CA 15-3, Ceruloplasmin and tissue polypeptide specific antigen as a tumour marker panel in breast cancer

Background: Tumour markers along with other tests, may be useful in the assessment of the prognosis, monitoring response to treatment and early detection of metastases in breast cancer. The most commonly used breast cancer antigen is CA 15-3.Objective: To examine the value of CA 15-3, ceruloplasmin and tissue polypeptide specific antigen (TPS) panel in the monitoring of breast cancer.Subjects: Serum concentrations of CA 15-3, ceruloplasmin and TPS were measured in 90 women: Fifteen controls, sixteen patients with benign breast disease (BBD), thirty one patients in remission and twenty eight patients with active breast cancer.Results: The results of CA 15-3, ceruloplasmin and TPS estimates were separated into four groups. The patients not in remission were found to have significantly higher levels of CA 15-3 (p0.05). The sensitivities of CA 15-3, ceruloplasmin, and TPS for detecting active breast cancer were 75.0%, 75.0%, and 78.0%, respectively.Conclusion: The highest sensitivity for active breast cancer detection was obtained by the combined use of three tumour markers. We concluded that there may be an advantage in using panels in the follow up of breast cancer patients, although so far such tests have too lowa specificity to be of practical value in screening

SAPHO syndrome with adrenal deficiency: a case report

Introduction: The SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteomyelitis) is a rare painful disorder, usually with a good long-term prognosis. Its etiology remains unclear, and various treatment regimens frequently fail to control the disease. Case presentation: A 46-year-old Caucasian female was referred for anterior chest wall and back pain. Physical examination was unremarkable except for skin lesions noted on soles of both feet, extremities and the face. A thoracic magnetic resonance imaging study demonstrated a lesion characterized with bone marrow edema and proliferation of soft tissue in the sternum. A brain MRI was requested secondary to the elevated prolactin level which was compatible with empty sella syndrome. Conclusion: The case presented here has the unique feature of adrenal deficiency presenting alongside the SAPHO syndrome and is presented as the first case reported. This syndrome could become complicated with different organ system involvement other than bone and skin. There is a need further studies that will explore the weak relationship between SAPHO syndrome and adrenal deficiency. © 2009 Eyigör et al.; licensee Cases Network Ltd

Butterfly Cartilage Tympanoplasty Long-term Results: Excellent Treatment Method in Small and Medium Sized Perforations

Objectives The aim of this study was to evaluate and report the long-term results of the butterfly cartilage tympanoplasty. Short-term and long-term hearing outcomes were compared according to age and perforation location as well. Methods Ninety-three patients who were diagnosed with noncomplicated chronic otitis media and underwent microscopic transcanal butterfly cartilage tympanoplasty due to anterior, posterior, and central tympanic membrane perforation were included. Age, gender, follow-up time, pre- and postoperative pure tone audiometry thresholds (both air and bone conduction), pre- and postoperative air-bone gaps (ABGs), if any residual perforation was noted. Results At the end of the follow-up period, successful closure occurred in 88 of 93 patients and success rate is 94.6%. In all patients, including those with residual perforations, the mean preoperative bone conduction threshold was 15.9 dB (range, 5 to 50 dB) among all groups whereas mean air conduction threshold was 36.4±15.1 dB (range, 10 to 90 dB) preoperatively and 28.8±14.3 dB in 6th month follow-up and 24.9±14.1 dB 24th month follow-up. Preoperative mean ABG was 22.1±7.1 dB (range, 5 to 40 dB) whereas 13.3±5.9 dB 6 months after surgery and 11.9±5.5 dB 24 months after surgery. There was a significant difference between pre- and postoperative ABG in both 6th and 24th month follow-up (P6 mo-24 mo<0.05). Furthermore, preoperative mean air conduction differed significantly from postoperative 6th and 24th month follow-up mean air conduction thresholds (P<0.05). Conclusion We suggested that butterfly cartilage tympanoplasty can be safely performed in small, moderate, and even large perforations, as the hearing outcomes and successful closure rate are similar to those of other surgical methods. Moreover, it can be performed under local anaesthesia and it has low complication rates

Clopidogrel-induced Spontaneous Spinal Epidural Hematoma

The hemorrhagic side effects associated with the use of clopidogrel are within the acceptable range and occur mainly at skin or gastrointestinal sites. We report a case of spontaneous spinal epidural hematoma (SSEH) in a 60-yr-old woman who was treated with clopidogrel for frequent transient ischemic attacks. To our knowledge, this is the second reported case of clopidogrel-induced SSEH. The patient's symptoms and past history of clopidogrel use suggested the diagnosis and made the procedure proceed quickly to operate SSEH 9 hr after the onset of paraplegia. The outcome was excellent. Therefore, with the popularity of antiplatelet prescription, physicians should keep in mind and urgently treat this unusual but critical side effect

The Effect of Hypermobility on Pain and Quality of Life in Young Adults

Objective:Hypermobility is the excessive range of motion of joints, and related to various musculoskeletal and extra-articular problems that may significantly impair quality of life (QoL) by causing pain. The aim of the study is to examine the prevalence of hypermobility in young adults, and its relationship with pain in various regions of body and QoL.Methods:Two hundred and twenty five volunteers, aged between 17 and 23, were classified as subjects-with-hypermobility or subjects-without-hypermobility according to the Beighton Criteria. Chronic pain was identified by using Nordic Pain Questionnaire, QoL was identified by Short Form-36 (SF-36) Questionnaire. Pain presence in 9 body regions and SF-36 scores were compared between groups using chi-square test and Independent Samples T-test, respectively.Results:Of the participants, 164 (64%) were female, 91 (36%) were male, 119 (46.7%) had hypermobility. Upper back was the body region with the highest pain prevalence where 79% of hypermobile and 74% of non-hypermobile subjects reported pain at least once in past 12 months. Pain prevalence in body regions did not differ between groups (p>0.05). In terms of QoL, physical and mental component scores of SF-36, as well as all subgroup scores except social function were significantly lower in hypermobile subjects (p<0.05).Conclusion:Pain prevalence in different body regions did not differ between subjects with and without hypermobility whereas the QoL was significantly impaired in hypermobile subjects. Hypermobility is a substantial anatomical finding in young adults that should not be disregarded. Education, emotional support and encouraging about strengthening and proprioception exercises may contribute to their quality of life

Changes in Islamic Hermeneutics and Social Evolution: A Comparative Study of Turkey and Algeria

In comparing the evolution of the current struggle between religious challengers and the ruling class in Algeria and Turkey, this paper examines why and how Algerians became involved in a civil war which has continued almost six years, and why Turkey was not like Algeria. In order to carry out this investigation, the following research questions are developed: What key factors favored or discouraged the use of violence in both countries? Since religion in and of itself does not lead to intolerance, what are the key factors that nourished the deviant interpretation? What is the impact of the sociopolitical cultural heritage of each country regarding violence and how people behave and act in a conflict? And what is the Islamic perception on extremism, violence, and terrorism? In the light of available evidence, the research deals with the reinterpretation of traditional Islamic concepts such as jahiliyyah, takfir, jihad, and separation that are the key terms in the explanation of the different responses given by the Islamic groups and movements in Algeria and Turkey. The findings show that the internal political conflict in both countries was the outcome of different re- interpretations and understandings of these concepts. In the reinterpretation of these concepts and in the response to secular repression, the sociopolitical cultural background of each country also has a considerable impact. The paper also analyzes the Islamic perceptions on the extremism, violence and terrorism at this time. In the conclusion, the paper points out some possible considerations for policy makers

Evaluation of high frequency horizontal VOR parameters in patients with chronic bilateral and unilateral peripheral vestibulopathy: a preliminary study

WOS: 000564115400001PubMed: 32862738Background Caloric test is one of the tests which evaluates the low frequency component of vestibular system for both diagnosis of the BPV and UPV. Aims the main objectives are to determine and increase the diagnostic value of BPV and UPV by evaluating the high frequency horizontal VOR parameters with HIMP, SHIMP and fHIT, to compare test results with healthy controls, and to evaluate correlation of these tests with vertigo dizziness imbalance (VDI) questionnaire results in these patients. Material and methods Six patients with BPV, ten patients with UPV and fifteen healthy controls were recruited. High frequency hVOR were evaluated with HIMP, SHIMP and fHIT. Vestibular symptoms and quality of life were assessed with VDI Questionnaire. Results Lower percentage of correct answers, and lower VOR gains were obtained in affected sides for BPV and UPV. HIMP elicited compensatory saccades in patients, whereas SHIMP elicited large anticompensatory saccades in controls and unaffected side of UPV, but no saccades in BPV. No correlation was found between VDI outcomes and all tests. Conclusions the results show that all tests are complementary each other and able to identify the affected labyrinth and to show residual vestibular function. These tests are thought to be important in the vestibular rehabilitation process

A Variation of the Cords of the Brachial Plexus on the Right and a Communication between the Musculocutaneous and Median Nerves on the Left Upper Limb: A Unique Case

During routine anatomical dissection of the upper extremity of a 64-year-old cadaver for educational purposes, we observed variations in the brachial plexus on each side. On the right an anomaly of cord formation was present and on the left there was a communication between the musculocutaneous nerve (MCN) and median nerve (MN). On the right side the brachial plexus showed two trunks, superior (C5 and C6) and inferior (C7, C8, and T1); the middle trunk was absent. The superior trunk bifurcated into anterior and posterior divisions, the anterior division continued as the lateral cord forming the MCN. The posterior division gave off the subscapular branch. The inferior trunk trifurcated into radial, median, and ulnar nerves. The radial nerve gave off the axillary and thoracodorsal nerves. The ulnar nerve gave off the median cutaneous nerves of the arm and forearm. The median nerve received a small ascending branch from the MCN. On the right side, there was a communicating branch from the MCN to the MN in the lower third of the arm region. This communicating branch also gave rise to a muscular branch to the brachialis muscle and the lateral cutaneous nerve of forearm. No additional heads of the biceps brachii muscle were observed in either upper limb. Knowledge of the variations of the brachial plexus in humans can be valuable for operations of the shoulder joint and its repair for providing an effective block or treatment for anesthetists and also for explaining otherwise incomprehensible clinical signs for neurologists