Volume 45, Issue 5

The emergence of SARS-CoV-2, responsible for COVID-19 disease, has caused a substantial worldwide pandemic and has become a significant public health problem. World Health Organization (WHO) has declared COVID-19 as a devastating health emergency for all countries. Public health officials continue to monitor the situation closely to control this new virus-related outbreak. In order to continue to manage this pandemic, a fast and sensitive diagnosis of COVID-19 is attempted. Emerging tests have become an essential part of the management of the COVID-19 crisis. This review article aims to provide a detailed explanation of ongoing and new diagnostic technologies for SARS-CoV-2 and a summary of method principles. Examples of new diagnostic methods for providing efficient and rapid diagnostic tests for managing the SARS-CoV-2 outbreak are also mentioned.

Objectives Hemolysis is a common problem causing interference on biochemical assays. In this study, we investigated the effect of in vitro hemolysis on the measurement of prealbumin, using normal and low prealbumin concentrations. Methods Serum pools containing normal and low levels of prealbumin were spiked with different dilutions of the hemolysate, which was prepared according to the classical osmotic shock procedure. The final concentrations of hemoglobin in the samples were 10.63, 6.25, 5.31, 2.66, 1.33, 0.66, 0.33 and 0 g/L. The prealbumin levels in these samples were analyzed for three times by the immunoturbidimetric method on AU680 clinical chemistry analyzer. Mean percent changes of prealbumin results were presented with interferographs. Results We observed that hemolysis interfered negatively with both normal and low level serum pools. This effect began to exceed the limit of 10% as a critical point in the concentration range 5.31 to 6.25 g/L hemoglobin concentration in both normal and low serum pools. The limit exceeding value was higher in the low serum pool than the normal serum pool (20% and 11%, respectively). Conclusions Clinical laboratories must be alert the effect on low prealbumin levels, especially in settings where hemolysis is an increasing problem.

Objectives Biological variation (BV) analysis of laboratory tests gets increased attention due to its practical applications. These applications include correct interpretation of laboratory tests, the decision on the availability of reference intervals, contributions to clinical decision-making. It is critical to derive the BV information accurately and reliably. Another crucial step is to perform the statistical analysis of the BV data. Although there are updated and comprehensive guidelines, there is no reliable and comprehensive tool to perform statistical analysis of BV data. Methods We presented BioVar, an online tool for statistical analysis of the BV data based on available and updated guidelines. Results This tool can be used (i) to detect outliers, (ii) to control normality assumption, (iii) to check steady-state condition, (iv) to test homogeneity assumptions, (v) to perform subset analysis for genders, (vi) to perform analysis of variance to estimate components of variation and (vii) to identify analytical performance specifications of laboratory tests. Moreover, plots can be created at each step of outlier detection to inspect outliers and compare gender groups visually. An automatic report can be generated and downloaded. Conclusion The tool is freely available through turcosa.shinyapps.io/biovar/, and source code is available on the Github: github.com/selcukorkmaz/BioVar.

Objective COVID-19 pandemia still continues to threaten the whole world. High dose ascorbic acid (AA) infusion is a choice of treatment and its efficiency is still being investigated. AA interferes with many clinical chemistry tests. However, data about the interference of high concentrations of AA is not sufficient. In this study, we aimed to investigate the interference of AA at high concentrations on commonly used chemistry assays. Materials and Methods Serum samples at AA concentrations of 200, 150, 100, 75, 50, 25, 10, 5, 2 and 0 mg/dL were prepared by using the stock solution of 15000 mg/dL AA. Each sample was analyzed by using the most common 30 chemistry tests (Abbott Architect C8000, Illinois, USA) and a POCT glucometer (STANDARD GlucoNavii, Gyeonggi-do, Republic of Korea). Results Creatinine, sodium and glucose (POCT) tests were found to be positively interfered by increasing AA concentrations; while direct bilirubin, lipase, UIBC, triglyceride, total cholesterol, HDL/LDL cholesterol tests were negatively interfered. Absolute interference (%) increased as the AA concentration increased. Conclusion This is the largest and first study to investigate the interference of high dose AA, which is used in severe COVID-19 patients nowadays. Manufacturers and clinicians should be aware of the possibility of aberrant results due to high dose AA infusion. Clinicians should not forget to consult a laboratory specialist, since he is the only person to monitor the reactions in all assays, and know the technical subjects like interferences, assay method specifications. This issue is very important for correct decision-making and interpretation of the data-mining studies accurately and efficiently. Öz Amaç COVID-19 pandemisi hala tüm dünyayı tehdit etmeye devam etmektedir. Yüksek doz askorbik asit (AA) infüzyonu, tedavide bir seçenektir ve etkinliği hala araştırılmaktadır. AA birçok klinik biyokimya testini interfere eder. Fakat yüksek konsantrasyonlardaki AA interferansı hakkında veriler yetersizdir. Bu çalışmada, yüksek doz AA’nın yaygın kullanılan biyokimya testleri üzerindeki interferansını araştırmayı amaçladık. Gereç ve Yöntem 15000 mg/dL AA stok solüsyonu kullanılarak 200, 150, 100, 75, 50, 25, 10, 5, 2 and 0 mg/dL AA konsantrasyonlarına sahip serum örnekleri hazırlandı. En yaygın kullanılan 30 biyokimya testi (Abbott Architect C8000, Illinois, ABD) ve bir hasta başı test cihazı (HBTC) glukometre (STANDARD GlucoNavii, Gyeonggi-do, Kore Cumhuriyeti) kullanılarak, hazırlanan her serum örneğinin analizi yapıldı. Bulgular Artan AA konsantrasyonlarıyla; kreatinin, sodyum ve glukoz (HBTC) testlerinde pozitif interferans olduğu; direkt bilirubin, lipaz, UIBC, trigliserit, total kolesterol, HDL/LDL kolesterol testlerinde ise negatif interferans olduğu bulundu. AA konsantrasyonu arttıkça interferans (%) büyüklüğü de artmaktaydı. Sonuç Bu çalışma, son zamanlarda ciddi seyirli COVID-19 hastalarında kullanılan çok yüksek dozdaki AA’nın biyokimya testleri üzerinde neden olduğu interferansı araştıran ilk ve en geniş çalışmadır. Üreticiler ve klinisyenler, yüksek doz AA infüzyonuna bağlı ortaya çıkabilecek anormal test sonuçlarının farkında olmalıdır. Klinisyenler böyle durumlarda bir laboratuvar uzmanına danışmayı unutmamalıdır. Çünkü laboratuvar uzmanı; tüm testlerdeki reaksiyonları takip edebilen, test metot özellikleri ve interferanslar gibi teknik konuları bilen tek kişidir. Doğru karar verme ve veri madenciliği çalışmalarının doğru ve verimli olarak yorumlanması açısından bu konu çok önemlidir.

Background It was aimed to investigate maternal serum hormone values used for aneuploidy screening, demographic characteristics and fetal measurements in the population of pregnant Syrian refugees (PSRs) and to compare with data from pregnant Turkish women (PTW). Material and methods The study assessed data from 2697 pregnant who underwent triple and double screening tests, including 1738 Turkish and 959 Syrian women. The maternal serum biomarkers, demographic characteristics and fetal sonography measurements were compared and biases were calculated. By multivariate linear regression analysis, group-specific regression coefficients were estimated. Results Mean total age and weight were found to be significantly different and lower in PSRs in all gestational ages evaluated (p < 0.001; p < 0.001). The first trimester, median biases for fß-hCG were found to be higher by 38% and 24.5% for weeks 11 and 13, respectively. In the second trimester, median values of tß-hCG showed negative biases of 11.8% and 21.2% on weeks 16 and 19 in PSRs, respectively (p < 0.001). It was considered that ethnicity has a stronger effect on first trimester hormone biomarkers than second trimester. The ethnic diversity showed the greatest effect on fß-hCG. Conclusion Race/ethnicity-specific regression coefficients and median values based on validated risk estimations should have to be used for fetal aneuploidy risk reports.

Objectives Trace elements are essential in thyroid functioning as they incorporate into biologically important enzymes as cofactors. The placenta can either activate or inhibit the transfer of maternal trace elements to the unborn. An imbalance of maternal trace elements in pregnancy may affect both maternal and newborn thyroid function. Methods Blood samples from 315 lactating mothers were collected in the first 48 h after delivery and evaluated for selenium (Se), copper (Cu), manganese (Mn), and zinc (Zn) using flame atomic absorption spectroscopy (FAAS) and quadrupole inductively coupled plasma-mass spectrometer (ICP-MS). Thyroid hormones and auto-antibodies (thyroid-stimulating hormone (TSH), free T3 (fT3), free T3 (fT4), anti–thyroid peroxidase (anti-TPO), and antithyroglobulin (anti-TG)) were analyzed in maternal blood using an electro-chemiluminescence immunoassay (ECLIA). Between 48 and 72 postpartum hours, spot blood samples were used for newborn screening-TSH measurement. Correlation and multivariate analyses were performed to evaluate the effect of maternal trace element levels on newborn screening-TSH levels. Results The medians (min-max) of maternal Se (45.16 µg/L (21.28–79.04)), Cu (210.10 µg/dL (117.04–390.64)), Mn (2.11 µg/L (0.20–3.46)), and Zn (0.43 mg/L (0.24–0.66)) were determined. A positive correlation was detected between Zn and maternal TSH levels (r=0.12, p < 0.05). Newborn screening-TSH was significantly correlated with maternal Cu (r=0.14, p < 0.01). Similarly, Cu exhibited weak associations in clustering analysis while others shared common clusters with newborn-screening TSH. Conclusions There was no significant association between most of the maternal serum trace elements and maternal thyroid hormone parameters, with an only exception between maternal Zn and maternal serum TSH. Finally, the association between maternal serum Cu levels and newborn screening-TSH levels may highlight the importance of maternal Cu levels on the newborn thyroid health.

Objective A high frequency of PI3K signalling pathway abnormalities and TP53 mutations are critical in the development and progression of breast cancer (BCa). We aimed to detect PIK3CA and TP53 mutations via an expression analysis of PIK3R1 , PTEN and SALL4 and correlate the expression of these genes with clinical parameters of BCa. Materials and methods PIK3CA and TP53 mutations in BCa samples were analysed by High-Resolution Melting (HRM) analysis, followed by Sanger sequencing, and the expression levels of PIK3R1 , PTEN and SALL4 were evaluated by RT-PCR methods. Results The frequency of PIK3CA and TP53 mutations was 42% and 38% according to the HRM and Sanger sequencing. There was a significantly high frequency of these mutations in ER( +), N0 and HER2( −) tumour samples. PIK3R1 and PTEN expression levels were high in tumour samples, whereas SALL4 expression was low. In patients with TP53 mutations, PIK3R1 expression was low, and this finding was statistically significant. PIK3R1 and PTEN expression levels showed statistically significant, respectively in G3 grades, ER(+), (PR)( +), HER2(+) and ER( +). Conclusions We suggest that these candidate genes could be potential prognostic biomarkers of BCa and that they should be considered in the evaluation of clinical parameters of BCa.

Background Prostate cancer (PC) incidence has risen globally. As there are no current independent biomarkers with high diagnostic efficiency to detect PC, this study was performed to investigate the relative gene expression levels of E2F3 and survivin in the whole blood of PC, benign prostate hyperplasia (BPH), and normal control individuals and to explore their diagnostic value. Material and methods Participants of the study were divided into three groups; normal control group (n=25), BPH patients (n=25), and PC patients (n=75). The E2F3 and survivin gene expression levels were assessed using real-time qPCR in addition to the measurement of free and total levels of prostate-specific antigen (PSA) using electrochemiluminescence assays. Results Survivin relative gene expression was over-expressed in PC and BPH patients compared to the normal control group, whereas, E2F3 did not differ significantly among the studied groups. Compared to PSA, E2F3 and survivin mRNA expression levels had lower diagnostic efficacy to differentiate PC from normal and BPH individuals with an area under curve (AUC) of 0.471 and 0.727, respectively. Further, survivin expression level was associated with increased the risk of PC. Conclusion Survivin and E2F3 relative expression levels in peripheral blood had low diagnostic performance to detect PC and individuals with high survivin expression levels may have higher risk to develop PC.

Background We evaluated population characteristics of serum 25-hydroxyvitamin D (25(OH)D) levels and determined the influence of age, gender and season in an extensive dataset. Materials and methods Laboratory results of 103,509 adults and 19,186 children were retrospectively evaluated. Study group was classified regarding ages as; <40, 40–50, 50–60 and >60 years for adults and 0–1, 1–12 months,1–3, 4–6, 7–9, 10–12, 13–15 and 16–18 years for children. Seasonal values were also determined. Levels were measured by Architect i1000 SR (Abbott Diagnostics, USA). Results The median (2.5–97.5 percentiles) of 25(OH)D levels were 38.75 (9.5–158.25) nmol/L for adults and 43.25 (11.25–125.5) nmol/L for children. There were significant gender differences for both adults and children. Values differed significantly among age subgroups (p’s < 0.01). A total of 63% of adults and 59.5% of children had 25(OH)D levels below 50 nmol/L (p < 0.001). 25(OH)D levels were significantly lower in the winter compared with summer (p’s < 0.001). Even levels in summer were moderate deficient for all group. Conclusion The rate of 25(OH)D deficiency was remarkable during the whole year. This will provide large-scale data about 25(OH)D status in Turkish people and may contribute to the prevention and treatment of this condition for better healthcare outcomes.

Objectives The aim of the present study is to evaluate the diagnostic powers of fractional magnesium, sodium and potassium as markers of renal tubular damage in normotensive type 2 diabetes mellitus (T2DM) patients with respect to microalbuminuria and estimated glomerular filtration rate (eGFR). Materials and methods Forty healthy volunteers and 91 normotensive T2DM patients were included in the study. Patient group was divided into two according to albuminuria level; 49 were normoalbuminuric and 42 were microalbuminuric. In addition to albumin in urine, urine and serum Na, K, Mg and creatinine values were measured to calculate fractional electrolyte excretion rates. Results In normoalbuminuric and microalbuminuric groups, fractional excretion of magnesium (FEMg) values were found to be significantly higher than the control group (p < 0.05). There was a moderate correlation between FEMg and albümin to cratinin ratio (ACR) (Spearman r = 0.3215, p < 0.05). In the ROC analysis for eGFR and FEMg based on microalbuminuria, the areas under the curve were 0.625 and 0.732, respectively (diagnostic sensitivity 59.52% and 66.67%; specificity 70.79% and 77.53%, p < 0.05). Conclusion For renal tubular damage predicted by microalbuminuria, FEMg could be accepted as a candidate biochemical marker with diagnostic and prognostic value.

Background The correct diagnosis rate in acute appendicitis (AA) is between 72 and 94% despite advanced laboratory and radiologic examinations. This study was conducted to determine the effectiveness of laboratory parameters in the diagnosis of children with appendicitis. Materials and methods Patients who underwent appendectomy were divided as AA (subdivided into two groups as perforated and non-perforated) and without appendicitis. White blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), red cell distribution (RDW), mean platelet volume (MPV), C-reactive protein (CRP), procalcitonin levels and Alvarado score were recorded. Results WBC, NLR and CRP levels were higher in patients with AA (p<0.05). According to the receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), p values and 95% confidence interval in predicting patients with and without appendicitis were NLR: 0.703, 0.025, 0.523–0.884; CRP: 0.822, <0.001, 0.725–0.919; procalcitonin: 0.631, 0.150, 506–0.755 and Alvarado score: 0.754, 0.05, 0.578–0.930, respectively. RDW, CRP and procalcitonin values of perforated appendicitis patients were higher compared with those of the non-perforated ones (p<0.05). According to the ROC curve, AUC, p values and 95%CI were NLR: 0.583, 0.094, 0.488–0.678; RDW: 0.715, <0.001, 0.628–0.802; CRP: 0.900, <0.001, 0.842–0.958; procalcitonin: 0.865, <0.001, 0.799–0.930 and Alvarado score: 0.727, <0.001, 0.641–0.812, respectively. Conclusions CRP is the most effective bioindicator in the diagnosis of AA, the detection of perforated cases. It was revealed that NLR is effective in the diagnosis of AA, procalcitonin and RDW values are effective in the separation of perforated cases.

Objectives Maintaining the thiol-disulphide balance is essential for antioxidant defense and apoptosis. The study aimed to evaluate of thiol-disulphide levels in patients with pulmonary embolism (PE). Methods The study included a total of 97 participants: 48 patients and 49 healthy individuals. Serum native thiol (NT), total thiol (TT) and disulphide (DS) levels (µmol/L) were measured using the novel spectrophotometric method. Results We found significantly lower levels of NT (195.44±83.3 μmol/L), DS (20.42±9.20 μmol/L) and TT (236.26±90.66 μmol/L) in patients with PE compared with the healthy controls (304.42±62.13, 24.33±8.09 and 353.07±63.58 μmol/L respectively). Patients with PE had lower serum albumin levels (3.11±1.03 g/dL) and higher ischaemia modified albumin (IMA) levels (0.82±0.16 g/dL) compared with the controls (3.89±0.52 and 0.67±0.15 g/dL, respectively). Serum albumin levels in patients were strongly correlated with plasma IMA (r=−0.737; p<0.001), NT (r=0.786; p<0.001) and TT levels (r=0.841; p<0.001). Serum NT levels were strongly correlated with serum TT levels (r=0.981; p<0.001) in patients. Conclusions This study found lower TT, NT and DS levels in patients with PE than in the control group. Our study revealed that thiol-disulphide homeostasis could be altered during PE and further studies are needed to be used as prognostic markers for hospital mortality.

Objectives The severity of interstitial fibrosis/tubular atrophy (IFTA) is the most important determinant of the irreversible progression of chronic kidney disease (CKD). Prolidase is the key enzyme in collagen turnover and is associated with an extracellular matrix increase. We aimed to evaluate the relationship between the presence and degree of IFTA and serum prolidase enzyme activity (SPEA) in patients undergoing a renal biopsy. Methods This cross-sectional study included 56 patients who underwent a renal biopsy (30 males; mean age 45.3 ± 16.8 years) and also 54 healthy volunteers (21 males; mean age 42.7 ± 8.2 years). IFTA scoring was performed on the basis of percentage of IFTA presence in renal biopsy tissues (1=<10%; 2=10–24%; 3=25–50%; 4=>50%). SPEA was measured by spectrophotometric method. Results The proteinuria and SPEA levels of the patients were significantly higher than the controls (p<0.001 and p<0.001, respectively). SPEA decreased significantly when the IFTA score increased (p<0.002). In the correlation analysis, the IFTA score was negatively correlated with SPEA (r s =−0.461, p<0.001), and positively correlated with proteinuria (r s =0.274, p=0.041). Conclusion These findings suggest that increased collagen turnover decreases over time concerning the progression of renal fibrosis. Monitoring of SPEA level may useful as a biomarker for early determination of CKD progression and severity.

Objectives There is currently trend that plasma might be alternative to serum due to some of its advantages. This study aimed to compare test results from heparinized plasma and serum. Methods Blood samples from total of 40 participants (20 healthy, 20 hemodialysis patients) were drawn into serum gel tubes with clot activator and lithium heparin gel tubes. Twenty-eight clinical chemistry analytes were measured in serum and plasma samples. To determine whether difference between test results is clinically significant, total error (TE) was calculated and compared total allowable error (TEa) limits. Results TE of below 5% was calculated for amylase, AST, calcium, total cholesterol, chloride, CK, glucose, HDL-cholesterol, iron, LDH, LDL-cholesterol, magnesium, sodium, total bilirubin, uric acid and urea. Albumin, ALT, creatinine, CRP, lipase, phosphorus, potassium, total protein, and triglyceride had TE of 5–7%. TE of 7–10% were determined for ALP, direct bilirubin, and GGT. TE values were within TEa limits for all analytes. Conclusions It was concluded that results of 28 analytes measured in lithium heparin gel tubes are comparable to those of serum gel tubes. It is thought that several advantages including reduced turnaround time might be provided by using plasma instead of serum for these tests.

Objectives We aimed to determine Human Leukocyte Antigen (HLA)-DRB1, DQB1, and MHC Class I related chain A (MICA) genotypes in patients with ulcerative colitis. Methods HLA-DRB1, HLA-DQB1, MICA genotyping of patient (n:85) and controls (n:100) were performed by PCR-SSO Luminex (One Lambda genotyping kit). Results We found significantly higher DRB1*01 (p:0.022, OR:0.23, CI:0.06–0.8) and MICA*0002/20/55 (p:0.03, OR:0.53, CI:0.29–0.93) alleles in control group whereas DRB1*14 (p:0.04, OR:2.25, CI:1–5.08), DRB1*15 (p:<0.0001, OR:4.54, CI:2.09–9.88) and MICA*0004 (p:0.01, OR:2.84, CI:1.2–6.7) alleles were higher in patient group. Conclusions The present study will inform the MICA and HLA genotypes about the protective (DRB1*01, MICA*0002/20/55) or susceptible (DRB1*14, DRB1*15, MICA*0004) alleles of the disease and helps the literature on Turkish patients with ulcerative colitis.

Objectives This study investigates whether a diagnostic threshold value of procalcitonin exists in Crimean-Congo hemorrhagic fever (CCHF), while also determining the correlation between serum procalcitonin and routine diagnostic laboratory markers, monitoring changes in procalcitonin levels over time during hospitalization, and exploring the effect of procalcitonin levels on survival rates. Methods A total of 161 patients, including 100 with laboratory-confirmed diagnosis of CCHF and 61 as a control group, were retrospectively investigated. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the contribution of procalcitonin when diagnosing the onset in CCHF patients. Procalcitonin levels were measured with Diazyme latex-enhanced immunoturbidimetric method in Roche Cobas C501 analyzer. A Mann–Whitney U -test was applied to compare the groups, a Mantel–Haenszel (log-rank) test was used to calculate for graphic of original individual patient time-to-event data, and a Kaplan–Meier survival curve was plotted. Results A ROC curve analysis identified a best predictive procalcitonin level cut-off point of 0.560 μg/L, with a specificity of 97% and sensitivity of 27% for CCHF. The highest levels of procalcitonin were measured on day 2 during the follow-up throughout and on the 5th day peaked for a second time, lower than the first. Conclusions Procalcitonin may serve as prognostic indicator and an auxiliary biomarker to rule out of CCHF. Öz Amaç Bu çalışmada, Kırım-Kongo Kanamalı Ateşi (KKKA) hastalığında prokalsitonin tanısal eşik değerinin olup olmadığı incelenirken, serum prokalsitonin ve rutin tanı laboratuvarı belirteçleri arasındaki korelasyonun belirlenmesi, prokalsitonin düzeylerinin hastanede yatış sırasındaki davranışının izlenmesi ve prokalsitonin düzeylerinin sağkalım oranları üzerindeki etkisi araştırıldı. GereçveYöntem 100’ü laboratuvarda doğrulanmış KKKA hastası ve 61’i kontrol grubu olarak dahil olmak üzere toplam 161 hasta geriye dönük olarak incelendi. KKKA hastalarında başlangıç tanısına prokalsitoninin katkısını değerlendirmek için ROC eğrisi analizi yapıldı. Prokalsitonin düzeyleri Roche Cobas C501 analizöründe Diazyme lateks destekli immünoturbidimetrik yöntemle ölçüldü. Grupları karşılaştırmak için Mann-Whitney U-testi uygulandı, orijinal bireysel hastanın olay-zaman verilerinin grafiğini hesaplamak için bir Mantel-Haenszel (log-rank) testi kullanıldı ve bir Kaplan-Meier sağkalım eğrisi çizildi. Bulgular ROC eğrisi analizi ile KKKA için % 97 özgüllük ve% 27 hassasiyeti ve en iyi öngörücü prokalsitonin kesim noktası konsantrasyonu 0.560 μg/L olarak saptandı. En yüksek prokalsitonin seviyeleri, hastane takipi boyunca 2. günde idi ve 5. günde ise birinciden daha düşük ikinci bir kez zirve yaptı. Sonuç Prokalsitonin, KKKA’ni ekarte etmek için prognostik bir gösterge ve yardımcı biyobelirteç olarak kullanılabilir.

Objectives The aim of this study was to compare low-density lipoprotein cholesterol (LDL-C) estimations using various formulas with directly measured LDL-C (d-LDL-C) in the Turkish population. Material and methods A total of 1,478 participants who were aged between 18 and 80 were classified into five groups according to serum triglyseride (TG) concentration as follows: <100, 100–199, 200–299, 300–399, and 400–1000 mg/dL. Glucose (Glu), LDL-C, total cholesterol (TC), HDL-C, TG, and HbA1C were measured with Cobas 6000 c501. d-LDL-C concentrations were measured by a homogenous direct assay using reagents. We investigated the accuracy 10 equations that are Friedewald, De Cordova, Ahmadi, Anandaraja, Teerakanchana, Chen, Hattori, Vujovic, Puavillai, and Hatta for estimating LDL-C in this study. Results In group 1, Anandaraja formula correlated best with d-LDL-C (r=0.367), but this correlation is weakly. In group 2; Teerakanchana formula (r=0.931), in group 3; Friedewald and Teerakanchana formulas (r=0.935, r=0.961), in group 4; Teerakanchana formula (r=0.950) and in group 5, Anandaraja formula (r=0.792) correlated best with d-LDL-C. Conclusions In this study, although there was a strong correlation between d-LDL-C measurement and estimated LDL-C formulas, there was a negative bias between results of these formulas and the d- LDL-C.

Objectives Fructose-1,6-bisphosphatase deficiency (FBPase deficiency, OMIM 229700) is an early-onset rare genetic disorder caused by mutations in the FBP1 gene. Case presentation Our patient was 17-years-old when she was diagnosed with the disease. Initial sequencing analysis with Ion Torrent technology failed to detect the gross deletion that covered complete exon 2 (c.-24-26_170 + 5192del) of FBP1 gene and caused the delay in diagnosis. Deletion was then detected when sequencing was performed in an Illumina MiSeq platform. Conclusions This case emphasizes the importance of sequencing data analysis for precise diagnosis of rare diseases and therapy planning.

Objectives Sysmex UN series fully automated urine analyzer reports a series of research parameters besides routine parameters including the “atypical cells” parameter. An automated instrument in clinical use capable of detecting neoplastic cells of the urinary tract will have paramount significance. Case presentation A 73 years old male patient with a recurrent high grade urothelial carcinoma admitted to our urology outpatient clinic due to hematuria. Urinalysis showed +3 hemoglobin, +3 leukocyte esterase, 200/HPF red blood cells, 300/HPF white blood cells. The instrument also reported atypical cells (7.6/µL or 1.3/HPF) under the heading of “research parameters.” Presence of atypical cells was confirmed by the manual microscopy. The patient has undergone transurethral resection of papillary lesions and the pathology report confirmed a recurrence. On follow-up, atypical cells fell to 0.1/µL after 40 days. Conclusions This case report presents a patient with atypical cells in urine, detected by a fully automated urine analyzer. The atypical cells presented on the screen of the analyzer were confirmed by the manual microscopy. This presentation may influence future studies pertaining to the subject.

Objective In this study, we aimed to investigate the changes in the levels of oxidative stress and antioxidant enzymes on the mandibular bone caused by the expression of aquaporin-1 and aquaporin-3 proteins. Material and method 14 Balb/C white mice were divided into two groups of seven, based on whether they are young or old. Mandibular tissue samples were taken for biochemical and histological analysis. Results Findings of our study has shown that, AQP-1 and AQP-3 immunoreactivity significantly decreased in mandibular bone tissues of aged mice in comparison to younger mice (p < 0.05). MDA and AOPP levels, which are the indicators of oxidative stress, increased in elderly mice and antioxidant defense system SOD enzyme activity was decreased (p < 0.05). The TNF-α cytokine level, which is the indicator for inflammations, was found to be higher in older mice than in young mice (p < 0.05). Conclusion As a result, it was observed that cellular damage, disruption in water – electrolyte balance and increased inflammation that occur during the natural process of aging had caused serious and irreversible disturbances.

Background Functional foods can help prevent metabolic diseases, and it is essential to evaluate functional characteristics of foods through in vitro and in vivo experimental approaches. Objective We aimed to use the bicameral cell culture system combined with the in vitro digestion to evaluate glucose bioavailability. Materials and methods Cake, almond paste, and pudding were modified by adding fiber and replacing sugar with sweeteners and polyols. Digestion process was modeled in test tubes. Rat enterocyte cells (IEC-6) were grown in a bicameral cell culture system to mimic the physiological characteristics of the human intestine. The glucose bioaccessibility and cellular glucose efflux were measured by glucose oxidase assay. Results and discussion The glucose bioaccessibilities of modified foods were significantly lower (cake: 2.6 fold, almond paste: 9.2 fold, pudding 2.8 fold) than the controls. Cellular glucose effluxes also decreased in the modified cake, almond paste, and pudding by 2.2, 4, and 2 fold respectively compared to their controls. Conclusion Our results suggest that combining in vitro  enzymatic digestion with cell culture studies can be a practical way to test in vitro glucose bioaccessibility and bioavailability in functional food development.