Introduction. Acute kidney injury (AKI) pathogenesis is complex. Findings of gentamicin nephrotoxicity are seen in 30% of the AKI patients. Vitamin D has proven to be effective on renin expression, inflammatory response, oxidative stress, apoptosis, and atherosclerosis. We aimed to investigate the effect of vitamin D in an experimental rat model of gentamicin-induced AKI. Methods. Thirty nonuremic Wistar albino rats were divided into 3 groups: Control group, 1 mL saline intramuscular (im) daily; Genta group, gentamicin 100 mg/kg/day (im); Genta + vitamin D, gentamicin 100 mg/kg/day (im) in addition to 1α, 25 (OH)2D3 0.4 mcg/kg/day subcutaneously for 8 days. Blood pressures and 24-hour urine were measured. Blood urea and creatinine levels and urine tubular injury markers were measured. Renal histology was semiquantitatively assessed. Results. Urea, creatinine and urine neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 were all increased in Genta group indicating AKI model. Systolic blood pressure decreased, but urine volume and glutathione increased in Genta + Vit D group compared to Control group. Histological scores indicating tubular injury increased in Genta and Genta + Vit D groups. Conclusions. Vitamin D does not seem to be effective on histological findings although it has some beneficial effects via RAS system and a promising effect on antioxidant system.

Background: Triple-negative breast cancer (TNBC) has none of the targeted treatment choices due to its distinct biological property, making this subtype a unique disease. In this study, we evaluated the impact of obesity on clinical outcomes of TNBC. Methods: The data of breast cancer patients admitted to our department were collected. TNBC was defined as lack of estrogen receptor (ER), progesterone receptor (PR) and HER-2. The body mass index (BMI) of 112 TNBC patients was calculated with weight at the time of diagnosis and height. The patients were classified into groups with a BMI of < 25 (normal/underweight), 25-29.9 (overweight) or ≥ 30 (obese). After a mean follow-up of 23.2 ± 15.5 months, there were 12 recurrences (10.71%) and 6 deaths (5.35%). Disease-free survival (DFS) and overall survival (OS) were assessed. Results: The survival analyses of all the patients did not demonstrate any differences in OS or DFS in obese as compared to non-obese patients. However, we showed that obesity was associated with a poorer OS for postmenopausal TNBC patients (p < 0.05). Conclusion: Obesity is related to a poorer OS in postmenopausal TNBC patients. Due to the heterogeneous disease profile of TNBC, larger randomized studies will be needed to clarify the exact role of obesity in TNBC.

Objectives. Hypertension and hypervolemia relationship was proven among renal disease, although it is not known in normal population. Present study determines the fluid distribution defects in relation to blood pressure. Material and Methods. In a population-based survey in Turkey demographics, height, weight, blood pressure, urine analysis, and serum creatinine measurements were recorded. Bioimpedance measured with the Body Composition Monitor. Results. Total 2034 population of 71.6% male, mean age 47 ± 12.6 (18–89) years, systolic blood pressure (SBP) 134.7 ± 20, diastolic blood pressure 77.9 ± 11.6 mmHg. Body mass index (BMI) was 28.5 ± 4.5 (15.8–50.6) kg/m2; overhydration was 0.05 ± 1.05 L. There was a correlation between extracellular water (ECW)/height and SBP (r = 0.21, P < 0.001). Receiver operating characteristic (ROC) curve with the performance of 0.60 (P < 0.001) that showed cut-off value of ECW/height was 10.06 L/m, with the 69% sensitivity and 45% specificity for SBP: 140 mmHg values. Risk factors for high SBP were increase of ECW/Height, age, BMI and presence of diabetes. ECW/height, SBP, and fat tissue index (FTI) increased in BMI categories (low, normal, and obese) and in diabetics. SBP and FTI were lower in smokers. Conclusions. High blood pressure may be accompanied by increased extracellular volume indices. In the future volume status assessment could be of use in evaluating the effectiveness of pharmacological intervention in the treatment of hypertension.

OBJECTIVE: Body composition analysis is useful technique for assessing hydration, nutritional status and predicting clinical outcomes. Bioimpedance analysis (BIA) is a cheap and noninvasive tool for monitoring body composition but needs some improvements regarding measurement methods. We aimed to fi nd out if body position has an effect on the BIA results. MATERIAL and METHODS: Personal characteristics including age, gender, height, weight and blood pressure were recorded. Hydration and nutritional status measured by body composition monitor in supine and standing positions consequently for each individual. RESULTS: Two hundred and one populations from various region in Turkey, 61% (n: 123) male, mean age was 46.3±12 years (18-76) of age, participated in this crossectional study. From supine to standing positions overhydration and extracellular water (ECW) were increased from 0.04±1.08 and 17.69±2.92 to 0.46±1.05 L and 17.84±2.90 L while intracellular water (ICW) decreased from 22.55±4.35 to 22.04±4.28 L signifi cantly. Systolic and diastolic blood pressures were 131.3±18.1 and 75.1±12 decreased to 127.0±16.0 and 72.2±9.0 mmHg in supine to standing positions (p> 0.05). CONCLUSION: Supine and standing positions could affect the volume parameters of BIA due to shift of ECW and ICW by gravity but nutritional parameters also changes signifi cantly. Protocols should be re evaluated in order to get more accurate results in bioimpedance measurements.

Objective: Triple negative and human epidermal growth factor receptor 2 (Her2) positive breast tumors are characterized by the absence of expression of estrogen and progesterone receptors and with either Her2 expression or not. Generally, they are larger tumors with higher grade, higher incidence of recurrence and distant metastasis. This article will investigate clinical, pathological, and molecular features of these high risk breast cancer patients and whether these features are correlated with recurrences or not. Materials and Methods:Breast cancer patients of 109 triple negative and 81 Her2 positive histology followed in the medical oncology department of our hospital between 2004 and 2011 were enrolled in the study. These patients were mostly treated with adjuvant and neoadjuvant chemotherapy. Results:The median age of patients was 51 and 52 years. Median follow-up duration was 22 and 29 months. Four patients in each group died during the follow-up. 5 year survival rates were 81.1% in triple negative group and 73.5% in Her2 positive group. Relapses were seen in 30 patients. Bone and brain were the most common metastatic sites in the first and second groups respectively. Triple negative patients having larger tumor size and Her2 positive patients having positive lymph node or not treated with radiotherapy have a statistically higher chance of relapse during the follow-up. Conclusion:Despite the short median follow-up time, approximately one sixth of our patients had recurrence and this supported the aggressive course of the disease in high risk patients. For this reason, risk factors that help us to predict the early recurrences in both of the groups are very important.Key words: Breast cancer, survival analysis, retrospective studies, recurrences ÖZET Amaç: Triple negatif ve insan epidermal büyüme faktör reseptörü 2 (Her2) pozitif meme tümörleri, östrojen ve progesteron reseptörlerinin negatif olması ve HER-2 ekspresyonun olup olmaması ile karakterizedir. Diğer meme kanserleri ile karşılaştırıldığında daha büyük ve daha yüksek dereceli tümörlerdir, erken nüks ve metastaz sıklığı daha fazladır. Bu yazıda yüksek riskli meme kanserlerinin klinik, patolojik ve moleküler özellikleri ve bu özelliklerin nüks ile ilişkisi araştırılacaktır. Sonuç: Kısa izlem süresine rağmen hastalarımızın yaklaşık altıda birinde nüks gözlenmesi, bu yüksek riskli hastalardaki agresif seyri desteklemektedir. Dolayısıyla her iki hasta grubunda da, hastalık nüksünü erken dönemde öngörülebilecek risk faktörlerinin saptanması önem taşımaktadır.Anahtar sözcükler: Meme kanseri, sağkalım analizi, retrospektif çalışmalar, nüks GirişMeme kanseri kadınlarda görülen kanserlerin en sık görülen türü olup yaklaşık %25-%30`unu oluşturmaktadır. Kansere bağlı mortalite (%18) ise akciğer kanserlerinden sonra ikinci sırada yer almaktadır (1). Meme kanseri 30 yaşından önce nadir görülmekle birlikte bu yaşı takip eden reprodüktif yıllarda hızlı bir artış gösterir. Bu artış menopoz sonrasında da yavaş eğimle yükselmeye devam eder (2).Son dönemlerde...

Background Hereditary angioedema (HAE) is a rare autosomal dominant inherited disease characterized by recurrent angioedema episodes and classified as HAE with C1-inhibitor (C1INH) deficiency (HAE-C1INH) and HAE with normal C1-inhibitor (HAE-nlC1INH). It may involve the face, larynx, upper airways, trunk, gastrointestinal system, genital area, and extremities. The angioedema attacks are disabling, and laryngeal edema can lead to asphyxiation and death if it is not treated successfully. We aim to investigate the association between the attack localizations and complement parameters of HAE C1INH patients. Methods Patients with HAE-C1INH from Ege University Faculty of Medicine were included. Patients with HAE-nl-C1INH were excluded from the study. Data on the clinical records were obtained retrospectively. Sociodemographic data, age at disease onset, annual attack frequencies, attack localizations, and complement parameters were recorded. Results One-hundred patients were in the study group. Fifty four percent of them were female. The majority of patients were HAE-C1INH type I (87%). The mean age at disease onset was 12.01 ±7.04 years. Plasma C4 levels were normal in eight patients (8.16%). The most frequently involved localizations were extremities (91%), gastrointestinal system (89%), and genital area (85%). Having a facial attack and erythema marginatum were both found to be correlated with the occurrence of laryngeal edema. Laryngeal edema was seen in 83.8% of the patients with erythema marginatum (P=0.010), and 75.9% of the patients with facial attacks (P<0.001). Conclusion The correlation between erythema marginatum and laryngeal edema was not reported in previous studies. Due to the unpredictable and fatal nature of the laryngeal attacks, all HAE patients and physicians should be alert of the occurrence and emergency treatment of laryngeal edema. We recommend that C4 alone should not be used to exclude the diagnosis of HAE-C1INH. The laboratory work-up should also include C1 inhibitor levels and C1INH function analysis.

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