Is serum BDNF level reliable parameter in detecting of dental anxiety before impacted third molar surgery?

BACKGROUND: Brain-derived neurotrophic factor (BDNF) is a factor that implicate in the pathophysiology and treatment of depression and anxiety. The aim of this study was to determine the relationship between dental anxiety and BDNF serum level through impacted third molar surgery. MATERIAL AND METHODS: In this randomized, double-blind, cross-sectional study, the sample included patients who had been admitted for the impacted third molar extraction under local anesthesia between January to November 2020. The primary predictor variable was serum BDNF level and the second predictor variable was dental anxiety scores before and after operation in patients. The primary outcome variable was the correlation between anxiety scores (APAIS, MDAS, STAI, VAS) and serum BDNF level. The sample included 55 patients (22 Male, 33 Female) aged 18 to 42 (24,2+5,55). RESULTS: Comparison of pre-operative scores (APAIS, MDAS, STAI, VAS and BDNF) and post-operative scores were statistically significant (P < .05). Post-operatively, MDAS and VAS scores decreased, while BDNF levels and STAI scores increased compared to the preoperative scores. BDNF was not correlated with APAIS, MDAS, STAI, and VAS preoperatively and postoperatively. CONCLUSIONS: There may be a relationship between serum BDNF level and dental anxiety scale, but, no correlation was found between them.

Impact of the arginine silicate inositol complex on bone metabolism in broiler chickens with tibial dyschondroplasia caused by manganese deficiency.

1. Tibial dyschondroplasia (TD) is a skeletal disorder in broilers that has financial implications, necessitating dietary modifications to reduce the prevalence of this disease. This study explored how arginine silicate inositol complex (ASI) supplementation affected tibial growth plate (TGP) and overall bone health in broilers with manganese (Mn) deficiency-induced TD.2. A total of 240 broiler chicks were divided into four groups, each consisting of 60 birds (15 replicates of four broilers each) as follows: i) Control, with 60 mg Mn per kg of diet; ii) ASI, with 60 mg Mn and 1 g ASI per kg of diet; iii) TD, with 22 mg Mn per kg of diet, and iv) TD+ASI, with 22 mg Mn and 1 g ASI per kg of diet.3. It was found that ASI supplementation increased tibial bone length in Mn-deficient TD broilers (p = 0.007). There was no Mn x ASI interaction for other bone morphometry variables (p > 0.05). However, both tibial bone mineral content and density were affected by Mn and ASI (p < 0.05). With ASI supplementation, serum bone-specific alkaline phosphatase and osteocalcin levels were elevated in the TD+ASI group compared to the TD group (p < 0.001). In the TD group, osteoprotegerin (OPG) levels in the TGP decreased compared to the control groups (p < 0.001).4. In contrast, ASI supplementation in the TD broilers counteracted the decrease in OPG compared to TD broilers without ASI supplementation (p < 0.001). The Mn level and ASI supplementation significantly influenced the OPG/receptor activator of the nuclear factor-κB ligand ratio (p < 0.001).5. In conclusion, the results demonstrated that inclusion of ASI in broiler diets could enhance bone formation variables by controlling OPG levels in the TGP, potentially serving as an effective method to decrease the occurrence of TD.

Risk factors for developing upper limb cellulitis after breast cancer treatment.

Cellulitis is one of the most important troubling complications of breast cancer treatment. Therefore, elucidating the risk factors for cellulitis in patients that have undergone breast cancer treatment is crucial. This is a retrospective medical record study among 523 patients who had received breast cancer treatment and were referred to the Lymphedema Clinic. Data on age, height, weight, BMI (body mass index), education level, arm dominance, history of previous surgery, axillary lymph node dissection, radiotherapy, and chemotherapy were noted. The time between operation and onset of lymphedema, duration of lymphedema, history of cellulitis, and number of cellulitis attacks were recorded. Circumference measurements were taken at four points on the upper limb. Univariate analysis showed that longer duration of lymphedema, larger circumference of the unaffected arm and larger circumference of the arm with lymphedema were associated with higher risk of cellulitis (p=0.008, p=0.007, p< 0.001, respectively). The incidence of cellulitis was higher in patients with lymphedema than patients who had no lymphedema (p< 0.001). Moreover, the frequency of cellulitis was higher in patients with lower education level (p=0.015). It was deter-mined that patients with cellulitis needed more compression garments (p< 0.001) and multi-layered bandage therapy (p< 0.001) than those without. Regression analysis revealed that presence of lymphedema (p=0.036), duration of lymphedema (p=0.048), radiotherapy (p=0.01) and educational level (0.019) are significantly associated with developing upper extremity cellulitis. It is important to consider these risk factors for the prevention and management of cellulitis in patients who undergo treatment for breast cancer. Early detection and treatment of lymphedema also remains essential for these patients.

Comparison of immune modulatory properties of human multipotent mesenchymal stromal cells derived from bone marrow and placenta.

Multipotent mesenchymal stromal cells (MSC) can be isolated from many tissues, including bone marrow (BM) and placenta (PL). Human placenta can be obtained readily without invasive procedures. There may be differences, however, in differentiation capacity and immunomodulation by MSC isolated from BM or PL. The early pregnancy factor (heat shock protein 10; EPF/Hsp10) is a small protein that exhibits immunomodulatory properties. We compared BM- and PL-MSC, and assessed their efficacy for suppressing T-cell proliferation in vitro and the role of EPF/Hsp10 in this process. PL-MSC were collected from whole placenta after removal of the amniotic and chorionic membranes followed by serial enzymatic digestions. The PL-MSC were compared to BM-MSC, obtained from healthy donors. Differentiation capacity, cytokine secretion, expression and secretion of immunomodulatory molecules, immunophenotype and real time proliferation were assessed using cytokine arrays, ELISA assays, flow cytometry, immunohistochemical staining and western blotting. Whereas BM-MSC consisted of a homogeneous cell population with strong expression of mesenchymal markers, PL-MSC consisted of a mixed population of cells with variable CD73, CD90 and CD105 expression. PL-MSC exhibited a significantly greater proliferation rate than BM-MSC. The presence of both stem cells and more mature cells in the PL-MSC cultures resulted in decreased differentiation capacity and reduced efficacy of immune suppression in co-cultures with T-cells. Although robust intracellular expression of EPF/Hsp10 in both BM- and PL-MSC was observed, secretion of the protein in response to immune activating stimuli remained below detectable levels. Secretion of pro-inflammatory cytokines was significantly greater in BM-MSC than PL-MSC, whereas no difference was observed in the secretion of hematopoiesis supporting growth factors. Development of culture methods for isolation of pure populations of PL-MSC may improve the quality of the product and reproducibility of results.

Evaluation of dynamic thiol-disulfide balance in preinvasive lesions of the cervix.

PURPOSE: This study aimed to determine the potential clinical use of dynamic thiol-disulfide balance in cases with preinvasive lesions of the cervix. METHODS: One hundred and sixteen patients with high-grade squamous intraepithelial lesion, 100 patients with low-grade squamous intraepithelial lesion, and 110 healthy controls were enrolled in the study. A fully automated colorimetric system was used to determine the levels of thiol-disulfide parameters. The ischemia-modified albumin, total oxidant-antioxidant capacity, and oxidative stress index of the retrieved cases were further analyzed. RESULTS: Native thiol and total thiol levels are significantly lower in the high-grade squamous intraepithelial lesion group according to control group (p: 0.004 and 0.015, respectively). Disulfide level is significantly increased in the high-grade squamous intraepithelial lesion group compared to control group (p: 0.004). Oxidative stress index levels in high-grade squamous intraepithelial lesion group were observed as significantly higher according to the control group (p: 0.014). Ischemia-modified albumin levels in the high-grade squamous intraepithelial lesion group were observed as significantly higher compared to the control group (p: 0.020). Disulfide levels are positively correlated with risk type of Human papillomavirus (r: 0.420, p < 0.001). CONCLUSION: The analysis of dynamic thiol-disulfide balance revealed considerable oxidative damage in patients with Human papillomavirus-related cervical precursor lesions compared to women with ordinary cytology specimens. Therefore, investigation of thiol-disulfide balance with presented method represents a new promising test for early diagnosis and management of women at high risk for cervical cancer.

An automated synthesis of 177Lu-EDTMP as an efficient bone-seeking therapeutic radiopharmaceutical.

OBJECTIVE: Radiolabeled bisphosphonates have found wide clinical use in nuclear medicine for palliative therapy of bone metastases. 177Lu-EDTMP was used to relieve metastatic bone pain in patients with breast or prostate cancer. The therapeutic efficacy of 177Lu-EDTMP at 1-, 3-, 6-, and 8-weeks post-therapy was evaluated using Standard Pain Scoring Assessment Criteria. In addition, toxicity was evaluated in terms of hematological parameters using the Common Terminology Criteria for Adverse Events V4.0. PATIENTS AND METHODS: A fully automated synthesis of 177Lu-EDTMP was achieved in this study with high radiochemical efficiency and high radiochemical purity. During the study, 75 patients (57 M: 18 F, mean age: 68.0 ± 11.1 years) of breast/prostate cancer with documented skeletal metastases were included. Patients were administered intravenously with 177Lu-EDTMP at a dose rate of 22.2-37.0 MBq/kg following a fully automated synthesis of 177Lu-EDTMP using a disposable cassette system. RESULTS: Among the 75 patients all treated with 177Lu-EDTMP, 59 patients were responsive and the remaining 16 patients did not respond to the therapy. Mean pain score values in the responder group were 5.60 ± 0.5, 4.3 ± 0.1, 2.6 ± 0.4 and 1.4 ± 0.7 at weeks 1, 3, 6, and 8, respectively. Also, the mean pain score decreased from a baseline score of 7.6 ± 1.6 to 1.4 ± 0.7 at week 8 in the responder group. Statistical analysis of the pain score data showed a significant decrease in pain score after each radiopharmaceutical treatment, compared to the baseline scores (p <0.0001). Mild to severe toxicity was observed in two patients each treated with 177Lu-EDTMP. CONCLUSIONS: These findings demonstrated that the 177Lu-EDTMP radiopharmaceutical could be used safely to achieve considerable therapeutic efficacy, in metastatic bone pain palliation together with the safe clinical application and low radiation exposure during preparation.

Ventricular repolarization indexes in patients treated with hydroxychloroquine - azithromycin combination for COVID-19.

BACKGROUND: Combination of hydroxychloroquine and azithromycin for the treatment of coronavirus disease 2019 (COVID-19) carries increased risk of corrected QT (QTc) prolongation and cardiac arrhythmias. OBJECTIVE:  To characterize the ventricular repolarization indexes which are associated with malignant ventricular arrhythmias in patients treated with hydroxychloroquine and concomitant azithromycin for COVID-19. METHOD: A total of 81 patients who had hydroxychloroquine and azithromycin combination therapy because of possible or  reverse-transcription polymertase chain reaction (RT-PCR) confirmed diagnosis of COVID-19 were included in the study. Baseline and control electrocardiograms (before and after treatment) were analyzed retrospectively. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, which are ventricular repolarization indexes, were calculated. RESULTS: While there was no significant increase in QTc interval in patients receiving combination therapy, there was a significant increase in ventricular repolarization indexes. CONCLUSION: The increase in ventricular replarization indexes is associated with the risk of arrhythmia. In patients using QTc prolonging medication for COVID-19 treatment, QTc monitoring alone may not be sufficient to follow-up for arrhythmia. Even if there is no prolongation in QTc, an increase in ventricular repolarization indexes may be seen (Tab. 5, Ref. 37).

The Effects of Oral Isotretinoin in Women with Acne and Polycystic Ovary Syndrome.

INTRODUCTION: Many patients who were diagnosed as polycystic ovary syndrome- (PCOS-) related acne were not capable of sustaining or beginning oral contraceptive pills (OCPs) due to pill scaring, contraindications of OCP use, migraine, or smoking. In this situation, oral isotretinoin treatment may become an important option for PCOS-related acne. The aim of the study was to determine the effects of isotretinoin treatment on PCOS patients who were complicated with severe cystic acne. MATERIALS AND METHODS: This study consisted of 40 female patients diagnosed as PCOS complicated with severe cystic acne. These patients were not eligible candidates for OCP use due to migraine, thrombophilia, heavy smoking, or pill scare. To establish baseline values of hormone levels, on days 2-5 of the menstrual cycle, venous blood samples were obtained. Moreover Modified Ferriman-Gallwey (mFG) score, acne score (AS), follicle count, and bilateral ovarian volumes were evaluated both before and after isotretinoin treatment. RESULTS: Isotretinoin treatment significantly decreased Ferriman-Gallwey score, free testosterone, insulin level, hemoglobin level, acne score, and ovarian volume. Increased triglyceride and cholesterol levels were detected after treatment. CONCLUSION: Isotretinoin treatment may have beneficial effects on free testosterone, insulin, acne score, and Ferriman-Gallwey score. Solely isotretinoin administration may supply adequate healing in PCOS patients' symptoms complicated with severe cystic acne who is not eligible candidates for OCP use. This trial is registered with Clinicaltrials.gov NCT02855138.

Maternal type 1collagen N-terminal telopeptide levels in severe hyperemesis gravidarum.

BACKGROUND: Nausea and vomiting occur 50-90% during the first trimester of pregnancy. However, patients with hyperemesis gravidarum (HG) may be hospitalized at an incidence rate of 0.8-2% before the 20th week of gestational age. The symptoms generally start during the 5-6th gestational weeks, reaching the highest degree during the 9th week, and decline after the 16-20th weeks of gestation. Clinical findings are proportional to the severity of the disease and severe HG is characterized with dehydration, electrolyte imbalance, and nutritional deficiency as a result of vomiting. METHODS: The study population consisted of two groups of pregnant volunteers at 5-12 weeks of gestation: a severe HG group and a control group. The HG severity was scored using the Pregnancy-Unique Quantification of Emesis (and nausea) (PUQE).The serum levels of the maternal Ca, parathyroid hormone (PTH), Na, K, blood urea nitrogen(BUN), creatinine, vitamin D(25OHD3), and the maternal urine NTx levels were compared between the groups. RESULTS: In total, 40 volunteers were enrolled in this study: 20 healthy pregnant volunteers and 20 with severe HG. There were no statistically significant differences between the maternal characteristics. The first trimester weight loss of ≥5 kg was significantly higher in the severe HG group (p < 0.001), while the control group had a significantly higher sunlight exposure ratio than the severe HG group (p = 0.021). The urine NTx levels were significantly higher in the severe HG group (39.22 ± 11.68NTx/Cre) than in the control group(32.89 ± 8.33NTx/Cre) (p = 0.028).The serum Ca, PTH, Na, K, BUN, and creatinine levels were similar between the groups (p = 0.738, p = 0.886, p = 0.841, p = 0.957, p = 0.892, and p = 0.824, respectively). In the severe HG group, the serum 25OHD3 levels were significantly lower than in the control group (p < 0.001). CONCLUSIONS: The data from this study indicated that severe HG is associated with increased urine NTx levels. However, large-scale studies are required to understand the clinical significance of this finding, as well as the long-term consequences of elevated urine NTx levels and the underlying mechanisms. TRIAL REGISTRATION: NCT02862496 Date of registration: 21/07/2016.

The use of an ostial stent does not increase the success rate of endoscopic dacryocystorhinostomy.

OBJECTIVE: This prospective, controlled study assessed how placing a stent into a newly formed ostium affects ostial patency, success and complication rates in endoscopic dacryocystorhinostomy patients. METHODS: In group 1 (40 eyes of 36 patients), both silicone tube intubation and tube stenting were performed. In group 2 (36 eyes of 34 patients), only silicone tube intubation was performed. Success, operative time and post-surgical complications were investigated two months post-operatively in each group. RESULTS: The success rates were 92.5 per cent and 83.3 per cent for groups 1 and 2 respectively, but the difference was not statistically significant (p = 0.294). The complication rates also differed between the two groups, but this was again insignificant. CONCLUSION: Compared with the use of a silicone tube alone, the addition of an ostial stent did not significantly increase the success rate of endoscopic dacryocystorhinostomy.

Induction of apoptosis by metformin and progesterone in estrogen-induced endometrial hyperplasia in rats: involvement of the bcl-2 family proteins.

This study compared the antiproliferative effects of metformin and progesterone, via examination of the Bcl-2/Bax-caspase apoptotic pathway in estrogen-induced endometrial hyperplasia (EH) in 40 rats. Two rats died after bilateral oophorectomy, and 1 week after surgery, the remaining 38 were randomly divided into three groups: the first (control, n = 12) received 4 mg/kg 17ß estradiol hemihydrate (E); the second (n = 13) received 4 mg/kg 17ß estradiol hemihydrate and 50 mg/kg metformin (E + M); and the third (n = 13) received 4 mg/kg 17ß estradiol hemihydrate and 1 mg/day medroxiprogesterone acetate (E + MPA). Histological markers and Bcl-2, Bax and caspase 9 expression were analyzed. Luminal epithelial thickness, density of gland and epithelial height was significantly higher in group E than in groups E + M and E + MPA. Histopathologic parameters were similar between the E + M and E + MPA groups. Bcl-2/Bax ratio was significantly decreased in the E + M and E + MPA groups and caspase 9 expression levels were significantly increased in the E + M and E + MPA groups, compared with the control group. In addition, Bcl-2/Bax ratio and caspase 9 expression were similar between the E + M and E + MPA groups. The data indicate that metformin reduces estrogen-induced EH in rats, via activation of the caspase-dependent mitochondrial apoptotic pathway, to the same degree as progesterone.

Comparison of medial and posterior surgical approaches in pediatric supracondylar humerus fractures.

OBJECTIVES: The aim of the current study was to compare the clinical results of pediatric supracondylar humerus fracture cases requiring open reduction through medial approach with posterior approach. PATIENTS AND METHODS: Retrospective cohort of 67 cases of pediatric supracondylar fractures was reviewed. Thirty-three patients (20 males, 13 female, average age: 8.3 ± 3.131) were treated with medial approach were compared with 34 patients (19 males, 15 females, average age: 7.5 ± 3.146) treated with posterior exposure. Median follow-up period of the first group was 35.04 months (range: 17-76 months) and of the second group was 36.04 (range: 16-65 months). Radiological evaluation included Baumann angle, carrying angles, and lateral humero-capitellar angles. Functional and cosmetic evaluation was assessed with range-of-motion measurements and the criteria defined by Flynn et al. RESULTS: No differences between groups were noted regarding gender, age, and follow-up periods. Operative time was significantly shorter in medial approach group [60.0 ± 14.5 vs. 75.8 ± 17.6 min (P = 0.002)]. Radiological measurements (Baumann, humero-capitellar, and carrying angles) were also similar between groups. When evaluated patients according to Flynn's criteria, for medial group, 31 cases (93.9%) had good-perfect result regarding ROM loss, whereas for posterior group 33 cases (97%) had good-perfect result. Regarding carrying angle change and posterior group were slightly better than medial group (perfect result observed in 91.1% vs 81.8%, respectively). The differences did not show statistical significance. CONCLUSION: In the treatment of supracondylar humerus fractures in children, both surgical approaches revealed similar functional and radiological outcomes with shorter operative time when medial approach was utilized.

Myeloid PTEN deficiency impairs tumor-immune surveillance via immune-checkpoint inhibition.

Tumor-host interaction is determined by constant immune surveillance, characterized by tumor infiltration of myeloid and lymphoid cells. A malfunctioning or diverted immune response promotes tumor growth and metastasis. Recent advances had been made, by treating of certain tumor types, such as melanoma, with T-cell checkpoint inhibitors. This highlights the importance of understanding the molecular mechanisms underlying the crosstalk between tumors and their environment, in particular myeloid and lymphoid cells. Our aim was to study the contribution of the myeloid PI3K/PTEN-signaling pathway in the regulation of tumor-immune surveillance in murine models of cancer. We made use of conditional PTEN-deficient mice, which exhibit sustained activation of the PI3K-signaling axis in a variety of myeloid cell subsets such as macrophages and dendritic cells (DCs). In colitis-associated colon cancer (CAC), mice deficient in myeloid PTEN showed a markedly higher tumor burden and decreased survival. We attributed this observation to the increased presence of immune-modulatory conventional CD8α(+) DCs in the spleen, whereas other relevant myeloid cell subsets were largely unaffected. Notably, we detected enhanced surface expression of PD-L1 and PD-L2 on these DCs. As a consequence, tumoricidal T-cell responses were hampered or redirected. Taken together, our findings indicated an unanticipated role for the PI3K/PTEN-signaling axis in the functional regulation of splenic antigen-presenting cells (APCs). Our data pointed at potential, indirect, tumoricidal effects of subclass-specific PI3K inhibitors, which are currently under clinical investigation for treatment of tumors, via myeloid cell activation.

Conventional trans-tibial versus anatomic medial portal technique for femoral tunnel preparation in anterior cruciate ligament reconstruction; comparison of clinical outcomes.

AIM: Method of femoral tunnel preparation in anterior cruciate ligament (ACL) reconstruction is controversial. In this study, we aimed to determine if there is any difference between the clinical outcomes of two most commonly used drilling techniques; which are conventional trans-tibial (TT) drilling of femoral tunnel and anatomic preparation of femoral tunnel through medial portal (MP), in patients who underwent ACL reconstruction. MATERIAL AND METHODS: One hundred and twenty-nine male patients who underwent ACL reconstruction between 2010 and 2012 were included in the study. Single-bundle reconstruction with a quadrupled autologous hamstring graft was performed in all patients. Femoral tunnel was drilled by the conventional TT technique in 58 patients (Group 1) and through MP in 71 patients (Group 2). Functional evaluation was made about 12 months postoperatively. Functional evaluation included the Lysholm Knee Scale, International Knee Documentation Committee Scoring (IKDC), and Tegner Activity Level Scale were used for assessment. The anteroposterior stability was assessed using KT-1000 arthrometer and the pivot shift test for assessment of rotational stability. RESULTS: Interval between injury and surgery was similar between two groups (median 8.0 vs. 10 weeks, for TT vs. MP, respectively). One hundred twenty-five patients attending the final follow-up examination (96.8%) were evaluated. The results of Lysholm, IKDC, and Tegner scales were found to be similar. According to KT-1000 arthrometer results, MP group revealed slightly better results than TT group. Regarding pivot shift, MP group showed significantly better stability than TT group (P < 0.001). CONCLUSION: The anatomical single-bundle femoral tunnel preparation in the reconstruction of the ACL seems as effective as the conventional technique in terms of functional stability in the midterm. The technique better preserved the rotational stability in non-professional athletes.

Reproductive performance after hysteroscopic metroplasty in infertile women: complete versus partial uterine septum.

OBJECTIVE: To investigate the impact of hysteroscopic metroplasty on pregnancy outcome in women with complete or incomplete uterine septum (US) accompanying infertility. MATERIALS AND METHODS: Seventy-three patients who had hysteroscopic metroplasty for complete and incomplete US with primary and secondary infertility were reviewed. Obstetric outcomes (number of pregnancies, live births, and miscarriages) up to 36 months follow up period were investigated. RESULTS: Twenty-five patients in complete US and 28 patients in incomplete US became pregnant in 36 months follow up. Postoperative miscarriage rate was significantly lower in patients with complete US (p = 0.0001,p = 0.0001, respectively). The mean gestational week at the time of birth and mean birth weight of the in- fants were significantly lower in patients with complete US compared to the incomplete US cases (p = 0.026, p = 0.049, respectively). Postoperative pregnancy rate was significantly lower in incomplete US patients with primary infertility compared with secondary in- fertility (p = 0.037). CONCLUSION: Hysteroscopic metroplasty improves fertility and pregnancy performance. This improvement is more prominent in patients with complete US, and incomplete US patients with secondary infertility.

F-18 FDG PET/CT imaging in the diagnostic work-up of thyroid cancer patients with high serum thyroglobulin, negative I-131 whole body scan and suppressed thyrotropin: 8-year experience.

OBJECTIVE: Fluorodeoxyglucose positron emission tomography/computed tomography imaging in the follow-up of patients with differentiated thyroid carcinoma who have high serum thyroglobulin, negative iodine-131 whole body scan and suppressed thyrotropin. PATIENTS AND METHODS: A total of 90 patients (31 male and 59 female) with differentiated thyroid carcinoma who have high serum thyroglobulin and negative iodine-131 whole body scan were included in the study between July 2006 and March 2014. All patients had undergone surgery (total thyroidectomy ± lymph node dissection) followed by iodine-131 ablation. Of the patients, 82 had papillary thyroid carcinoma and 8 follicular thyroid carcinoma. Serum thyrotropin was suppressed (< 2 µ IU/ml) during the Fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging procedure. RESULTS: The overall sensitivity of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in the detection of metastasis of differentiated thyroid cancer was 84.8%, the specificity 79.1%, respectively. The sensitivity and specificity of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in classic type of papillary cancer was 83.3% and 54.5%, respectively. The corresponding figures for the tall cell variant was 85.7% and 87.5%, respectively. The difference between the two histological subtypes was statistically significant (p < 0.05). CONCLUSIONS: Our results suggest that fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging could be a valuable test for the routine follow-up of patients with differentiated thyroid carcinoma.

Gastric gastrointestinal stromal tumor with bone metastases - case report and review of the literature.

Gastrointestinal stromal tumors (GISTs) represent rather rare neoplasms. Most GISTs are benign; malignant tumors account for 20- 30% of cases (overall, approximately 10- 30% of GISTs exhibit malignant behavior). GISTs most commonly metastasize to the liver and abdominal cavity. Distant metastases to other sites, especially to the bones, are relatively rare. We report a case of a 62 year  old man with metastatic spread of GIST to skull, ribs and both sacroiliac joints manifesting six months after surgical resection of a gastric tumor. Although bone metastases from GISTs are rare and there are only a few reported cases in the literature, this case emphasizes that metastatic disease should always be considered in a patient with gastric GIST and suspicious bone lesions.

Coexistence of gallbladder agenesis and cholangiocarcinoma: report of a case.

Gallbladder agenesis (GA) is a rare condition and was first described by Lemary in 1701. Nearly 400 cases of GA is described in the literature and it is associated with various congenital abnormalities and malformations in some cases. Cholangiocarcinoma (CCA) is the malignant tumor arising from bile ducts. A wide range of risk factors have been identified for cholangiocarcinoma. A case of cholangiocarcinoma in which gallbladder agenesis was found incidentally was described in this study.

Suppression of activin A signals inhibits growth of malignant pleural mesothelioma cells.

BACKGROUND: Activins control the growth of several tumour types including thoracic malignancies. In the present study, we investigated their expression and function in malignant pleural mesothelioma (MPM). METHODS: The expression of activins and activin receptors was analysed by quantitative PCR in a panel of MPM cell lines. Activin A expression was further analysed by immunohistochemistry in MPM tissue specimens (N=53). Subsequently, MPM cells were treated with activin A, activin receptor inhibitors or activin-targeting siRNA and the impact on cell viability, proliferation, migration and signalling was assessed. RESULTS: Concomitant expression of activin subunits and receptors was found in all cell lines, and activin A was overexpressed in most cell lines compared with non-malignant mesothelial cells. Similarly, immunohistochemistry demonstrated intense staining of tumour cells for activin A in a subset of patients. Treatment with activin A induced SMAD2 phosphorylation and stimulated clonogenic growth of mesothelioma cells. In contrast, treatment with kinase inhibitors of activin receptors (SB-431542, A-8301) inhibited MPM cell viability, clonogenicity and migration. Silencing of activin A expression by siRNA oligonucleotides further confirmed these results and led to reduced cyclin D1/3 expression. CONCLUSION: Our study suggests that activin A contributes to the malignant phenotype of MPM cells via regulation of cyclin D and may represent a valuable candidate for therapeutic interference.

FDG PET/CT appearance of multicentric Castleman's disease mimicking lymphoma.

We report a case of a multicentric form of Castleman's disease with multiple lymph nodes showing intense FDG uptake on whole body scan mimicking non-Hodgkin's lymphoma. In this report, the patient had multiple cervical, mediastinal, hilar, retroperitoneal and abnormal lymph nodes in the groin. (18)F-fluorodeoxyglucose positron emission tomography/computed tomography was performed before tissue sampling. (18)F-FDG/PET demonstrated multiple areas of increased uptake in cervical, mediastinal, hilar, retroperitoneal and groin lymph nodes, suggesting a generalized disease of the lymphatic system including non-Hodgkin's lymphoma. The final diagnosis is based on the histopathological findings of the material obtained from the cervical lymphadenectomy. The histological diagnosis was multicentric plasma cell variant of Castleman's disease. (18)F fluorodeoxyglucose positron emission tomography/computed tomography scan helped to identify the lymph nodes involved throughout the whole body, but did not help to differentiate non-Hodgkin's lymphoma. The clinical conclusions and PET/CT findings are described in this report.