Comparison of 18F FDG PET / CT, MRI (DWI + DCE) and MRI + 18F FDG PET/CT in the detection of axillary metastatic lymph nodes in patients with newly diagnosed breast cancer

Aim: We visually and quantitatively investigated the success of using 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) [Dynamic contrast enhancement (DCE) and diffusion weighted imaging (DWI)] separately and together in detecting axillary lymph node metastasis in patients with newly diagnosed breast cancer. Methods: One hundred and thirteen patients who underwent 18F FDG PET/CT were evaluated, 102 patients of these patients had also MRI (DEC + DWI). Primary tumour size (Tsize), SUVmax of primary tumour (SUVmaxT), short diameter of largest axillary lymph node on PET/CT (LnDPET/CT), SUVmax of axillary lymph node (SUVmaxLn), metabolic tumour volume of the primary tumour (MTV), short diameter of largest axillary lymph node on MRI (LnDMRI), the presence of fatty hilum absence and apparent diffusion coefficient (ADC) were evaluated. Results: In visual analysis, sensitivity and specificity values of 18F FDG PET/CT, MRI and MRI+18F FDG PET/CT were 78.85, 94% – 72.27%, 96.15 – 83.87%, 98.04%, respectively. In the quantitative evaluation, ADC≤1.2 x 10-3 mm2/sec (OR = 6.665, p = 0.001, 95CI%: 2.181–20.370) and LnSUVmax> 2 (OR = 15.2, p<0.001, 95CI%: 4.587–50.376) were independent predictors in detecting axillary lymph node metastasis. Conclusion: LnSUVmax >2 and ADC ≤ 1.2 x 10-3 mm2/sec can be used as independent predictors of detecting axillary lymph node metastasis in patients with newly diagnosed breast cancer. t predictors in detecting axillary lymph node metastasis in patients with newly diagnosed breast cancer

The role of diffusion-weighted imaging on 3 tesla magnetic resonance in the clinical staging and pathological grading of clear cell renal carcinoma

Aim: To evaluate the contribution of the apparent diffusion coefficient (ADC) to distinguish between the four clinical stages and pathological grading in patients with clear cell renal cell carcinoma (RCC) on 3T MRI. Methods: MRI of 93 patients with histopathological diagnosis of clear cell RCC were evaluated retrospectively. Clinical stage was evaluated according to American Joint Committee on Cancer and histopathological examination was evaluated according to the Fuhrman grading system. ADC values were compared for each clinical stage and pathological grade. Results: Clinical stages were I in 51 patients (54.8%), II in 14 patients (15%), III in 15 patients (16.1%), and IV in 13 patients (13.9%). The Fuhrman grade of the patients were I in 8 (8.6%) patients, II in 55 (59.1%) patients, III in 23 (24.7%) patients and IV in 7 (7.5%) patients. Clinical stage I and Fuhrman grade I had significantly higher ADC values than all groups (p<0.001). The sensitivity was 81% and the specificity was 80.4% when the optimum cut-off value of ADC was taken as 1.41×10−3 mm2/s to differentiate between clinical stage I and other stages (II, III, and IV) (AUC:0.910; 95CI:0.855-0.964; p<0.001).  The optimum cutoff value of ADC was taken as 1.67×10−3 mm2/s to differentiate between Fuhrman grade I and other grades (II, III and IV), the sensitivity was 88.2% and the specificity was 100% (AUC: 0.927; 95CI: 0.872- 0.983; p<0.001). Conclusions: In patients with renal mass suggestive of clear cell RCC in imaging studies; The possibility of lymph node or distant metastatic lesion should be considered in patients with an ADC of the primary tumor site less than 1.41×10−3 mm2/s, and the presence of distant metastasis in patients with an ADC less than 1.22×10−3 mm2/s

The relationship of serum asymmetric dimethylarginine concentrations and lung involvement in patients with COVID-19 infection

Aim: COVID-19 infections the tissue through angiotensin converting enzyme 2 receptor, which is also expressed on endothelial cells. Endothelial dysfunction may be associated with lung involvement. Asymmetric dimethylarginine (ADMA) is an indirect marker of endothelial dysfunction. The aim of our study was to evaluate ADMA concentrations and to identify its association with lung involvement in patients with COVID-19 disease. Methods: We included 42 patients with COVID-19 infection and lung involvement (Group 1). Forty-two age and sex matched patients without pneumonia acted as the control group (Group 2). All patients gave blood samples for ADMA at the 1st month control visit after discharge. We compared C-reactive protein (CRP) and ADMA concentrations in addition to routine biochemical parameters between groups. Results: Patients with lung involvement had higher admission glucose, CRP, and ADMA concentrations, and displayed lower hemoglobin concentration and lymphocyte count compared to patients without lung involvement. Although patients with lung involvement had higher ADMA concentrations with respect to those without; plasma ADMA levels were also higher than normal values in control group. Multivariate analysis identified log CRP concentration (OR= 3.047, 95% CI=1.881-5.023, p<0.001) as the independent predictor for lung involvement. And, there was a correlation between ADMA and CRP (r: 0.318, p: 0.003). Conclusion: We revealed elevated ADMA concentrations as the surrogate of endothelial dysfunction in COVID-19 patients whether they have pneumonia or not

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Comparison of groundwater recharge estimation techniques: a case study from the Kucuk Menderes River basin in Turkey

Quantification of groundwater recharge is a basic prerequisite for efficient groundwater management. While there are several approaches to estimating groundwater recharge rates, some of the approaches proposed cannot be applied in basin-wide hydrogeological investigations due to a lack of data. Thus, some conventional recharge estimation techniques for which data are most often available have to be used in estimating groundwater recharge. In this study, water level fluctuation, the precipitation vs water level relation, and hydrological budget methods, are used to estimate recharge rates in the Kucuk Menderes River basin in Turkey. The recharge values obtained from these methods are compared and found that while some of them agree with each other, some vary at least in order of magnitude

Effect of polymerization cycles on flexural strengths and microhardness of different denture base materials

Gundogdu, Mustafa/0000-0003-2527-0392WOS: 000402590800007PubMed: 28090030The purpose of this study was to evaluate the effect of.different polymerization cycles on the flexural strengths and microhardness of two denture base materials (Meliodent and Paladent). Heat-polymerized acrylic resin specimens (65.0 mm longx10.0 mm widex2.5 mm in height) were prepared using different short and long polymerization cycles. After the specimens had been polymerized, they were stored in distilled water at 37 +/- 1 degrees C for 24 h. Flexural strength test was performed at a cross-head speed of 5 mm/min and Vickers microhardness was measured. Data were analyzed with a 1-way analysis of variance followed by Tukey test, and Student t-test (alpha=0.05). the flexural strengths and microhardness were significantly different between Meliodent and Paladent (p<0.05). Significant differences were found among the polymerization cycles in terms of flexural strengths and microhardness (p<0.05). Polymerization with G cycle may be suggested for Meliodent and H cycle may be suggested for Paladent.Scientific Research Projects (Atatiirk University) [2012/70]Supported by the 2012/70 numbered project of Scientific Research Projects (Atatiirk University)

Von Hippel Lindau disease with metastatic pancreatic neuroendocrine tumor causing ectopic Cushing's syndrome

We present a 39-year-old woman who was previously diagnosed with Von Hippel Lindau Disease (VHLD). She had surgery and radiotherapy for cranial hemangioblastoma (HA) 11 years ago and had unilateral adrenalectomy for pheochromocytoma in another hospital 6 month prior to her admission to our center. Moon face, buffalo hump, central obesity, progressive weight gain and menstrual irregularities persisted after adrenalectomy. Her laboratory results were consistent with ectopic Cushing's syndrome (ECS). A pancreatic solid mass with a nodule on the left lung were revealed upon computed tomography. In addition, Gallium-68 Somatostatin Receptor PET confirmed the pancreatic involvement and demonstrated additional lesions on the left lung and in the aortocaval lymphatic system on the right side, suggesting metastatic pancreatic neuroendocrine tumor (PNET). Peptide receptor radionuclide therapy (PRRT) with [(177)Lutetium-DOTA(0), Tyr(3)] octreotate was performed on the patient, with no side effects observed. She was discharged from the hospital 10 days after the first cycle

Exogenous Nitric Oxide and Silicon Applications Alleviate Water Stress in Apricots

Many plants confront several environmental stresses including heat, water stress, drought, salinity and high-metal concentrations that are crucial in defining plant productivity at different stages of their life cycle. Nitric oxide (NO) and Silicon (Si) are very effective molecules related in most of them and in varied biochemical events that have proven to be protective during cellular injury caused by some stress conditions like water stress. In the current work, we studied the effect of Si and NO alone and NO + Si interactive application on the response of plants exposed to water deficiency and well-watered plants for the Milord apricot variety. Water stress caused a reduce in chlorophyll content, dry and fresh weight, leaf area, stomatal conductivity, leaf relative water content and nutrient elements, while it caused an increase in leaf temperature, leaf proline, leaf malondialdehyde (MDA) content and membrane permeability. Si, NO and Si + NO combination treatments under water stress conditions significantly decreased the adverse effects of water stress on leaf temperature, leaf area, dry and fresh weight, stomata conductivity, relative water content, membrane permeability, L-proline and MDA content. The shoot dry weight, chlorophyll content, stomata conductivity and leaf relative water content in Si + NO treated apricot saplings increased by 59%, 55%, 12% and 8%, respectively. Combined treatment (Si + NO) was detected to be more effective than single applications (Si or NO) on some physiological, biochemical, morphological and nutritional properties of apricot under water stress conditions

Do Volume-Based and Metabolic 18F FDG PET/CT Parameters Identify Groups at Risk for Poor Prognosis in Patients with Newly Diagnosed Metastatic and Non-Metastatic Non-Small Cell Lung Cancer?

WOS: 000574549000007To determine the relationship between F-18 FDG PET/CT parameters of the primary tumor/nodal metastasis/distant metastasis and overall survival (OS) of patients with newly diagnosed non-small cell lung cancer (NSCLC). Data from 159 patients with newly diag-nosed NSCLC who underwent pretreatment 18F FDG PET/CT were analyzed. the SUVmax, SUVmean, the metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor, lymph node metastasis, and distant metastasis were measured. the total MTV and total TLG were calculated. the optimal cut-off values of the F-18 FDG PET/CT parameters were determined using receiver operating characteristics curve analysis. Kaplan-Meier curves were used to determine OS. There were a total of 101 deaths during the follow-up (range, 3.7-54.2 months). the median OS was 26.4 months for the entire group, 11.8 months for patients with metas-tasis, and 41 months for patients with no metastasis (p= 328 and TLG < 328 were 32% and 80%, respectively. Independent predictors for OS were found as SUVmaxN in the group of patients with distant metastasis, and SUVmax, MTV of the primary tumor (MTVT), and lymph node size (LNsize) in the group of patients without distant metastasis. F-18 FDG PET/CT may distinguish patients with high risk for poor prognosis in patients with and without metastasis