Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels >2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p < 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

Bipolar Disorder and Cancer

Prevalence studies and studies on causation relations have shown that the relation between psychiatric disorders and chronic physical diseases is neglected. For heterogeneous diseases an increasing number of susceptibility variants are being defined. Alzheimer disease, bipolar disorder, breast and prostate cancer, coronary artery disease, Chron's disease, systemic lupus eritematosus, type 1 and type 2 diabetes mellitus are mentioned together with epigenetic concept. In acrocentric zone of chromosome 13, breast cancer, retinoblastoma, chronic Iymphocytic leukemia genes with B cells, dopamin loci of bipolar disorder are found together. Among bipolar and healthy individuals, an increase risk of breast cancer in female cases has been resported. On the other hand, psychosocial factors that affect stress and response to stress itself may be important variables in prognosis and progression of different cancer types. During the course of many cancer types –especially brain tumors- and during treatment of chemotherapeutic agents, bipolar symptomatology may appear. In this article, it is reviewed with relevant literature that whether an etiological relation between bipolar disorder and cancer exist and how both diseases affect each other's course and treatment

Inertial focusing of microparticles in curvilinear microchannels with different curvature angles

Inertial microfluidics has become one of the emerging topics due to potential applications such as particle separation, particle enrichment, rapid detection and diagnosis of circulating tumor cells. To realize its integration to such applications, underlying physics should be well understood. This study focuses on particle dynamics in curvilinear channels with different curvature angles (280A degrees, 230A degrees, and 180A degrees) and different channel heights (90, 75, and 60 A mu m) where the advantages of hydrodynamic forces were exploited. We presented the cruciality of the three-dimensional particle position with respect to inertial lift forces and Dean drag force by examining the focusing behavior of 20 A mu m (large), 15 A mu m (medium) and 10 A mu m (small) fluorescent polystyrene microparticles for a wide range of flow rates (400-2700 A mu L/min) and corresponding channel Reynolds numbers. Migration of the particles in lateral direction and their equilibrium positions were investigated in detail. In addition, in the light of our findings, we described two different regions: transition region, where the inner wall becomes the outer wall and vice versa, and the outlet region. The maximum distance between the tight particle stream of 20 and 15 A mu m particles was obtained in the 90 high channel with curvature angle of 280A degrees at Reynolds number of 144 in the transition region (intersection of the turns), which was the optimum condition/configuration for focusing

A complete low cost radon detection system

Monitoring the Rn-222 activity through the 1200 km long Northern Anatolian fault line, for the purpose of earthquake precursory, requires large number of cost effective radon detectors. We have designed, produced and successfully tested a low cost radon detection system (a radon monitor). In the detector circuit of this monitor, First Sensor PS100-7-CER-2 windowless PIN photodiode and a custom made transempedence/shaping amplifier were used. In order to collect the naturally ionized radon progeny to the surface of the PIN photodiode, a potential of 3500 V was applied between the conductive hemispherical shell and the PIN photodiode. In addition to the count rate of the radon progeny, absolute pressure, humidity and temperature were logged during the measurements. A GSM modem was integrated to the system for transferring the measurements from the remote locations to the data process center. (c) 2013 Elsevier Ltd. All rights reserved

Spatial distribution of Po-214 ions in the electrostatic collection

A low cost Si-PIN photodiode-based radon monitor was successfully designed and produced to monitor precursory earthquake indicators in the Northern Anatolian Fault Line. The spatial distribution of Po-214 ions was determined by comparing the 7.69 MeV Po-214 peak in the MCA spectrum and the Geant4 energy distribution of alpha particles at various detector source distances. (C) 2013 Elsevier Ltd. All rights reserved

Comparison of simulated and measured spectra from an X-ray tube for the energies between 20 and 35 keV

Design and production of a simple and low cost X-ray imaging system that can be used for light industrial applications was targeted in the Nuclear Physics Laboratory of Istanbul Technical University. In this study, production, transmission and detection of X-rays were simulated for the proposed imaging device. OX/70-P dental tube was used and X-ray spectra simulated by Geant4 were validated by comparison with X-ray spectra measured between 20 and 35 keV. Relative detection efficiency of the detector was also determined to confirm the physics processes used in the simulations. Various time optimization tools were performed to reduce the simulation time. (C) 2015 Elsevier B.V. All rights reserved

A low cost X-ray imaging device based on BPW-34 Si-PIN photodiode

A low cost X-ray imaging device based on BPW-34 silicon PIN photodiode was designed and produced. X-rays were produced from a CEI OX/70-P dental tube using a custom made +/- 30 kV power supply. A charge sensitive preamplifier and a shaping amplifier were built for the amplification of small signals produced by photons in the depletion layer of Si-PIN photodiode. A two dimensional position control unit was used for moving the detector in small steps to measure the intensity of X-rays absorbed in the object to be imaged. An Aessent AES220B FPGA module was used for transferring the image data to a computer via USB. Images of various samples were obtained with acceptable image quality despite of the low cost of the device. (C) 2016 Elsevier B.V. All rights reserved