Taxonomy of breast cancer based on normal cell phenotype predicts outcome

Accurate classification is essential for understanding the pathophysiology of a disease and can inform therapeutic choices. For hematopoietic malignancies, a classification scheme based on the phenotypic similarity between tumor cells and normal cells has been successfully used to define tumor subtypes; however, use of normal cell types as a reference by which to classify solid tumors has not been widely emulated, in part due to more limited understanding of epithelial cell differentiation compared with hematopoiesis. To provide a better definition of the subtypes of epithelial cells comprising the breast epithelium, we performed a systematic analysis of a large set of breast epithelial markers in more than 15,000 normal breast cells, which identified 11 differentiation states for normal luminal cells. We then applied information from this analysis to classify human breast tumors based on normal cell types into 4 major subtypes, HR0–HR3, which were differentiated by vitamin D, androgen, and estrogen hormone receptor (HR) expression. Examination of 3,157 human breast tumors revealed that these HR subtypes were distinct from the current classification scheme, which is based on estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. Patient outcomes were best when tumors expressed all 3 hormone receptors (subtype HR3) and worst when they expressed none of the receptors (subtype HR0). Together, these data provide an ontological classification scheme associated with patient survival differences and provides actionable insights for treating breast tumors

Widal Test in Diagnosis of Typhoid Fever in Turkey

We studied the value of the Widal tube agglutination test for the diagnosis of typhoid fever. The subjects were all adults >18 years of age and were divided into four groups: (i) 317 healthy blood donor controls, (ii) 31 bacteriologically confirmed patients with Salmonella enterica serotype Typhi, (iii) 21 patients with a clinical diagnosis of typhoid fever, and (iv) 41 febrile nontyphoid patients. Blood donor controls were screened with a slide agglutination test for the Salmonella enterica serotype Typhi O and H antigens, and positives were then tested with the Widal test. Acute- and convalescent-phase sera from patients in groups 2, 3, and 4 were obtained 7 to 10 days apart and tested by the Widal test. Using a cutoff of ≥1/200 for the O antigen test performed on acute-phase serum gave a sensitivity of 52% and a specificity of 88% with a positive predictive value (PPV) of 76% and a negative predictive value (NPV) of 71%. This increased to 90% sensitivity and specificity with a PPV of 88% and an NPV of 93% when the convalescent-phase serum was tested. We concluded that O and H agglutinin titers of ≥1/200 are of diagnostic significance. The Widal test is easy, inexpensive, and relatively noninvasive. It can be of diagnostic value when blood cultures are not available or practical. The results must be interpreted cautiously because of the low sensitivity of the test. The Widal test done on convalescent-phase serum gave more-reliable results with higher specificity and sensitivity

Two similar patient instances for a rare disease: Bronchitis plastica

[No Abstract Available

A very rare cause of recurrent hemoptysis in a young male patient: Pseudosequestration

WOS: 00043874760002

Talc granulomatosis with multiple parenchymal and pleural nodules

WOS: 000326022700011PubMed ID: 2384718

Multiple intercostal nerve sheath cysts located at costovertebral angle in bilateral hemithorax

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An Imported Dengue Fever Case in Turkey and Review of the Literature

Dengue fever is an acute viral disease that can affect all age groups in tropical and subtropical countries. The predominant vectors are the mosquitoes namely Aedes aegypti and A.albopictus. Although there have been no case reports in Turkey due to DF, there is seroepidemiological evidence indicating the presence of Dengue virus (DENV) in Turkey. In this case report we presented an imported dengue fever case. The patient was 40 years old, previously healthy male, Switzerland citizen. He had immigrated from Dubai to India two weeks ago and after one week from immigration he attended to a hospital in India because of high fever. The NS1 antigen test (Bio-Rad Laboratories, USA) was found positive and the patient was followed-up with diagnosis of dengue fever in India. During his visit to Turkey, he attended to the hospital for a routine control and his analysis revealed thrombocytopenia (PLT: 48.000/mu l), leukopenia (white blood cell: 2800/mu L) and elevated liver enzymes (AST: 76 U/L, ALT: 83 U/L). Fever was not detected in follow-up. The patient had petechial rash on his lower extremities, white blood cell and PLT count increased to 4100/mu l and 93.000/mu l, respectively. Liver function tests revealed a decrease in AST (63 U/L) and ALT (78 U/L) on the third day. The PLT count increased to 150.000/ml. Since the patient had no fever and had normal physical and laboratory findings, he was discharged from the hospital. For the confirmation of dengue fever diagnosis the serum sample was sent to National Public Health Center, Virology Reference and Research Laboratory where IgM and IgG antibodies against DENV types 1-4 were investigated by indirect. immunofluorescence method (Euroimmun, Germany). The serum sample yielded positive result at the dilutions of 1/1000 for IgM and 1/10.000 for IgG. The last dilution of type 3 DENV IgM and IgG were determined high density of fluorescein, thus the serotype was identified as "DENV type 3". Travel-related diseases become important with increasing travel opportunities, globalization and transportation, recently. As a result, this imported case with foreign nationality was the first dengue fever case confirmed by clinical and laboratory tests in Turkey

Expectoration of Tracheobronchial Grass Inflorescence Mimicking a Chest Wall Tumor

WOS: 000396412600027In this case presentation, a 19-year-old male patient was examined because of complaints of right lateral chest swelling, lateral pain, and high fever at night. After a chest CT, the patient was directed to our clinic with a pre-diagnosis of chest wall tumor following the detection of peripheral consolidation concurrent with atelectasis in the lower lobe lateral basal segment in the right lung and a lesion with irregular contour in pleura and the thoracic wall, starting at this level and descending to the inferior. Because the symptoms pointed to infection, antibiotic therapy was started and a fine-needle aspiration biopsy was concurrently performed. Results of the biopsy were reported as "suspicious cytology." The patient, who responded to antibiotic therapy both clinically and radiologically, expectorated a foreign body during monitoring. Pathological examination reported "in herbal quality, grass inflorescence" as the traits of the expectorated body. In the literature there are cases in which grass inflorescence, in accordance with its nature, passed distally out of the chest wall with migration following the aspiration. However, no other publication has reported an intriguing case such as ours, in which the grass inflorescence caused inflammation that mimicked a chest wall tumor and then was expectorated moving in the opposite direction