Safety and efficacy analysis of microwave ablation in small hepatocellular carcinomas sized below 3 cm

Purpose: The aim of this study was to investigate the efficacy and safety of microwave ablation (MWA) in small hepatocellular carcinomas sized ≤ 3 cm, determine long-term survival, and identify prognostic factors for survival rates. Material and methods: In this study, the radiological and laboratory findings obtained from 31 consecutive patients who underwent MWA were retrospectively evaluated. The survival periods and complication rates were analysed. Results: Microwave ablation was applied to 42 hepatocellular carcinoma nodules in 31 patients. The mean age of the patients was 61 ± 7.3 (median 62, range 46-78) years. The mean overall survival (OS) was 47.4 ± 3.3 months. The rates of cumulative OS in the first, second, and third years were 95.2%, 91.8%, and 79.2%, respectively. The mean disease-free survival (DFS) rate was 24.1 ± 2.5 months. The cumulative DFS rates in the first, second, and third years were 75.6%, 52.5%, and 28.2%, respectively. The number of tumours and tumour distribution were determined as prognostic factors. No major complication was detected, but six patients (13.9%) developed minor complications after MWA. Conclusions: Microwave ablation in patients with hepatocellular carcinoma is a safety treatment modality with very low rates of complications. It offers an effective treatment with a high rate of complete response and local disease control according to the short-term results. In the long term, it prolongs the survival time of the treated patients. The number of tumours and tumour distribution were determined as prognostic factors affecting survival rates

A radiomic signature based on magnetic resonance imaging to determine adrenal Cushing's syndrome

Purpose: The aim of this study was to develop radiomics signature-based magnetic resonance imaging (MRI) to determine adrenal Cushing’s syndrome (ACS) in adrenal incidentalomas (AI). Material and methods: A total of 50 patients with AI were included in this study. The patients were grouped as nonfunctional adrenal incidentaloma (NFAI) and ACS. The lesions were segmented on unenhanced T1-weighted (T1W) in-phase (IP) and opposed-phase (OP) as well as on T2-weighted (T2-W) 3-Tesla MRIs. The LASSO regression model was used for the selection of potential predictors from 111 texture features for each sequence. The radiomics scores were compared between the groups. Results: The median radiomics score in T1W-Op for the NFAI and ACS were -1.17 and -0.17, respectively (p < 0.001). Patients with ACS had significantly higher radiomics scores than NFAI patients in all phases (p < 0.001 for all). The AUCs for radiomics scores in T1W-Op, T1W-Ip, and T2W were 0.862 (95% CI: 0.742-0.983), 0.892 (95% CI: 0.774-0.999), and 0.994 (95% CI: 0.982-0.999), respectively. Conclusion: The developed MRI-based radiomic scores can yield high AUCs for prediction of ACS

A rare coronary artery anomaly - type X dual left anterior descending artery: a case report with brief literature review

Introduction: Type X dual left anterior descending artery (LAD), which is a rare subtype of coronary artery anomalies and newly defined in the literature, usually presents an asymptomatic clinical course and is detected incidentally in diagnostic angiography. However, in the presence of obstructive disease, myocardial revascularization may be required. It is critical to identify the presence of Type X dual LAD in order to prevent misdiagnoses in coronary angiography and to prevent complications during angioplasty or surgical myocardial revascularization. We present a case of rare type X dual LAD coronary anomaly presented with chest pain. Case presentation: A 66-year-old female patient was admitted to the hospital with the complaints of atypical chest pain and palpitations. Examinations revealed sinus tachycardia, mitral valve calcific degeneration, mild tricuspid valve insufficiency, and left atrial dilatation on echocardiography, hyperlipidemia and normal troponin I value. Coronary artery disease risk (according to the Framingham risk score) was low (8%), and coronary coronary computed tomography angiography (CCTA). The calcium score was calculated as 1782 Agatston. There were calcified atheroma plaques in the left main coronary artery (LMCA) ostium and distal section causing less than 25% stenosis. A well-developed diagonal branch of LAD was observed. The LAD calibration was thin and terminated at the proximal of anterior interventricular sulcus (AIVS). Therefore, it was evaluated as short LAD. A long LAD was detected, which was arising from the right coronary sinus with a separate ostium, reached the AIVS at the midventricular level after a pre-pulmonic course in front of the right ventricular outflow tract and extended to the apex. The long LAD was located in front of the right ventricle, close to the anterior chest wall. As there were no signs of myocardial ischemia or injury, calcified lesions in coronary arteries were nonstenotic (excluding thus acute coronary syndrome as cause of chest pain) the medical treatment with antilipidemia and hypertension and atherosclerosis modifying medications has been started and she was discharged with recommendations to continue treatment, modify risk factors for coronary artery disease and follow-up visits were scheduled. Conclusion: Our case demonstrated that rare dual type X LAD can be detected by CCTA in a patient evaluated for chest pain. CCTA is a useful tool for detection of coronary anomalies, that should be sought in patients with chest pain, absence of acute myocardial injury and low Framingham risk score

Next Generation Sequencing Based Multiplex Long-Range PCR for Routine Genotyping of Autoinflammatory Disorders

Background: During the last decade, remarkable progress with massive sequencing has been made in the identification of disease-associated genes for AIDs using next-generation sequencing technologies (NGS). An international group of experts described the ideal genetic screening method which should give information about SNVs, InDels, Copy Number Variations (CNVs), GC rich regions. We aimed to develop and validate a molecular diagnostic method in conjunction with the NGS platform as an inexpensive, extended and uniform coverage and fast screening tool which consists of nine genes known to be associated with various AIDs. Methods: For the validation of basic and expanded panels, long-range multiplex models were setup on healthy samples without any known variations for MEFV, MVK, TNFRSF1A, NLRP3, PSTPIP1, IL1RN, NOD2, NLRP12 and LPIN2 genes. Patients with AIDs who had already known causative variants in these genes were sequenced for analytical validation. As a last step, multiplex models were validated on patients with pre-diagnosis of AIDs. All sequencing steps were performed on the Illumina NGS platform. Validity steps included the selection of related candidate genes, primer design, development of screening methods, validation and verification of the product. The GDPE (Gentera) bioinformatics pipeline was followed. Results: Although there was no nonsynonymous variation in 21 healthy samples, 107 synonymous variant alleles and some intronic and UTR variants were detected. In 10 patients who underwent analytical validation, besides the 11 known nonsynonymous variant alleles, 11 additional nonsynonymous variant alleles and a total of 81 synonymous variants were found. In the clinical validation phase, 46 patients sequenced with multiplex panels, genetic and clinical findings were combined for diagnosis. Conclusion: In this study, we describe the development and validation of an NGS-based multiplex array enabling the “long-amplicon” approach for targeted sequencing of nine genes associated with common AIDs. This screening tool is less expensive and more comprehensive compared to other methods and more informative than traditional sequencing. The proposed panel offers advantages to WES or hybridization probe equivalents in terms of CNV analysis, high sensitivity and uniformity, GC-rich region sequencing, InDel detection and intron covering

Efficacy of the endovascular ovarian vein embolization technique in pelvic venous congestion syndrome

Purpose: Pelvic pain, either related or unrelated to menstruation, is especially common in women of reproductive age. Thirty-nine per cent of all women suffer from chronic pelvic pain at some point in their lives, and pelvic venous congestion syndrome (PVCS) is the cause of this pain in 30% of cases. The aim of this study was to determine factors affecting the success of endovascular venous embolization used in the treatment of PVCS, and to present the longterm treatment results. Material and methods: The data of 144 female patients who underwent endovascular ovarian vein embolization for PVCS between January 2012 and July 2020 were retrospectively analysed. Results: Pain management was determined to be very successful in 37 (25.6%) patients, successful in 55 (38.1%), and unsuccessful in 52 (35.3%). Treatments using a coil alone were significantly more successful in pain management than those involving the use of different materials in addition to the coil (p = 0.036). In addition, patients with unilateral insufficiency before the procedure were found to have more successful pain management than those with bilateral insufficiency (p = 0.041). Reproductive/postmenopausal state and parity did not have a statistically significant effect on treatment efficacy (p = 0.250 and p = 0.573, respectively). Conclusions: Endovascular pelvic venous embolization is an important option in the treatment of PVCS due its less invasive and reproducible nature

Evaluation of e148q and concomitant aa amyloidosis in patients with familial mediterranean fever

The aim of the study was to compare the clinical phenotype of patients with familial Mediterranean fever (FMF)-related AA amyloidosis, according to the age of FMF diagnosis and E148Q genotype. Patients with biopsy-confirmed FMF-related AA amyloidosis were included in the study. Tel-Hashomer criteria were applied in the diagnosis of FMF. All patients had detailed baseline assessment of clinical features, renal functions, genetic testing, histopathological diagnosis of amyloidosis, and treatment received. Multiple comparisons were performed according to the age of diagnosis, disease phenotype, mutation, and mortality. Our study included 169 patients with a diagnosis of AA amyloidosis. There were 101 patients diagnosed with FMF \u3c 18 years of age and 68 patients diagnosed who were ≥18 years of age. The three most common clinical manifestations were fever (84.6%), abdominal pain (71.6%), and arthritis (66.9%). The most common allele among FMF patients was M694V (60.6%), followed by E148Q (21.4%), and M680I (10.3%). The most frequent genotypes were M694V/M694V (45.0%), M694V/E148Q (14.8%), and E148Q/E148Q (11.2%) among 169 patients in our cohort. During the follow-up period, 15 patients (10 male, 5 female) died, of whom 14 had M694V homozygous genotype and one was homozygous for E148Q. Clinicians should be aware of patients with homozygous E148Q genotype for close monitoring and further evaluation. The possible relationship between E148Q and AA amyloidosis needs to be confirmed in other ethnicities

Assessment of Surrogate Markers for Cardiovascular Disease in Familial Mediterranean Fever-Related Amyloidosis Patients Homozygous for M694V Mutation in MEFV Gene

Cardiovascular disease (CVD) remains underestimated in familial Mediterranean fever-associated AA amyloidosis (FMF-AA). We aimed to compare early markers of endothelial dysfunction and atherosclerosis in FMF-AA with a homozygous M694V mutation (Group 1 = 76 patients) in the Mediterranean fever (MEFV) gene and in patients with other genotypes (Group 2 = 93 patients). Measures of increased risk for future CVD events and endothelial dysfunction, including flow-mediated dilatation (FMD), pentraxin-3 (PTX3), and carotid intima-media thickness (cIMT), and fibroblast growth factor 23 (FGF23) as a marker of atherosclerotic vascular disease were compared between groups. The frequency of clinical FMF manifestations did not differ between the two groups apart from arthritis (76.3% in Group 1 and 59.1% in Group 2, p \u3c 0.05). FMD was significantly lower in Group 1 when compared with Group 2 (MD [95% CI]: −0.6 [(−0.89)–(−0.31)]). cIMT, FGF23, and PTX3 levels were higher in Group 1 (cIMT MD [95% CI]: 0.12 [0.08–0.16]; FGF23 MD [95% CI]: 12.8 [5.9–19.6]; PTX3 MD [95% CI]: 13.3 [8.9–17.5]). In patients with FMF-AA, M694V homozygosity is associated with lower FMD values and higher cIMT, FGF23, and PTX3 levels, suggesting increased CVD risk profiles. These data suggest that a genotype–phenotype association exists in terms of endothelial dysfunction and atherosclerosis in patients with FMF-AA

Assessment of Surrogate Markers for Cardiovascular Disease in Familial Mediterranean Fever-Related Amyloidosis Patients Homozygous for M694V Mutation in MEFV Gene

Cardiovascular disease (CVD) remains underestimated in familial Mediterranean fever-associated AA amyloidosis (FMF-AA). We aimed to compare early markers of endothelial dysfunction and atherosclerosis in FMF-AA with a homozygous M694V mutation (Group 1 = 76 patients) in the Mediterranean fever (MEFV) gene and in patients with other genotypes (Group 2 = 93 patients). Measures of increased risk for future CVD events and endothelial dysfunction, including flow-mediated dilatation (FMD), pentraxin-3 (PTX3), and carotid intima-media thickness (cIMT), and fibroblast growth factor 23 (FGF23) as a marker of atherosclerotic vascular disease were compared between groups. The frequency of clinical FMF manifestations did not differ between the two groups apart from arthritis (76.3% in Group 1 and 59.1% in Group 2, p \u3c 0.05). FMD was significantly lower in Group 1 when compared with Group 2 (MD [95% CI]: −0.6 [(−0.89)–(−0.31)]). cIMT, FGF23, and PTX3 levels were higher in Group 1 (cIMT MD [95% CI]: 0.12 [0.08–0.16]; FGF23 MD [95% CI]: 12.8 [5.9–19.6]; PTX3 MD [95% CI]: 13.3 [8.9–17.5]). In patients with FMF-AA, M694V homozygosity is associated with lower FMD values and higher cIMT, FGF23, and PTX3 levels, suggesting increased CVD risk profiles. These data suggest that a genotype–phenotype association exists in terms of endothelial dysfunction and atherosclerosis in patients with FMF-AA

Determination of accuracy level of agricultural spraying application in Sanliurfa/Turkey

When calibration, spraying height, applied pressure, volume rate, nozzle type and application time of equipment used in pesticide applications are incorrect, this causes the amount of agricultural pesticide applied per unit area to be more or less needed. A survey study was carried out on farmers in order to determine whether or not they adjust application pressure of pesticide equipment, nozzle type, volume rate, spraying height and calibration of spraying equipment needed for pesticide application to have values, and also whether or not they carry out agricultural pesticide application in accurate weather conditions such as wind speed, air temperature, relative humidity, temperature and application time. This research was conducted in 2008 by randomly determining 110 agricultural organizations located in villages in the center of Sanliurfa/Turkey and its districts. Survey study was carried out by taking data from pesticide applications processes made on products such as cotton, wheat, barley, lentils and corn which have been intensely produced in the region. It was determined that in general, farmers operated field sprayer at very high pressures in agricultural pesticide application and they did not adjust travel speed of boom sprayer based on the calibration of pesticide application equipment. Moreover, based on data obtained from survey studies, application operators and farmers did not know values of wind speed, temperature and relative humidity required for agricultural pesticide applications.When calibration, spraying height, applied pressure, volume rate, nozzle type and application time ofequipment used in pesticide applications are incorrect, this causes the amount of agricultural pesticideapplied per unit area to be more or less needed. A survey study was carried out on farmers in order todetermine whether or not they adjust application pressure of pesticide equipment, nozzle type, volumerate, spraying height and calibration of spraying equipment needed for pesticide application to havevalues, and also whether or not they carry out agricultural pesticide application in accurate weatherconditions such as wind speed, air temperature, relative humidity, temperature and application time.This research was conducted in 2008 by randomly determining 110 agricultural organizations located invillages in the center of Sanliurfa/Turkey and its districts. Survey study was carried out by taking datafrom pesticide applications processes made on products such as cotton, wheat, barley, lentils and cornwhich have been intensely produced in the region. It was determined that in general, farmers operatedfield sprayer at very high pressures in agricultural pesticide application and they did not adjust travelspeed of boom sprayer based on the calibration of pesticide application equipment. Moreover, basedon data obtained from survey studies, application operators and farmers did not know values of windspeed, temperature and relative humidity required for agricultural pesticide applications