Role of magnetic resonance spectroscopy in differential diagnosis of solitary pulmonary lesions

PURPOSEThe aim of our study was to evaluate the availability of magnetic resonance spectroscopy (MRS) for the differentiation of benign or malignant pulmonary nodules and masses.METHODSA total of 59 patients (45 male, 14 female) with pulmonary nodules and masses were included in this prospective study. MRS was applied to the pulmonary lesions of the patients and choline levels were determined. Afterwards CT-guided percutaneous needle biopsy was performed. According to the biopsy results, pulmonary lesions were benign in 25 patients and malignant in 34 patients.RESULTSCholine levels were significantly higher in malignant lesions compared with benign lesions (p 1.65 µmol/g compared to those with choline levels ≤1.65 µmol/g (p < 0.001).CONCLUSIONMRS is a noninvasive method that can be used in the differential diagnosis of pulmonary nodules and masses

The value of routine measurement of serum calcitonin on insufficient, indeterminate, and suspicious thyroid nodule cytology

Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cut-off in 23 (2.6%) patients ranging between 6.5 - 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, 7 patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III) and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement.

Favorable Effects of Astaxanthin on Brain Damage due to Ischemia- Reperfusion Injury

Background:Activated inflammation and oxidant stress during cerebral ischemia reperfusion injury (IRI) lead to brain damage. Astaxanthin (ASX) is a type of carotenoid with a strong antioxidant effect.Objective:The aim of this study was to investigate the role of ASX on brain IRI.Methods:A total of 42 adult male Sprague-Dawley rats were divided into 3 groups as control (n=14) group, IRI (n=14) group and IRI + ASX (n=14) group. Cerebral ischemia was instituted by occluding middle cerebral artery for 120 minutes and subsequently, reperfusion was performed for 48 hours. Oxidant parameter levels and protein degradation products were evaluated. Hippocampal and cortex cell apoptosis, neuronal cell count, neurological deficit score were evaluated.Results:In the IRI group, oxidant parameter levels and protein degradation products in the tissue were increased compared to control group. However, these values were significantly decreased in the IRI + ASX group (p&lt;0.05). There was a significant decrease in hippocampal and cortex cell apoptosis and a significant increase in the number of neuronal cells in the IRI + ASX group compared to the IRI group alone (p&lt;0.05). The neurological deficit score which was significantly lower in the IRI group compared to the control group was found to be significantly improved in the IRI + ASX group (p&lt;0.05).Conclusion:Astaxanthin protects the brain from oxidative damage and reduces neuronal deficits due to IRI injury.</jats:sec

Protective Effects of Astaxanthin on Nephrotoxicity in Rats with Induced Renovascular Occlusion

Background: Various effects of Astaxanthin was shown in the studies including its antioxidant, anti-inflammatory, anti-tumor and immunregulator effects. Objective: The aim of this study was to evaluate the beneficial effects of Astaxanthin on renovascular occlusion induced renal injury and to investigate the possible mechanisms. Methods: The rats were randomly assigned into three groups as follows: Group 1: control group (n=12), Group 2: renal ischemiareperfusion injury group (n=12), Group 3: renal ischemia-reperfusion + asthaxantine treated group (n=12). The control group and the renal ischemia-reperfusion group were given 2cc/kg/g olive oil for 7 days before establishing ischemia to renal tissue. Astaxanthin dissolved in olive oil was given orally to the renal ischemia+astaxanthin group for 7 days before inducing renal ischemia. Caspase-(3, 8, 9), GSH, SOD, Total Thiol, TNF-α, IL-6, 8-OHdG were performed for each group. Results: Renal IRI was verified by analysing the pathological changes of renal tissues and the renal functions after renal reperfusion. Much less renal tubular damage was determined the IRI+ASX group in comparison to the IRI group. Caspase-8, -9 and -3 immunoreactivity was observed to be minimal in the control group. Apoptosis was observed to be significantly reduced in the IRI + ASX group with respect to IRI group and close to the level of the control group (p &lt;0.05). Caspase-3 levels of tissue samples were significantly increased in IRI group compared to other groups, but significantly lower in IRI+ASX group with respect to the IRI group (p&lt;0.05). The TOS and OSI levels, indicating increased oxidative stress, were significantly lower in the IRI+ASX group with respect to the IRI group (p &lt;0.001), but still higher than the control group (p &lt;0.001). In addition to GSH, SOD and Total Thiol levels, TAS levels were also significantly higher in IRI + ASX group in comparison to the IRI group (p &lt;0.05). TNF-α, IL-6, lipid hydroperoxide, AOPP and 8-OHdG levels were lower in the IRI+ASX group than the IRI group (p &lt;0.001). MPO, IL-6, TNF-α levels, representing the parameters indicating neutrophil infiltration and inflammation of the renal tissues, significantly increased in IRI group with respect to the other groups (p &lt;0.005). Conclusion: When all the data obtained in our study were evaluated, ASX was determined to prevent renal damage due to renovascular occlusion to a great extent, through complex mechanisms involving antioxidant, anti-inflammatory and antiapopitotic effects. Biochemical, histological and oxidative stress parameters were improved due to ASX. </jats:sec

The Prognostic Importance of Tumor Budding in Intestinal-Type Gastric Adenocarcinoma

Amaç: Mide kanseri kansere bağlı ölümlerin önde gelen sebeplerinden biridir. Tümör tomurcuklanması birçok kanserde prognostik faktör olarak gösterilmiştir. Bu çalışmada intestinal tip mide adenokarsinomunda tümör tomurcuklanmasının prognostik önemini değerlendirmeyi amaçladık. Hastalar ve Yöntem: Çalışmaya 2015-2021 yılları arasında Patoloji Kliniğinde intestinal tip mide adenokarsinom tanısı almış 152 olgu dahil edildi. Tümör tomurcuklanması düşük, orta, yüksek olarak gruplandı. Hematoksilen-Eosin boyalı preparatlar tümör diferansiyasyonu, lenfovasküler invazyon (LVİ), perinöral invazyon (PNİ), lenf nodu tutulumu, invazyon derinliği (pT) ve tümör tomurcuklanması açısından yeniden değerlendirildi. Bulgular: Çalışmaya katılan olguların %30.9 (n=47)’unda tümör tomurcuklanması düşük, %37.5 (n=57)’inde orta, %31.4 (n=48)’ünde yüksek yoğunlukta idi. İstatistiksel olarak tümör tomurcuklanması arttıkça tümör boyutu artmakta (p&lt;0,05), olguların takip süreleri kısalmakta, sağ kalım süresi (p&lt;0,05) ve tümör diferansiasyonu (p&lt;0,05) azalmakta idi. Tümör tomurcuklanması ile LVİ (p&lt;0,05), PNİ (p&lt;0,05), pT(p&lt;0,05), lenf nodu tutulumu (p&lt;0,05) ve olguların mortalitesi (p&lt;0,05) arasında istatistiksel olarak anlamlı ilişki gözlendi. Tümör tomurcuklanması ile cinsiyet, yaş, tümör lokalizasyonu ve operasyon tipi arasında istatistiksel olarak anlamlı ilişki gözlenmedi (p&gt;0,05). Sonuç: Tümör tomurcuklanması kötü prognostik faktörlerle ilişkilidir. Tedavi seçiminde ve olguların takibinde önemli olabileceğinden tümör tomurcuklanma durumu patoloji raporlarına dahil edilebilir.</jats:p

The Malignancy Risk Assessment Of Cytologically Indeterminate Thyroid Nodules Improves Markedly By Using A Predictive Model

Objectives: The majority of thyroid nodules are discovered incidentally, and the management may be a challenge if the fine needle aspiration specimen yields indeterminate findings. Our aim was to develop an individualized risk prediction model to provide an accurate estimate of cancer risk in patients with cytologically indeterminate thyroid nodules. Materials and Methods: Clinical records, ultrasound images, and cytopathology reports of patients who underwent thyroidectomy were retrospectively reviewed. Logistic regression analysis was used to identify the predictive ability of each variable for malignancy, and a nomogram was built by integrating patients' age, multiplicity of nodules, cytology results, and suspicious ultrasound features, such as microcalcifications and irregular margins. Results: For the 233 indeterminate nodules according to the Bethesda System for Reporting Thyroid Cytopathology, the malignancy rates of the subgroups “atypia of undetermined significance,” “suspicious follicular neoplasia,” and “suspicious for malignancy” were 44.3, 47.7, and 88.0%, respectively. It was found that the Bethesda category “suspicious for malignancy,” microcalcifications, and irregular margins were independent risk factors for malignancy. The area under the receiver operating characteristics curve was 0.784, which suggested that the presented nomogram had considerable discriminative performance. Conclusions: The nomogram developed in our study accurately predicts the malignancy risk of thyroid nodules with indeterminate cytology by using clinical, cytological, and ultrasonographic features. (C) 2018 European Thyroid Association Published by S. Karger AG, BaselWo