The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement

Zona zoster is rarely observed in patients with malignancy; when present, it follows a dermatomal fashion. Involvement of widely separated regions is very rare. Hereby, zona zoster causing enlarged intramammary lymph nodes (IMLN) in the opposite breast is reported for the first time in literature. The masses were hypoechoic on US with no hilum and hypervascular on color Doppler US. MRI showed hypointense masses with type 3 time-intensity curve and adjacent vessel sign. The complete regression of the nodes after the antiviral therapy confirmed the diagnosis. In breast cancer patients, IMLN enlargements may mimic breast cancer metastasis, and zona zoster infection of the mastectomy site may present with contralateral IMLN enlargement due to altered lymphatic drainage. When breast US is not sufficient for the differential diagnosis, breast MRI may warrant proper diagnosis, and prevent unnecessary biopsies. Antiviral treatment with followup would be sufficient for management

Evaluation of Trace Element Levels and Antioxidant Metabolism in Cattle with Cutaneous Papillomatosis

Background: Cutaneous papillomas are benign proliferative neoplasms. The aetiology and pathogenesis of the disease are very complex. Papillomatosis lesions can be detected anywhere on the body, frequently appearing on the surface of the head, neck, teats, udder, external genital mucosa and upper part of the gastrointestinal tract. The disease is not life threatening but due to loss of productivity, owners often cull animals with papillomatosis. The relationships between trace elements, heavy metals and cancer are still researching. The aim of this study was the evaluation of the relationships between trace elements and antioxidant metabolism, and cutaneous papillomatosis, in cattle.Materials, Methods & Results: Eleven cattle with cutaneous papillomatosis and 10 healthy cattle constituted the study group and control group, respectively. Clinical examinations were performed on all animals. Blood samples were collected and Cr, Cu, Fe, Mg, Mn, Se, Zn, As, B, Ni, Si and Co levels were determined. The analyses were conducted with an inductively coupled plasma-optical emission spectrophotometer. In addition, catalase (CAT), glutathione (GSH), malondialdehyde (MDA) and ceruloplasmin (Cp) concentrations were measured. The Ni, Si and MDA levels of the study group were significantly higher than those of the control group (P < 0.05) but the Se levels of the study group were significantly lower than in the control group (P < 0.05). The normality of the data was determined with the Shapiro-Wilk Test and the Independent Samples t-Test or Mann-Whitney U test was used for statistical comparison of the groups.Discussion: Trace elements are essential components of biological systems. The levels of trace elements, such as Cu, Co, I, Se, Zn and Mn, which are affected by grazing activity, influence ruminants’ reproductive performance and other production parameters. The elements Al, As, Cr, Ni and Sn are also presumed to be essential for ruminant metabolism, although sufficient research data are not available. In the present study, Cr, Cu, Fe, Mg, Mn, Zn, As, B and Co levels were not significantly different between the papilloma and control groups. Se is an important trace element for skin health. This study revealed a mean serum Se level in animals with papillomatosis that was significantly lower than in the healthy group. Although the mode of anticancer activity of Se is not clear, some factors, such as antioxidant protection, improved immune system surveillance, carcinogen detoxification, modulation of cell proliferation and inhibition of tumour cell invasion and angiogenesis, are important. Ni is classified as a toxic heavy metal. In addition, it could be carcinogenic to humans. Ni level was two times higher in the papillomatosis group than in the healthy animals, in the present study. This result may indicate that Ni has a role in the genesis of papillomatosis in cattle. Si injection can cause inflammation, granulomas and cancer. There are few reports about Si levels in animals and the significant difference in the Si levels in cattle with cutaneous papillomatosis reported in this study may be a new indicator for the disease. The skin contains antioxidant molecules that include GSH, alpha-tocopherol or vitamin E, ascorbic acid or vitamin C, glutathione peroxidases, glutathione reductase, glutathione S-transferases (GSTs), superoxide dismutases (SODs), CAT and quinine reductase. There is strong interaction between ROS and/or their oxidant products and antioxidant molecules in the skin. In this study, although MDA levels were higher in the study group than in the control group, there was no significant difference between the groups in their CAT levels, and also in the GSH and CP levels. In conclusion, these results may evidence the systemic effects of papillomatosis on trace element levels and on oxidant metabolism in cattle

A New Approach to Blood Parameters in Dogs with Hemorrhagic Enteritis

Background: Some blood parameters have diagnostic and prognostic importance for the infections in human medicine. However, there is insufficient research regarding the importance of blood parameters and their correlations in veterinary medicine. Increased blood cell distribution width (RDW) and platelet activity can link with the important inflammatory markers. The main objective of the present study was the evaluation of the relationship among some important blood parameters namely RDW, platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT), their potential usage in the diagnosis and determination of the clinical severity in dogs with hemorrhagic enteritis.Materials, Methods & Results: In this study, the case records of 29 dogs with hemorrhagic enteritis were evaluated and the records of 10 healthy dogs were used as controls. The animals of the study group were presented at the Ondokuz Mayis University, Veterinary Internal Medicine Clinic. The complete blood count (CBC), which includes the total WBC, RBC, hematocrit (HCT), hemoglobin concentration (Hgb), MCV, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RDW, PLT, MPV, PCT, and PDW, was determined. Significant positive correlations between RDW and RBC, HCT, MCHC, PLT and PDW, and a negative correlation with MCV, were determined. PDW was positively correlated with the lymphocyte count, MCHC and RDW, and negatively correlated with PCT. PLT was negatively correlated with MCV and MPV and positively correlated with RBC and RDW. In addition, MPV was positively correlated with MCV and MCH, and negatively correlated with PLT. Furthermore, there were significant differences between the granulocyte, WBC, HCT, RDW and PDW values (P < 0.001) and monocyte count, Hgb and MCV (P < 0.05), of the study and control groups.Discussion: Acute hemorrhagic enteritis has various causes in dogs such as idiopathic hemorrhagic gastroenteritis and a number of viral, bacterial and parasitic agents. Hematological and biochemical parameters are not specific to enteric diseases, but these paremeters can provide clinically helpful information for differential diagnosis, response to treatment, and prognosis. In this frame, the evaluation of MCV and RDW in combination, and the determination of the mean red cell size and the extent of heterogeneity of the red cell population, can be especially useful to the diagnosis of different red blood cell disorders. In the present study, differences in RDW and MCV values were statistically significant between the study and control groups (P < 0.05). Increased RDW and decreased MCV can be good indicators of hemorragic diseases and in the present study, in addition to these findings, decreased Hgb and Hct confirmed anemia in dogs with hemorrhagic enteritis. The other key findings of this study were statistically significant relationships between RDW, PLT and PDW, which could be important indicators of inflammation in dogs with hemorrhagic enteritis. These parameters should be evaluated carefully in clinical cases of hemorrhagic enteritis. However, due to nature of retrospective studies, there were some limitations (the lack of another control group of dogs suffering from other hemorrhagic diseases) lack of serial measurements of the blood parameters and further studies should be carried out on dogs with hemorrhagic enteritis for a more detailed evaluation and confirmation of the findings of this study

Screening and diagnostic breast MRI:how do they impact surgical treatment? Insights from the MIPA study

Objectives: To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes. Methods: The MIPA observational study enrolled women aged 18-80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis. Results: A total of 5828 patients entered analysis, 2763 (47.4%) did not undergo MRI (noMRI subgroup) and 3065 underwent MRI (52.6%); of the latter, 2441/3065 (79.7%) underwent MRI with preoperative intent (P-MRI subgroup), 510/3065 (16.6%) D-MRI, and 114/3065 S-MRI (3.7%). The reoperation rate was 10.5% for S-MRI, 8.2% for D-MRI, and 8.5% for P-MRI, while it was 11.7% for noMRI (p&nbsp;≤&nbsp;0.023 for comparisons with D-MRI and P-MRI). The overall mastectomy rate (first-line mastectomy plus conversions from conserving surgery to mastectomy) was 39.5% for S-MRI, 36.2% for P-MRI, 24.1% for D-MRI, and 18.0% for noMRI. At multivariable analysis, using noMRI as reference, the odds ratios for overall mastectomy were 2.4 (p&nbsp;&lt;&nbsp;0.001) for S-MRI, 1.0 (p&nbsp;=&nbsp;0.957) for D-MRI, and 1.9 (p&nbsp;&lt;&nbsp;0.001) for P-MRI. Conclusions: Patients from the D-MRI subgroup had the lowest overall mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). This analysis offers an insight into how the initial indication for MRI affects the subsequent surgical treatment of breast cancer. Key points: • Of 3065 breast MRI examinations, 79.7% were performed with preoperative intent (P-MRI), 16.6% were diagnostic (D-MRI), and 3.7% were screening (S-MRI) examinations. • The D-MRI subgroup had the lowest mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). • The S-MRI subgroup had the highest mastectomy rate (39.5%) which aligns with higher-than-average risk in this subgroup, with a reoperation rate (10.5%) not significantly different to that of all other subgroups

Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA).

Funder: Bayer AGFunder: Università degli Studi di MilanoOBJECTIVES: Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue. METHODS: This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases. RESULTS: Of 5896 analyzed patients, 2763 (46.9%) had conventional imaging only (noMRI group), and 3133 (53.1%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692/3133 women (22.1%), with preoperative intent in 2441/3133 women (77.9%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers ≥ 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (p < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4% (MRI group) versus 14.4% (noMRI group) (p < 0.001). The additional planned mastectomy rate in the MRI group was 11.3%. The overall performed first- plus second-line mastectomy rate was 36.3% (MRI group) versus 18.0% (noMRI group) (p < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5% versus 11.7%, p < 0.001). CONCLUSIONS: Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3% more mastectomies, and with 3.2% fewer reoperations in the breast conservation subgroup. KEY POINTS: • In 19% of patients of the MIPA study, breast MRI was performed for screening or diagnostic purposes. • The current patient selection to preoperative breast MRI implies an 11% increase in mastectomies, counterbalanced by a 3% reduction of the reoperation rate. • Data from the MIPA study can support discussion in tumor boards when preoperative MRI is under consideration and should be shared with patients to achieve informed decision-making

A Service of zbw Does Time Inconsistency Problem Apply For Turkish Monetary Policy? Does Time Inc onsistency Problem Apply For Turkish Monetary Poli cy ? Does Time Inconsistency Problem Apply For Turkish Monetary Policy?

Standard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may Abstract We analyze the implications of the time inconsistency problem for the Turkish monetary policy in the last two decades. After deriving the restrictions that the Barro and Gordon model imposes on a time series model for inflation and output, we show that the time inconsistency problem can explain both the short-run and the long-run behaviour of inflation and output in the Turkish economy. The results also reveal that the Turkish monetary policymakers have put more emphasis on output stability than price stability in the last decade. JEL Classification: E31, E52, E6

Star and miktoarm star block (co)polymers viaself-assembly of ATRP generated polymer segments featuring Hamilton wedge and cyanuric acid binding motifs

Hamilton wedge (HW) end-functionalized poly(styrene) (PS-HW, Mn = 5400 g mol-1, PDI = 1.06), HW mid-chain functionalized poly(styrene) (PS-HW-PS, Mn = 4600 g mol-1, PDI = 1.04), cyanuric acid (CA) end-functionalized poly(styrene) (PS-CA, Mn = 3700 g mol-1, PDI = 1.04) and CA end- functionalized poly(methyl methacrylate) (PMMA-CA, Mn = 8500 g mol-1, PDI = 1.13) precursors were successfully synthesized via a combination of atom transfer radical polymerization (ATRP) and copper catalyzed azide-alkyne cycloaddition (CuAAC). The precursor polymers were characterized via size exclusion chromatography (SEC) and 1H NMR with respect to both molecular weight and structure. Supramolecular homopolymer (PS-HW-PS-CA), block copolymer (PS-HWPMMA-CA), star polymer (PS-HW-PS - PS-CA) as well as miktoarm star polymer (PS-HW-PS - PMMA- CA) were formed in solution in high yields at ambient temperature (association close to 89% for PS-HW-PS-CA, 90% for PS-HW-PS - PS-CA and 98% for PS-HW-PS - PMMA-CA) via H-bonding between the orthogonal recognition units, HW and CA. The formation of supramolecular polymers was confirmed via 1H NMR at ambient temperature in deuterated methylene chloride (CD 2Cl2) solution. © The Royal Society of Chemistry 2011