinical complaints of difference in hearing. Conclusion: According to our results, audiometric threshold shifts can be detected in patients who undergo primary TKA usingentamicin loaded bone cement. However, no permanent shifts were observed during close follow-up.