Can Extraprostatic Extension Be Predicted by Tumor-Capsule Contact Length in Prostate Cancer? Relationship With International Society of Urological Pathology Grade Groups.

OBJECTIVE. The objective of our study was to evaluate the relationship between the tumor-capsule contact length, defined as tumor contact length (TCL), and extraprostatic extension (EPE) using the MRI-based TCL measurements and the real TCL measurements from pathology and to determine whether the International Society of Urological Pathology (ISUP) grade group of the tumors influenced this relationship. MATERIALS AND METHODS. In this retrospective study, we reviewed prostate multiparametric MRI (mpMRI) studies performed between 2012 and 2018 of 1576 patients and found that 134 patients also underwent radical prostatectomy (RP) after mpMRI. Finally, 86 patients with index lesions in contact with the prostate capsule in RP specimens were enrolled in the study. ROC analysis was used to evaluate the cutoff values of TCLs measured at pathology and TCLs measured on MRI in terms of EPE according to ISUP grade groups. RESULTS. There was no statistically significant cutoff value for pathology-based TCL measurements in individual ISUP grade groups and subgroups. Although not statistically significant, pathology-based TCL cutoff values decreased (from 21.0 to 11.0 mm) as ISUP grade group increased in terms of EPE positivity. When the relationship between MRI-based TCL measurements and EPE was considered, statistically significant cutoff values (range, 14.5-16.6 mm) could be determined in many groups and subgroups with low ISUP grades (sensitivity, 66.7-100%; specificity, 52.8-93.0%; p = 0.006-0.042). However, no statistically significant cutoff value was found for high ISUP grades. CONCLUSION. ISUP grade groups may have an effect on the TCL-EPE relationship. When the MRI-based TCL and EPE relationship is evaluated independent of ISUP grade group, a cutoff value around 15-16 mm may be usable to predict EPE.

Role of diffusion-weighted MRI in the differential diagnosis of endometrioid and non-endometrioid cancer of the uterus.

Background Many publications have examined the relationship between apparent diffusion coefficient (ADC) values and tumor grade in endometrial cancer. Nevertheless, none were designed to evaluate according to the histopathological type of endometrioid and non-endometrioid tumors. Purpose To evaluate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of endometrioid and non-endometrioid cancer of the uterus, by comparing them with contrast-enhanced magnetic resonance imaging (MRI) findings. Material and Methods Institutional review board approval and informed consent were obtained. The MRI findings of 63 patients with endometrial cancer were retrospectively evaluated and divided into four groups: Grades I, II, and III endometrioid tumors, and non-endometrioid tumors. ADC values, DWI quotients ( b = 1000 s/mm2), and post-contrast signal intensities between lesions and the myometrium (b1000q-Cq values) were evaluated. The one-way-ANOVA, student's t-test, Kruskal-Wallis test, and receiver operating characteristic (ROC) analysis were used for statistical evaluation. Results Mean ADC values were 0.86 ± 0.14 in Grade I, 0.80 ± 0.7 in Grade II, 0.71 ± 0.14 in Grade III for endometrioid tumors, and 0.70 ± 0.12 in non-endometrioid tumors. There was a significant difference in ADC values between Grade I and Grade III ( P = 0.006), and non-endometrioid tumors ( P = 0.003). The difference was also significant between Grades I + II and Grade III ( P = 0.009), and non-endometrioid tumors ( P = 0.004). Besides, there was a significant difference between endometrioid and non-endometrioid tumors ( P = 0.022). However, when considering b1000q (F = 0.640, P = 0.593) and Cq (χ2 = 6.233; P = 0.101), no significant difference was detected among the groups. Conclusion The difference in ADC values between the endometrioid and non-endometrioid tumors was statistically significant. However, the difference in DWI and contrast-enhancement findings were not statistically significant. Furthermore, the mean ADC values had an inverse relationship with tumor grade in the endometrioid cancer group.

Comparative evaluation of a fissure sealant and a flowable composite: A 36-month split-mouth, randomized clinical study.

OBJECTIVES: The purpose of the present clinical evaluation was to investigate the effect of a fissure sealant and a flowable composite at fissures of permanent molars in terms of retention and caries-incidence rates over a 36-month period. METHODS: Thirty-four patients, ages varied from 16 to 22 years, diagnosed with at least 2 non-cavitated pit-and-fissure caries in the first and second molars were involved in the study. A total of 220 sealants, were placed in 117 upper molars and 103 lower molars. Teeth were sealed with either a flowable resin composite (Tetric Evo Flow) or a sealant material (Helioseal F)(n = 110). Each restoration was evaluated in terms of retention and caries incidence at 6, 12, 24 and 36 months according to their location as well. Data were analyzed using Mann-Whitney U, Friedman and 1-way ANOVA tests at p < 0.05. RESULTS: Tetric Evo Flow showed total retention with 95.5%, 93.8%, 88.5% and 80.2% at 6, 12, 24 and 36-month follow-ups respectively, while Helioseal F had retention rates of 95.5%, 94.8%, 85.4% and 80.2% respectively. After 36-months, there were 6 subjects totally lost in Helioseal F group, whereas 7 of the Tetric Evo Flow sunjects were totally lost. Caries development was firstly detected at 12-month evaluation for both of the materials however, no significant differences were observed among materials in retention rates or caries incidence after 36-month follow-ups (p > 0.05). SIGNIFICANCE: Using the flowable composite found as effective as the fissure sealant after 36-months regarding retention and caries incidence rates.

Abbreviated and Standard Breast MRI in Neoadjuvant Chemotherapy Response Evaluation: A Comparative Study.

OBJECTIVES: This study aims to investigate the efficacy of abbreviated breast magnetic resonance imaging (MRI) in neoadjuvant chemotherapy (NAC) response evaluation. METHODS: MR images of 50 locally advanced breast cancer patients who underwent standard protocol (SP) breast MRI before and after NAC were re-evaluated retrospectively. Abbreviated protocol (AP) was obtained by extracting images from SP and then evaluating them in a separate session. Protocols were compared with the histological findings after surgery as the reference standard. RESULTS: A statistically significant difference was found between the two protocols in response evaluation by the McNemar test (p=0.018). However, the Kappa value was 0.62 (p<0.001), which indicates substantial agreement. No statistically significant differences were found between the two protocols (AP and SP) and pathological results in the McNemar test (p=0.12, p=0.60, respectively). Kappa values were 0.48 (p<0.001) and 0.60 (p<0.001), respectively, which indicates moderate agreement for both protocols with higher values by SP evaluation. The residual maximum median diameters were smaller than the pathology, with both protocols (p<0.001). CONCLUSION: Despite the statistical differences, there was a significant correlation in response evaluation between the two protocols. The pathological results were moderately correlated with both protocols, with SP slightly higher. However, the residual maximum median diameters were smaller than the pathology with both protocols. These results may limit the use of AP in evaluating the local extent of the tumor, especially in patients who will undergo breast-conserving surgery.

The relationship between prevalence of dental anxiety and dental caries: cross-sectional study / A relação entre a prevalência da ansiedade de tratamentos odontológicos e cárie dentária: estudo transversal

Objective: This cross-sectional study aimed to assess level of DA among dental students in different grades and patients and to evaluate associations between DA and presence of dental caries. Material and Methods: Both four hundred all-grade dental students of Istanbul University and patients of Istanbul University Hospital were included in the study after random selection. Data regarding gender, oral hygiene habits, frequency of dental visits, and educational level were obtained via questionnaire. DA of participants were measured using both Modified Dental Anxiety Scale (MDAS) and Dental Fear Survey (DFS). The prevalence of caries was determined using International Caries Detection and Assessment System Criteria (ICDAS). Data were analyzed using Kruskal-Wallis, Mann-Whitney U and Chi square tests. Results: Female patients and female 4th-year students had significantly higher MDAS scores (p<0.05). First-year students had significantly higher MDAS and DFS scores than 4th and 5th-year students (p<0.05). Patients who had caries and brushed their teeth less than twice a day had significantly higher MDAS scores (p<0.05). Among 3rd-year students, individuals who visited dentist regularly had lower MDAS scores (p<0.05). Conclusion: DA among senior dental students was lower than that in younger students with an increase in knowledge about dentistry. Tooth brushing frequency and caries prevalence was associated with DA in patient group. No association was found between DA and frequency of dental visits, except in 3rd-year students (AU)

Objetivo: Este estudo transversal teve como objetivo avaliar o nível de DA entre estudantes de odontologia de diferentes anos de graduação, pacientes e associações entre DA e apresença de cárie dentária. Material e Métodos: Quatrocentos estudantes de odontologia de todas os anos da Universidade de Istambul e pacientes do Hospital Universitário de Istambul foram incluídos no estudo após randomização. Dados sobre sexo, hábitos de higiene bucal, frequência de consultas odontológicas e escolaridade foram obtidos por meio de questionário. DA dos participantes foram medidos usando dois questionários: Modified Dental Anxiety Scale (MDAS) e Dental Fear Survey (DFS). A prevalência de cárie foi determinada usando os critérios do Sistema Internacional de Detecção e Avaliação de Cárie (International Caries Detection and Assessment System Criteria - ICDAS). Os dados foram analisados usando os testes Kruskal-Wallis, Mann-Whitney U e Qui quadrado. Resultados: Pacientes do sexo feminino e estudantes também do sexo feminino do 4º ano apresentaram scores de MDAS significativamente maiores (p <0,05). Os alunos do primeiro ano tiveram pontuações MDAS e DFS significativamente mais altas do que os alunos do 4º e 5º ano (p <0,05). Pacientes que tinham cárie e escovavam os dentes menos de duas vezes ao dia apresentaram scores de MDAS significativamente maiores (p <0,05). Entre os alunos do terceiro ano, os indivíduos que visitavam o dentista regularmente apresentaram menores scores de MDAS (p <0,05). Conclusão: A DA entre os alunos do último ano de odontologia foi menor do que entre os alunos mais jovens, devido ao aumento do conhecimento sobre odontologia. A frequência de escovação e a prevalência de cárie foram associadas à DA no grupo de pacientes. Não foi encontrada associação entre DA e frequência de consultas odontológicas, exceto em alunos do 3º ano.(AU)

Effects of different kinds of beers on the surface roughness of glazed and polished methacrylate and Silorane-based composites: a 1-month study.

BACKGROUND: The aim of this in vitro study was to evaluate the effect of different kind of beers on the surface roughness of glazed and polished methacrylate- and Silorane-based resin composites after different immersion periods. METHODS: Methacrylate-based resin composites (Tetric N-Ceram, Ceram-X) and a Silorane-based resin composite (Filtek Silorane) were tested in the study. A total of 126 specimens (n=42 for each composite) were fabricated using a cylindrical custom metal mould. Surface roughness measurement was performed using a profilometer at baseline and after a 1-week and 1-month immersion in different kind of beers or distilled water. The results were analysed using repeated measure ANOVA and Tukey's HSD test (α=0.05). RESULTS: Repeated measure ANOVA results revealed that immersion period was a significant factor in the surface roughness of the tested specimens (p<0.001). The lowest surface roughness values were obtained with the specimens' polished Optidisc+BisCover LV. Regardless of the polishing systems used, Tetric N-Ceram showed the statistically lowest surface roughness values (p<0.05), whereas Filtek Silorane showed the highest surface roughness (p<0.001). CONCLUSION: The surface roughness values of the tested resin composites were affected by the polishing procedure used, the exposure time in the solutions and the type of composite resin.

Relationships between serum PSA levels, Gleason scores and results of 68Ga-PSMAPET/CT in patients with recurrent prostate cancer.

AIM: To investigate the relationship between serum PSA level, Gleason score of PCa and the outcomes of Ga68-PSMA PET/CT in patients with recurrent PCa. METHODS: A total of 109 consecutive patients (median age 71 years; range 48-89 years) who had PSA recurrence after RP and/or hormonotherapy and/or radiotherapy were included in this study. Local recurrences, lymph node metastasis (pelvic, abdominal and/or supradiaphragmatic), bone metastases (oligometastatic/multimetastatic) and other metastatic sites (lung, liver, brain, etc) were documented. RESULTS: In 91(83.4%) patients at least one lesion characteristic for PCa was detected by68Ga-PSMA PET/CT. The median serum total PSA (tPSA) was 6.5 (0.2-640) ng/ml.There was a significant difference between 68Ga-PSMA PET/CT positive and negative patients in terms of serum total PSA value. No statistical significance was found between positive and negative 68Ga-PSMA PET/CT findings in terms of Gleason score. Local recurrence was detected in 56 patients. whereas lymph node metastases were demonstrated in 46 patients. Pelvic nodal disease was the most frequent presentation followed by abdominal and supradiaphragmaticnodal involvement. Bone metastases [oligometastasis, (n = 20); multimetastasis, (n = 35)⦌ were also detected in 55 patients. In the ROC analysis for the study cohort, the optimal cut-off value of total serum PSA was determined as 0.67 ng/ml for distinguishing between positive and negative 68Ga-PSMA PET/CT images, with an area under curve of 0.952 (95% CI 0.911-0.993). CONCLUSIONS: 68Ga-PSMA PET/CT was found to be an effective tool for the detection of recurrent PCa. Even though no relationship was detected between the GS and 68Ga-PSMA PET/CT findings, serum total PSA values may be used for estimating the likelihood of positive 68Ga-PSMA PET/CT results.

Role of diffusion weighted MRI in the differential diagnosis of endometrial cancer, polyp, hyperplasia, and physiological thickening.

Our purpose was to evaluate the role of diffusion-weighted imaging (DWI) in the diagnosis of various common pathologies of the uterine cavity, by comparing them with contrast-enhanced MRI findings. One hundred sixty-four patients with lesions in endometrial cavity were included in the study. The patients were grouped in four (one malignant and three benign groups). We have observed that the differences of the apparent diffusion coefficient, b1000q, and Cq values between various common benign and malignant lesions were statistically significant (P<.001). However, the differences of the values between benign groups were not statistically significant (P>.05). Alternatively, endometrial polyp group's signal intensity on DWI was different than the other groups.