The benign mimickers of carcinoma on breast MRI

The similarity between benign and malignant pathologies on magnetic resonance imaging (MRI) and a wide-ranging variability of the lesions from benign proliferative changes to invasive breast carcinoma cause a lower and wide-ranging specificity of breast MRI relative to its surpass sensitivity. A wide range of tissue components such as the skin, the adipose tissue, vascular and neural tissues, connective tissues, glandular tissues, ducts, and muscle tissues are found here all together. This pictorial review was aimed at deliberating benign mimickers of breast carcinoma on MRI and trying to call attention to the overlapping and distinctive features

Sexual functions and prolactin levels in patients with bipolar disorder

Objective: Mood stabilizers and antipsychotic drugs are known to have adverse effects on sexual function. However, patients often refrain from speaking about sexual complaints that may cause dose reduction and discontinuation of the drug without medical supervision. In this study we aimed to evaluate sexual functions of patients with bipolar disorder in remission period, considering prolactin levels and medications. Method: We recruited 52 patients with bipolar disorder in remission according to DSM-IV diagnostic criteria. Prolactin levels were measured in all patients. The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used to assess sexual dysfunction. Results: Mean prolactin levels were 24.71 ± 4.25 and 19.96 ± 5.52 ng/ml respectively for females and males. Patients taking mood stabilizer (MS) and mood stabilizer plus antipsychotic (AP) treatment had different prolactin levels (p<0.001). Total GRISS scores were not different for MS and MS+AP treatment groups. We didn't find a correlation between Total GRISS scores and prolactin levels. There was a significant deterioration in female non-sensuality, female dissatisfaction and anorgasmia subscales of female patients and significant deterioration in premature ejaculation, impotence and male dissatisfaction subscales of male patients. Discussion: In our sample, both men and women patients with bipolar disorder in remission have sexual dysfunctions. Our results suggest that prolactin levels are not sufficient to demonstrate the sexual dysfunction. To enhance patient compliance it is necessary to focus more on sexual symptoms of patients receiving MS and AP treatment

Is the necrosis/wall ADC ratio useful for the differentiation of benign and malignant breast lesions?

WOS: 000402802300017PubMed ID: 28339285Objective: To determine whether the necrosis/wall apparent diffusion coefficient (ADC) ratio is useful for the malignant-benign differentiation of necrotic breast lesions. Methods: Breast MRI was performed using a 3-T system. In this retrospective study, calculation of the necrosis/wall ADC ratio was based on ADC values measured from the necrosis and from the wall of malignant and benign breast lesions by diffusion-weighted imaging (DWI). By synchronizing post-contrast T1 weighted images, the separate parts of wall and necrosis were maintained. All the diagnoses were pathologically confirmed. Statistical analyses were conducted using an independent sample t-test and receiver operating characteristic analysis. The intraclass and interclass correlations were evaluated. Results: A total of 66 female patients were enrolled, 38 of whom had necrotic breast carcinomas and 28 of whom had breast abscesses. The ADC values were obtained from both the wall and necrosis. The mean necrosis/wall ADC ratio (6 standard deviation) was 1.6160.51 in carcinomas, and it was 0.6560.33 in abscesses. The area under the curve values for necrosis ADC, wall ADC and the necrosis/wall ADC ratio were 0.680, 0.068 and 0.942, respectively. A wall/necrosis ADC ratio cut-off value of 1.18 demonstrated a sensitivity of 97%, specificity of 93%, a positive-predictive value of 95%, a negative-predictive value of 96% and an accuracy of 95% in determining the malignant nature of necrotic breast lesions. There was a good intra- and interclass reliability for the ADC values of both necrosis and wall. Conclusion: The necrosis/wall ADC ratio appears to be a reliable and promising tool for discriminating breast carcinomas from abscesses using DWI. Advances in knowledge: ADC values of the necrosis obtained by DWI are valuable for malignant-benign differentiation in necrotic breast lesions. The necrosis/wall ADC ratio appears to be a reliable and promising tool in the breast imaging field

Science teachers' views on the internet use in education (The Case of Kırşehir)

Bu araştırmada, fen bilimleri öğretmenlerinin, interneti kullanma amaçları, kullandıkları web siteleri, internet destekli öğretimin öğrencilerin öğrenme düzeyi üzerindeki etkilerine yönelik görüşleri, internet destekli öğretim uygulamalarında karşılaştıkları sorunlar, web sitelerindeki içeriklerin oluşturulması ve düzenlenmesine ilişkin beklentileri ile fen bilimleri öğretiminde internetin kullanımı açısından kendilerini değerlendirmelerine yönelik görüşler incelenmiştir. Araştırma, nitel durum çalışması kapsamında g erçekleştirilen bir çalışmadır ve çalışma grubunu Kırşehir merkez ilçede görev yapan 48 adet Fen bilimleriö ğretmeni oluşturmaktadır. Araştırmanın verileri, yedi adet açık uçlu sorudan oluşan bir görüş formu kullanılarak elde edilmiş , v erilerin analizinde, betimsel analiz yöntemi kullanılmıştır. Araştırma sonuçları, fen bilimleri öğretmenlerinin interneti daha çok bilgi edinme, araştırma yapma ve iletişim kurma amacıyla kullandıklarını, fen bilimleri öğretiminde en çok fenokulu.net ve e ba.gov.tr adresli web sitelerinden haberdar oldukları, internetin, öğrencilerin öğrenme düzeylerini olumlu yönde etkilediğine yönelik görüş bildirdiklerini göstermiştir. Ayrıca öğretmenler, internet hızının yavaş olması ve içeriklerin ücretli ya da yetersiz olmasını en çok karşılaştıkları sorunlar arasında göstermişlerdir.This study investigated the science teachers' aims of using the Internet, the websites they benefit from, their views on the effects of the Internet assisted teaching on students' levels of learning, the issues they face in the Internet assisted teaching applications, their expectations as to creating and editing the contents on the websites, as well as the views on their self-evaluation in term of using the Internet in science education. The study was conducted within the framework of qualitative case study, and the participants included 48 Science teachers workin g in the city center of Kırşehir. The data of the study were collected using an interview form that included seven open -ended questions, and the analysis was conducted using descriptive analysis method. The results of the study indicated that science teach ers used the Internet mostly for the purposes of obtaining information, doing research, and communicating. The results further revealed that science teachers were more aware of the websites, fenokulu.net and eba.gov.tr in science education and provided views suggesting that the use of the Internet affected students’ levels of learning positively. In addition, science teachers regarded the slow Internet and the paid or insufficient contend as the most commonly faced issues

The benign mimickers of carcinoma on breast MRI

The similarity between benign and malignant pathologies on magnetic resonance imaging (MRI) and a wide-ranging variability of the lesions from benign proliferative changes to invasive breast carcinoma cause a lower and wide-ranging specificity of breast MRI relative to its surpass sensitivity. A wide range of tissue components such as the skin, the adipose tissue, vascular and neural tissues, connective tissues, glandular tissues, ducts, and muscle tissues are found here all together. This pictorial review was aimed at deliberating benign mimickers of breast carcinoma on MRI and trying to call attention to the overlapping and distinctive features

Effects of Laparoscopic Ureterolithotomy and Simultaneous Trans-Trocar Semi-Rigid Ureteroscopy on Stone-Free Rate in the Treatment of Proximal Ureteral Stones

WOS: 000218668400005Objective This study presents the effects of the use of semi-rigid ureteroscopy simultaneously during laparoscopic ureterolithotomy on the stone-free rate and, the techniques used to perform laparoscopic ureterolithotomy less invasively. Materials and Methods Between November 2011 and July 2013, laparoscopic ureterolithotomy was performed in 19 patients with proximal ureteral stones. A history of failed shock wave lithotripsy (SWL) or semi-rigid ureteroscopy (sr-URS), presence of ureter stones >= 15 mm and/or impacted stones, or a socioeconomic status not allowing the patient to reach an advanced center for flexible ureteroscopy (f-URS) were identified as the surgical indications. Results Fourteen male (74%) and five female (26%) patients were enrolled in the study and the mean age was 36.4 +/- 15.11 (15-70) years. The stones were located on right side in five patients (26%) and left side in 14 patients (74%). The mean stone size was 16.2 +/- 3.55 mm (8-22). The mean operation time was 138.9 +/- 29.56 minutes (90-200). The mean urethral catheter and drain removal time was 31.2 +/- 24.28 (16-120) and 50.8 +/- 33.61 hours (18-168), respectively. There was no postoperative complication in long-term period and stone-free rate was 100%. Conclusion Laparoscopic ureterolithotomy is a feasible alternative in a patient who had previously failed minimally invasive methods and/or with large impacted proximal ureteral stone. Furthermore, to use semi-rigid ureteroscopy during the laparoscopic procedure increases the stonefree rate and prevents the need for an additional procedure in case of concurrent presence of small kidney stones

Comparison of reducing effect on lung injury of dexamethasone and bosentan in acute lung injury: an experimental study

WOS: 000330182500001PubMed: 24342001Background: Different medical therapies are employed in acute lung injury (ALI) but there is still a debate about the efficacy of these drugs. Among these therapies steroids are clinically applied and bosentan is experimentally studied. The aim of this study was to evaluate the efficacy of these two drugs to treat inflammation in ALI by histopathological comparison. Methods: The five experimental groups (n = 5 per group) were: saline control (Group I); lipopolysaccharide (LPS) + saline (Group II); LPS + dexamethasone (Group III); LPS + 50 mg/kg bosentan (Group IV); and LPS + 100 mg/kg bosentan (Group V). Bosentan was administered orally one hour before and 12 hours after LPS treatment. Dexamethasone was administered intraperitoneally in three doses of 1 mg/kg; one dose was co-administered with LPS and the other two doses were given respectively 30 minutes before and after LPS treatment. Vasodilation-congestion, hemorrhage, polymorphonuclear leukocyte (PMN) infiltration, mononuclear leukocyte (MNL) infiltration, alveolar wall thickening, alveolar destruction/emphysematous appearance, and focal organization were the parameters used as criteria for evaluating inflammation and efficacy of treatment. Results: Compared to the LPS-only group (Group II), dexamethasone treatment (Group III) resulted in significant improvements in vasodilation-congestion, hemorrhage, PMN and MNL infiltration, alveolar wall thickening and emphysematous areas. Treatment with 50 mg/kg dose of bosentan (Group IV) also resulted in significant improvements in hemorrhage, PMN and MNL infiltration, alveolar wall thickening and alveolar destruction. Reducing lung injury and reparative effects of 100 mg/kg bosentan were significant in all parameters. Conclusions: Bosentan is as effective as dexamethasone for treating lung injury in ALI. Bosentan at 100 mg/kg can be recommended as a first treatment choice based on its significant reducing lung injury and reparative effects

Mass and non-mass breast MRI patterns: A radiologic approach to sick lobe theory

Background According to sick lobe theory, one or more lobes of the breast are more prone to the development of carcinoma. However, the implications of this theory in breast magnetic resonance imaging (MRI) are unknown. Purpose To evaluate the MRI appearance of mass type (multifocal and multicentric diseases) and non-mass type (non-mass enhancements) sick lobe patterns, together with the histopathology results. Material and Methods MRI reports of 2015 patients in two tertiary breast imaging centers between June 2012 and June 2018 were retrospectively reviewed for multifocal-multicentric diseases and segmental, linear, and regional enhancements. A total of 113 patients were included. The specimens obtained by thick needle, vacuum, excisional biopsy/lumpectomy or mastectomy after breast MRI scans were pathologically assessed. The pathologic results were categorized as invasive carcinoma, precursor, and benign proliferative lesions according to the 2012 World Health Organization Classification of Tumors. Results The percentage of underlying benign and precursor invasive lesions was significantly different in patients with mass and non-mass MRI patterns. While the pathology results of mass type patterns were premalignant and malignant in all cases, nearly half of the underlying histologies were benign proliferative subtypes in patients with non-mass type patterns. Conclusion In this study, the mass and non-mass patterns derived from sick lobe theory were related to different risks of malignancy in the pathological examinations

Socıal Transformatıon In Safevıd Admınıstratıon

On altıncı yüzyılın başlarından on sekizinci yüzyılın ortalarına kadar tarih sahnesinde kalan Safevî Devleti, Balkanlar’dan Orta Asya’ya, Kafkaslardan Hürmüz Boğazı’na kadar çok geniş bir coğrafyada bugün de etkileri devam eden değerli bir tarihsel figürdür. Bu nedenle İran, Türkiye, Avrupa, Japonya ve Amerika’da Safevîler üzerine dikkat çekici bir akademik ilgiden söz edilebilir. Çünkü tarih sahnesinde dinî bir tarikatın çekirdeğini oluşturduğu bu denli güçlü bir siyasi yapı sıkça karşılaşılabilecek bir olgu olmadığı gibi görmezden gelinebilecek bir durum da değildir. Gerçeği söylemek gerekirse Safevî araştırmalarının asıl zorluğu da sözü edilen mistik ve cezbedici çekirdek ile bunun tarihsel yansımalarından kaynaklanmaktadır. Tarihî Azerbaycan ve günümüz İran’ında geçerli olan Safevîlerle halef selef ilişkisi, Türkiye için Osmanlı mirasından ve mezhepsel yapıdan kaynaklanan kadim ötekilik durumu ve son olarak Müslüman olmayan ülkelerde -özellikle Batı’da- İslâm’ın heterodoks yüzünün siyasi temsilcisi olması vasfı, Safevî çalışmalarını çok katmanlı ve ideolojik önyargılara açık bir zemine kaydırabilmektedir. Bu nedenle Safevîlerle ilgili çalışmalar, ya kronolojik bir siyasi tarih düzleminde ya da söz konusu ideolojik bakışların yönlendirmesinde belirli bir güzergâha mahkûm gibidir. Çalışmamızda bizden öncekileri tekrar etmemek adına Safevî tarihinin kronolojik boyutu ana hatlarıyla sınırlı tutulmuştur. Araştırmanın merkezine Safevî Devleti’nin, Karakoyunlular ve Akkoyunlular gibi kendilerinden önceki Türk devletleriyle etkileşimleri, idari yapılanma, ordu yapısı, etnik, kültürel ve ekonomik yapılar açısından sebep sonuç ilişkisi gözetilerek v yerleştirilmiştir. Böylelikle Safevîlerin varoluş süreci bir devamlılık iddiasına oturtulmuştur. Böylece Karakoyunlular ve Akkoyunluların askerî, idarî, etnik ve ekonomik özelliklerinin Safevîler’deki yansımaları somut verilere dayandırılmıştır. Bahsedilen iki Türkmen devleti ile Safevîler arasındaki temel farklılık olan Safevî Tarikatı’nın devlet içindeki konumu -devletleşme öncesi ve sonrasıyla birlikte- tarihsel gelişimi içinde ele alınmıştır. Safevî Devleti tarihi, Şah İsmail’den Tahmasb’ın birinci dönemine kadar I. Dönem olarak adlandırılmış ve bu adlandırmanın idari, etnik ve dinî sebepleri ortaya konmuştur. Erdebil Tekkesi etrafında örgütlenen Kızılbaş Türkmenler tarafından kurulan devletin Tahmasb’la başlayan değişimi açıklanmış, bu değişimin hem devlete hem de inanç sitemine nüfuz ediş süreci izah edilmiştir. Bu süreç, yalnızca bölgedeki demografik yapının değil; Hazar’ın Batısından Anadolu içlerine, Kafkasların eteklerinden Arap Yarımadası kapılarına kadar bölgenin inanç haritasının da değişimine etki etmiştir. Bu gerçeklik sözü edilen bölgenin siyasi, etnik ve inanç tarihinin aydınlatılması adına hayatidir. Safevîler hakkındaki bu çalışma, başta İran olmak üzere Osmanlı ve Cumhuriyet’in, başta Türkmenler olmak üzere ilgili tüm etnik yapıların, en çok da Kızılbaşlık ve Şia’nın daha iyi anlaşılmasına hizmet edecektir.Remained on the stage of history from the early of 14th century to the middle of 18th century, Safavid Empire is a valuable historical figure of which effects are also continuing today on a too wide geography from the Balkans to Middle Asia, the Caucasus to the Strait of Hormuz. For this reason, a remarkable academic interest in the Safavids can be mentioned in Iran, Turkey, Europe, Japan and USA. Because, on the stage of history, such a strong political structure of which core is constituted by a religious sect is neither a fact that would be able to be encountered frequently, nor a situation that would be able to be neglected. To be truthful, the real difficulty of Safavian studies is due to the said mystic and charming core and the historical reflections of this. Successor-predecessor relationship with the Safavids, which is current in the historical Azerbaijan and today’s Iran; state of the old otherness arising from Ottoman heritage and denominational (sect) structure, for Turkey; and finally, feature of its being political representative of heterodox face of Islam in the non-muslim countries ̶ particularly in the West; can slide Safavian studies to a platform that is vulnerable to multi-layer and ideological prejudices. Therefore, studies on the Safavids are like the doomed to a certain course either on a chronological plane of political history or in directing the said ideological points of view. In our study, we confined chronological dimension of Safavid Empire to broad strokes in order not to repeat those before us. We put interactions of Safavid Empire with Turkish states such as the Qara-Qoyunlus and Aq-Qoyunlus who came before the Safavids, into the center of the study, by paying regard to the cause and effect relationship in terms of administrative structuring, army structure, and ethnical, cultural and economical structures. vii Thus, we placed existence process of the Safavids into a claim of continuity. So, reflections of military, administrative, ethnical and economical features of the Qara-Qoyunlus and Aq-Qoyunlus on the Safavids were based on tangible data. We addressed position, within the the state, of Safavid Sect which is essential difference between the said two Turkmen states and the Safavids ̶ together with before and after state formation ̶ within its historical development. We named the history of the Safavid Empire as ‘First Period’ from Shah Ismail I to the first period of Shah Tahmasb I and put forward administrative, ethnical and religious reasons of this naming. We explained the change which began with Shah Tahmasb I in the state that was founded by the Qizilbash Turkmen who were organized around Ardabil Lodge, and we showed forth penetration process of this change into both the state and belief system. This process had an effect on the change not only in demographic structure in the region, but also in belief map of the region, from Western Part of Khazar into the inlands of Anatolia, mountain foots of the Caucasus to the gates of Arabian Peninsula. This reality is vital to enlighten political, ethnical and belief-related history of the above-mentioned region. This study which is about the Safavid Empire, will help to understand better the Ottoman and the Republic of Turkey, in particular to Iran, the relevant all ethnical structures, including the Turkmen, and Qizilbashness and the Shi’a none more so than