Relevance of additional immunohistochemical markers in the differential diagnosis of small B-Cell lymphomas: a case-Control study

Clinical and pathological differential diagnosis of small B-cell lymphomas (SBCLs) is still controversial and may be difficult due to their overlapping morphology, phenotype, and differentiation to plasma cells. We aimed to examine the expression of the immune receptor translocation-associated protein 1 (IRTA1), myeloid cell nuclear differentiation antigen (MNDA), lymphoid enhancer-binding factor-1 (LEF1), and stathmin 1 (STMN1) markers in SBCL cases involving different sites that may have plasma cell differentiation. Materials and Methods: We studied 154 tissue samples with lymphoma involvement from 116 patients and evaluated the staining distribution of the markers. Expressions were evaluated in 21 chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), 7 follicular lymphoma (FL), 14 nodal marginal zone lymphoma, 17 extranodal marginal zone lymphoma, 55 splenic marginal zone lymphoma, 22 marginal zone lymphoma-not otherwise specified, and 18 lymphoplasmacytic lymphoma/Waldenström macroglobulinemia cases by immunohistochemistry. Results: The results confirmed that LEF1 was the most sensitive and specific marker for CLL/SLL and STMN1 was the most sensitive and specific marker for FL (p<0.001). MNDA and IRTA1 were useful markers to distinguish marginal zone lymphomas. Conclusion: Our results suggest that LEF1 for CLL/SLL and STMN1 for FL are reliable markers. LEF1, MNDA, STMN1, and IRTA1 are helpful with other routinely used immunohistochemical markers in a diagnostic algorithm considering their limitations

Scheduling surgery after transarterial embolization: does timing make any difference to intraoperative blood loss for renal cell carcinoma bone metastases?

PURPOSEOur purpose is to clarify the optimal timing of surgery after transarterial embolization (TAE) for renal cell carcinoma (RCC) bone metastases.METHODSThis retrospective study included 41 patients with RCC bone metastases embolized between 2013 and 2019. Different-sized particulate and/or liquid embolic agents were used for TAE. Embolizations were categorized into groups 1–3 according to the interval between TAE and surgery (group 1: 3 days). Degree of embolization after TAE was graded visually based on angiographic images (90%). The relationship between the TAE–surgery interval and intraoperative blood loss (IBL) and the correlation between IBL and embolization grade were examined. Lesion sizes and the relationships among lesion localizations and contrast media usage, intervention time, and IBL were also analyzed.RESULTSForty-six pre-operative TAEs (single lesion at each session) were performed in this study (26 in group 1, 13 in group 2, 7 in group 3). Lesion sizes and distributions were similar between groups (p = 0.897); >75% devascularization was achieved in 40 (TAEs 86.96%), but the IBL showed no correlation with the embolization rate (r=0.032, p = 0.831). The TAE–surgery interval was 1–7 days. The median IBL in group 1 (750 mL; range, 150–3000 mL) was significantly lower than those in the other groups (p = 0.002). Contrast media usage (p = 0.482) and intervention times (p = 0.261) were similar for metastases at different localizations. IBL values after TAE were lower for extremity metastases (p = 0.003).CONCLUSIONBone metastases of RCC are well-vascularized, and to achieve lowest IBL values, surgery should preferably be performed <1 day after TAE

A Real-Life Turkish Experience of Ruxolitinib in Polycythemia Vera

Introduction:Ruxolitinib is a small -molecule inhibitor of the JAK1/2 pathway. This study aimed to reveal the results and side-effect profile of the use of ruxolitinib as a treatment option in polycythemia vera (PV).Methods:A total of 34 patients with PV from 18 different centers were included in the study. The evaluation of the response under treatment with ruxolitinib was determined as a reduction in spleen volume (splenomegaly size: ≥35%) by imaging and control of hematocrit levels (≤45%) compared to baseline.Results:While the number of patients in which a reduction in spleen volume and hematocrit control was achieved was 19 (55.9%) at 3 months of treatment, it was 21 (61.8%) at 6 months. Additionally, while the number of side effects was negatively correlated with the reduction in spleen volume (Spearman’s rho: -0.365, p=0.034), a decrease in the hematocrit level was positively correlated (Spearman’s rho: 0.75, p=0.029). Those without a reduction in spleen volume experienced more constipation (chi-square: 5.988, Fisher’s exact test: p=0.033).Conclusion:This study shed light on the use of ruxolitinib in PV and the importance of splenomegaly on studies planned with larger patient groups

Clinical and laboratory features of adult celiac patients who were consulted to Uludag University gastroenterology polyclinic at last 5 years

Bu retrospektif çalışmada 49 çölyak hastasının dosyaları taranmıştır. Hastaların başvuru anındaki yaşları, cinsiyetleri, şikayetleri, komorbit durumları, laboratuvar parametreleri, serolojileri, kemik mineral dansiteleri ve histopatolojik bulguları incelenmiştir. Yaş ortalaması 39 yıldır. Kadın/Erkek oranı 3,2dir. Hastaların şikayetleri incelendiğinde en sık diyare (%55), kilo kaybı (%44) ve İBS (irritabl barsak sendromu) benzeri semptomlar (%32) ile başvurduğu görülmüştür. Hastaların %11 inin başvuru anında herhangi bir şikayeti olmamıştır. 2 hastada kriptojenik karaciğer sirozu, 1 hastada konjenital hepatik fibroz, 1 hastada sarkoidoz, 1 hastada psöriazis ve ailevi akdeniz ateşi birlikteliği mevcuttur. Hastaların başvuru anında %79unda anemi mevcuttur (n=37). Hastaların %82sinde demir eksikliği mevcuttur (n=36). Hastaların %84ünde vitamin D eksikliği mevcuttur (n=16). Hastaların %44ünde osteopeni (n=7), %44ünde osteoporoz (n=7) mevcuttur. Hastaların glutensiz diyet öncesi çalışılan serolojik testleri taranmıştır. Hastaların %83ünde Ig A AGA (anti gliadin antikoru) pozitiftir (n=34). Hastaların %95inde Ig G AGA pozitiftir (n=38). Hastaların %70inde Ig A EMA (anti endomisyum antikoru) pozitiftir (n=28). Hastaların %32,5inde Ig G EMA pozitiftir (n=13). Hastaların %85inde Ig A tTG(doku transglutaminazı) pozitif saptanmıştır (n=11). Hastaların %30unda Ig G tTG pozitif saptanmıştır (n=4). Hastaların hepsinde HLA DQ2 pozitiftir. Hastaların patoloji raporları taranmıştır. Alınan biyopsi sayılarının ortancası 4?tür. Hastaların %87,8inde Marsh evre 3 tutulum mevcuttur. Yaklaşık %1 oranında görülen çölyak hastalığı ile ilgili Türkiyede erişkin hasta grubunda yapılan yayın sayısı oldukça azdır. Bu çalışma ile erişkin hastalarda çölyak hastalığının ne kadar geniş spektrumda klinik tablolarla karşımıza çıkabildiği göstermek istedik.In this retrospective study, we investigated 49 celiac patients files. At presentation patients age, sex, symptoms, comorbid conditions, laboratory parameters, serology, bone mineral density, and histopathologic findings were examined. The average age was 39 years. Female/male ratio was 3.2 . When we observed patients presenting symptoms, the most frequent symptoms were diarrhea (55%), weight loss (44%) and IBS (irritable bowel syndrome) like symptoms (32%). 11% of the patients did not have any symptoms at all. Two patients had cryptogenic liver cirrhosis, one patient had congenital hepatic fibrosis, one patient had sarcoidosis, and one patient had both psoriasis and Familial Mediterranean Fever. At presentation there were anemia in 79% (n=37), vitamin D deficiency in 84% (n=16), osteopenia in 44% (n=7), and osteoporosis in 44% (n=7) of the patients. Patients serological parameters studied before gluten free diet were investigated. 83% of the patients was positive for IgA AGA (anti gliadin antibody) (n=34), 95% was positive for IgG AGA (n=38), 70% was positive for IgA EMA (Endomysial Antibody) (n=28), 32,5% was positive for IgG EMA (n=13), 85% was positive for IgA tTG (Tissue Transglutaminase Antibodies) (n=11), and 30% was positive for IgG tTG (n=4). HLA-DQ2 was positive in all patients. Histopathologic findings were investigated. There was Marsh stage 3 involvement in 87.8% of the patients. Celiac disease prevalence is aproximately 1% and there is very few data about adult celiac disease in Turkey. The aim of this study is to describe clinical and laboratory properties of adult celiac disease. Key words: celiac disease, clinical presentation

Plazma arkı ile kesilmiş parçalarda yüzey kalitesine etki eden faktörlerin araştırılamsı

TEZ2727Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 1997.Kaynakça (s. 53-55) var.vi, 59 s. : rnk. res. ; 30 cm.…Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi Tarafından Desteklenmiştir. Proje No: FBE. 96/ YL. 126

Results of `Two Above- One Below Approach' with Intermediate Screws at the Fracture Site in the Surgical Treatment of Thoracolumbar Burst Fractures

The aim of this retrospective clinical study was to evaluate and compare the results of the technique so called ‘two above one below approach’ with intermediate screws at the fracture site with long-segment posterior fusion in the surgical treatment of thoracolumbar burst fractures. For this purpose neurologically intact 27 patients having isolated one level thoracolumbar burst fracture underwent posterior instrumentation and fusion in our clinic via ‘two above-one below approach’ with intermediate screws at the fracture site. A control group consisting of 15 patients having one level thoracolumbar burst fracture treated with long segment posterior spinal fusion in our institute was formed. At the preoperative, postoperative and final follow up period, anterior body height loss, local kyphosis and sagittal index values of both groups were noted. At the final follow up Visual Analogue Pain Scale and Oswestry disability scores were noted. Retrospective data from both groups underwent statistical analysis. In both groups anterior body height loss, local kyphosis and sagittal index measurements improved at the final follow-up, but there was no significance between two groups in terms of radiological and clinical follow-up data. The loss of correction in local kyphosis of short-segment group in the interval between postoperative and follow-up period was also significant. No implant failure was noted. As a conclusion 'two above one below approach’ with intermediate screws at the fracture site is associated with loss of correction radiographically, but favorable clinical outcomes in the presence of any implant failure can be achieved in the treatment of thoracolumbar burst fractures

A remarkably long remission achieved with ibrutinib monotherapy in a patient who was diagnosed with steroid refractory sclerosing chronic GVHD

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Energy-based Design of Steel Structures According to the Predefined Interstory Drift Ratio

The methods which take place in current building codes and used in seismic design of structures are generally linear elastic. Inelastic behavior of the structures under the effect of earthquake is considered indirectly in seismic design codes. Recent studies enable inelastic behavior of structures to be taken into account properly in the structural design. In this study, a calculation method oriented towards the design of new structures which fulfill the predefined interstory drift ratio according to the usage function of the structures was offered by considering the inelastic behavior of the structural members and by using the energy balance of the structures. Interstory drift ratios when the steel structure displacements reach the target displacements were compared with the initial interstory drift ratios and the results were interpreted

Determination of earthquake safety of RC frame structures using an energy-based approach

An energy-based approach for determining earthquake safety of reinforced concrete frame structures is presented. The developed approach is based on comparison of plastic energy capacities of the structures with plastic energy demands obtained for selected earthquake records. Plastic energy capacities of the selected reinforced concrete frames are determined graphically by analyzing plastic hinge regions with the developed equations. Seven earthquake records are chosen to perform the nonlinear time history analyses. Earthquake plastic energy demands are determined from nonlinear time history analyses and hysteretic behavior of earthquakes is converted to monotonic behavior by using nonlinear moment-rotation relations of plastic hinges and plastic axial deformations in columns. Earthquake safety of selected reinforced concrete frames is assessed by using plastic energy capacity graphs and earthquake plastic energy demands. The plastic energy dissipation capacities of the frame structures are examined whether these capacities can withstand the plastic energy demands for selected earthquakes or not. The displacements correspond to the mean plastic energy demands are obtained quite close to the displacements determined by using the procedures given in different seismic design codes