Clinical significance of serum synaptophysin-like 1 protein levels in breast cancer.

Background: Mammography, used for breast cancer (BC) screening, has limitations such as decreased sensitivity in dense breasts. Currently used tumor markers are insufficient in diagnosing breast cancer. In this study, we aimed to investigate the relationship between serum levels of synaptophysin-like protein 1 (SYPL1) and BC and compare SYPL1 with other blood tumor markers. Methods: The study group consisted of 80 female patients with a histopathological diagnosis of invasive BC who received no radiotherapy/chemotherapy. The control group was 72 women with no previous history of breast disease and evaluated as Breast Imaging Reporting and Data Systems (BI-RADS 1-2) on imaging. Serum SYPL1, cancer antigen 15-3 (CA 15-3), and carcinoembryonic antigen (CEA) were measured in both groups.

Comparing the Efficiency of Imaging Modalities in Detection of Recurrent Breast Cancer.

Objective: To investigate the effectiveness of the different imaging modalities in detecting recurrence in breast cancer follow-up. Materials and Methods: Sixty-four women with recurrent breast cancer were examined between January 2020 and July 2022. Recurrency was divided into four categories: local; regional; second primary; and distant metastasis. The detectability of recurrent lesions with mammography (MG), ultrasound (US) and magnetic resonance imaging (MRI), was evaluated. In addition, recurrences that firstly appeared by positron emission tomography (PET) scan were recorded. Results: Twenty-seven (42.2%) recurrences were local, 10 (15.6%) were regional and 27 (42.2%) were second primary. Forty-six (71.9%) of them were determined to have invasive carcinoma, 8 (12.5%) were ductal carcinoma in situ, and 10 (15.6%) were axillary metastases. Eight (12.5%) of them were first diagnosed by PET-computed tomography/MRI. Among the available images performed, 78.7% could be detected pathologically by MG, 95.2% by US, and 100% by MRI. Distant metastasis associated with other types of recurrence was detected in 6 (9.4%) cases. Conclusion: MRI is the most powerful imaging modality in detecting recurrent breast cancer. With the addition of US to routine MG follow-up, a higher rate and early detection of recurrent cancers can be achieved.

Is there a potential biomarker in distinguishing invasive breast carcinomas with elevated Ki-67 levels among 2D-SWE, SMI, and 18F-FDG PET-CT/MRI-derived parameters?: A single-center data.

PURPOSE: To investigate the strength of quantitative imaging and metabolic parameters in differentiating invasive breast carcinomas with elevated Ki-67 levels. MATERIALS AND METHODS: A total of 123 patients with 129 breast lesions confirmed as invasive breast carcinoma underwent shear wave elastography (SWE), superb microvascular imaging (SMI) and positron emission tomography (PET)/CT or MRI. Adler's grade (classifying the microvascularity into four types) and Vascular Index (VI) was obtained by SMI as microvascular parameters. In addition, the stiffness value (Emean ) was evaluated in kilopascal by SWE. The average of consecutive measurements was recorded as mean VI and mean Emean . PET scan parameters were obtained as SUVmax and SULpeak . Lesions were divided into two groups according to the Ki-67 expression, low as ≤ 14 and high as >14. RESULTS: Adler's grading was the most correlated imaging parameter with high Ki-67 expression (p < 0.05), while VI and Emean had poor correlation (p > 0.05). SUVmax and SULpeak indicated a significant linear correlation with Ki-67 but a moderate correlation with the high levels of Ki-67 (p < 0,001). The sensitivity of VI, Emean , SUVmax and SULpeak was 64.6%, 66.7%, 65.7%, and 66.7% when the cut-off point was set to 5.25, 102.5, 6.59, and 2.63, respectively. SUVmax had the highest AUC value of 0.740, according to the ROC curve analysis. CONCLUSIONS: Our results suggest that the quantitative parameters obtained by advanced imaging methods may be useful in predicting the high proliferation in invasive breast carcinomas. But none of them is eligible to be used as an independent biomarker in distinguishing aggressive behavior. Nevertheless, as a noninvasive method, visual assessment of microvascular morphology using SMI increases the prognostic efficiency in invasive breast carcinomas.

Original contribution: sleeve gastrectomy reduces soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) levels in patients with morbid obesity.

BACKGROUND: Early diagnosis of subclinical cardiovascular disease (CVD) in patients with morbid obesity is important. We investigated the effects of sleeve gastrectomy (SG) on serum soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), oxidized LDL (oxLDL), and other metabolic and inflammatory parameters associated with atherosclerosis in patients with morbid obesity. METHODS: Body mass index (BMI) measurements and assays of metabolic and inflammatory markers were taken in patients in an SG surgery group and a healthy control group and compared at baseline and 12 months after SG. Correlations with changes in these parameters and variations in sLOX-1 were analyzed. RESULTS: Metabolic and inflammatory marker values in the surgery (n = 20) and control (n = 20) groups were significantly different at baseline (p < 0.001). The majority of surgery group biomarker levels significantly decreased with mean BMI loss (- 11.8 ± 9.0, p < 0.001) at 12 months, trending toward control group values. Baseline albumin level as well as percentage reductions in oxLDL and the cholesterol retention fraction (CRF) were found to be significantly correlated with percentage reduction in sLOX-1 at 12 months following SG. CONCLUSION: Metabolic and inflammatory biomarkers elevated at baseline significantly decreased after SG weight loss. Weight loss induced by SG may limit endothelial damage by reducing levels of oxLDL and LOX-1 as assessed by sLOX-1. These findings suggest that sLOX-1 may function as a marker of atherosclerotic disease states in patients with morbid obesity and that metabolic/bariatric surgery can play a meaningful role in CVD prevention.

Circulating nuclear factor-kappa B mediates cancer-associated inflammation in human breast and colon cancer.

BACKGROUND: Inflammation is recognized as a hallmark feature of cancer development and progression. The aim of our study was to investigate the significance of serum nuclear factor kappa-B (NF-κB) levels as a circulating marker in the monitoring of inflammation in breast and colon cancer; to show the relationship between NF-κB with inflammatory parameters as tumour necrosis factor-α (TNF-α), soluble TNF-related apoptosis-inducing ligand (sTRAIL), interleukin-6 (IL-6), pentraxin-3 (PTX-3), procalcitonin (PCT), and C-reactive protein (CRP) levels. METHODS: Serum NF-κB, TNF-α, sTRAIL, IL-6, PTX-3, PCT, and serum CRP levels were measured using enzyme-linked immunosorbent assay (ELISA) in 40 patients with breast cancer, 40 patients with colon cancer and 30 healthy controls. RESULTS: The serum NF-κB, TNF-α, IL-6, PTX-3, PCT, and serum CRP concentration was significantly higher, and the serum sTRAIL concentration was significantly lower in the patients with breast and colon cancer than in healthy controls. NF-κB was positively correlated with CRP and negatively correlated with sTRAIL. CONCLUSIONS: These results suggest that increased NF-κB may decrease the clinical efficacy of sTRAIL in solid tumour cells. There is a relationship between inflammation and carcinogenesis so that the development of cancer occurs with chronic inflammation in breast and colon. The study results have shown that colon and breast cancer patients have increased systemic inflammation, as measured by increased circulating cytokines, and acute-phase proteins, or by abnormalities in circulating cells. NF-κB may combine with other markers of the systemic inflammatory response in prognostic scores in cancer. In addition to surgical resection of the tumour, and conventional radio and chemotherapy for cancer treatment, the use of sTRAIL or other agonists for cancer therapy appeared a new potential therapy.

The evaluation of oxidative stress parameters in breast and colon cancer.

ABSTRACT: Our aim in this study was to investigate the relationship between serum ischemia modified albumin (IMA) levels with oxidative stress parameters [protein carbonyl (PCO), advanced protein oxidation products (AOPPs), malondialdehyde (MDA), total nitric oxide (NOx), prooxidant-antioxidant balance (PAB), and ferric reducing of antioxidant power (FRAP)] in breast cancer (BC) and colon cancer (CC).In total, 90 patients undergoing surgical treatment for BC (n = 45) or CC (n = 45) and 35 healthy controls were included in this cross-sectional study.The serum PCO, AOPPs, MDA, NOx, PAB, and IMA levels were all statistically significantly higher in the cancer patients than in the control group. MDA, NOx, and PAB levels were significantly lower in the BC group than in the CC group. FRAP values were statistically significantly lower in both the CC group and the BC group compared to the control. IMA showed a weak positive correlation with CA-19.9 (r = 0.423 P = .007) but a moderate positive correlation with tumor size in the CC group. IMA showed a positive correlation with metastasis, grade, and HER2 and a negative correlation with ER and PR in the BC group.Oxidative stress is a key player in the development of solid malignancies. Cancer development is a multistage process, and oxidative stress caused by the production of ROS/RNS in the breast and colon may predispose individuals to BC and CC. Patients with BC and CC had an impaired oxidative/antioxidant condition that favored oxidative stress. The ROC analysis indicated that IMA sensitivity above 80% could be used as a secondary biomarker in diagnosis.

Associations Between miRNAs and Two Different Cancers: Breast and Colon.

OBJECTIVE: Screening approaches using microRNAs (miRNAs) have been gaining increased attention owing to their potential applications in the diagnosis, prognosis, and monitoring of cancer, because aberrant miRNA expression plays a role in the development and advancement of malignancies. The objectives of this study were to characterize mir21, miR31, mir143, mir145, and control RNU43, which are differentially expressed in peripheral blood mononuclear cells (PBMCs) of breast and colorectal cancer patients, compared to that in controls and to establish whether this is specific to breast and colon cancer for use as tumor markers. METHODS: Thirty newly diagnosed patients with breast cancer and 30 patients with colorectal cancer were enrolled together with 30 healthy controls. PBMCs were isolated from venous blood samples of individuals. Next, miRNA expression analysis was performed by a two-step method of reverse transcription and qPCR. RESULTS: The expression levels of miR-143 and miR-31 were significantly decreased, whereas the expression levels of miR-145 and miR-21 were significantly increased in breast cancer patients compared to those in healthy subjects. Moreover, the expression levels of miR-143, miR-145, and miR-21 were significantly increased and, in contrast, the changes in the expression levels of miR-31 were not statistically significant in colon cancer compared to those in healthy subjects. miR-21 exhibited the highest increase in both breast and colon cancers. There was a weak positive correlation between miR-145 and CA-15.3 in patients with breast cancer (r = 0.451; p = 0.012). miR-143 was positively correlated with the TNM stage in colon cancer patients (r = 0.568; p = 0.001). CONCLUSION: A biomarker panel composed of miR-21, miR-31, miR-143, and miR-145 in PBMC may provide a new diagnostic approach for the early detection of breast and colon cancer. As miR-21 expression was found to be the highest among all the miRNAs evaluated, it may represent a new tumor biomarker and a candidate therapeutic drug or gene target in colon and breast cancer.

Inflammatory mediators in the diagnosis and treatment of acute pancreatitis: pentraxin-3, procalcitonin and myeloperoxidase.

INTRODUCTION: Acute pancreatitis (AP) is the third most common gastrointestinal disease at hospital admission. The etiology and pathogenesis of this disease are not completely clear. Our study was intended to determine the systemic levels of pentraxin-3 (PTX-3), myeloperoxidase (MPO), procalcitonin (PCT), and C-reactive protein (CRP) as prognostic parameters in early stages of AP. We also determined the effects of treatment on PTX-3, MPO, PCT and CRP levels in AP. MATERIAL AND METHODS: The study group comprised 44 AP patients (22 male, 22 female; age: 49.3 ±16.9 years) referred to our outpatient clinic. Additionally, our investigation included a control group of 30 healthy volunteers (18 male, 12 female; age: 50.8 ±12.6 years). RESULTS: Leukocytes, glucose, aspartate aminotransferase (AST (SGOT)), alanine aminotransferase (ALT (SGPT)), alkaline phosphatase (ALP), total and direct bilirubin levels were significantly higher in the AP group (p < 0.05, all). CRP, PTX-3, MPO and PCT were considerably higher in the AP group (p < 0.001, all), and after treatment, CRP, PTX-3, MPO and PCT levels were significantly lower (p < 0.001, all). CONCLUSIONS: Our findings indicated that the CRP, PTX-3, MPO and PCT levels increase in patients with AP and hence these indicators can be used as diagnostic factors to predict inflammation severity in AP. It was revealed that after treatment, there were significant reductions in biomarker levels. However, further research is needed in order to understand how these biomarkers can help to monitor inflammatory responses in AP.

The role of FDG PET/CT in detection of distant metastasis in theinitial staging of breast cancer.

BACKGROUND/AIM: We aimed to evaluate the role of FDG PET/CT in the detection of extraaxillary regional nodal/distant metastasis in breast cancer patients and to assess the value of FDG PET/CT for detecting distant metastases in patient subgroups. MATERIALS AND METHODS: A total of 254 patients with breast cancer (248 female, 6 male) who underwent PET/CT for initial staging were enrolled. Patients were divided into four groups: Group 1 consisted of 154 patients diagnosed by tru-cut/core/FNAB, Group 2 comprised 32 patients diagnosed by excisional biopsy, Group 3 included 62 patients who had mastectomy-axillary lymph node dissection, and Group 4 consisted of 6 patients who had axillary lymph node metastasis diagnosed by excisional biopsy. RESULTS: PET/CT detected distant metastasis in 76 of the 254 patients. Of these patients, 21.7% had bone/bone marrow metastasis, 7.1% had lung metastasis, 13% had mediastinal lymph node metastasis, 4.8% had liver metastasis, 9.8% had other organ/system metastasis, and 6% had other lymphadenopathies. According to T staging, the percentages of distant metastasis were as follows: 13.6% of the 66 T1 stage patients, 35.7% of the 129 T2 stage patients, 40% of the 20 T3 stage patients, and 33.3% of the 39 T4 stage patients. CONCLUSION: FDG-PET/CT led to a change in the stage of disease and the treatment approach in newly diagnosed breast cancer patients due to its superiority in detecting extraaxillary regional lymph node metastases and distant metastases.

Do 18F-FDG PET/CT findings have a relationship with histopathological and immunohistochemical factors of breast cancer in men?

PURPOSE: We aimed to investigate the relationship between histopathological and immunohistochemical features of male breast cancer (MBC) and comprehensive fluorine-18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) parameters. METHODS: Fifteen male patients with newly diagnosed breast cancer who underwent F-FDG PET/CT were included in the study. Maximum and average standardized uptake value (SUVmax and SUVavg), metabolic total volume, and total lesion glycolysis (TLG) were compared with the histopathological and immunohistochemical findings of patients. In addition, metabolic tumor-node-metastases (TNM) staging was performed following the determination of metastatic axillary lymph nodes and tumor size by F-FDG PET/CT and verified by histopathological evaluation. RESULTS: There were no significant differences between all groups classified on the basis of histopathological and immunohistochemical parameters for SUVmax, SUVavg, TLG, and metabolic total volume. The only difference was found in patients with distant metastases and stage IV. SUVmax, SUVavg, and TLG were higher in patients with distant metastases compared with patients without distant metastases (P: 0.005, 0.011, and 0.042, respectively). Strong correlations were found between metabolic TNM staging and histopathological TNM staging (for T stage; r: 0.590, P: 0.021, N stage; r: 0.694, P: 0.002, TNM stage; r: 0.835, P: 0.002). In addition, no differences were found with any metabolic F-FDG PET/CT parameters in survival. CONCLUSION: Although no correlation was found between metabolic parameters and groups categorized on the basis of histopathological or immunohistochemical features, F-FDG PET/CT is a reliable imaging modality to determine tumor size, axillary lymph node involvement, and metabolic TNM staging of MBC. In addition, none of those metabolic F-FDG PET/CT parameters predicted survival in MBC.

Comparison of (18)F-fluorodeoxyglucose PET/CT findings with vascular endothelial growth factors and receptors in colorectal cancer.

The purpose of this study was to evaluate the association of (18)F-fluorodeoxyglucose (FDG)-PET/CT findings with the vascular endothelial growth factor (VEGF) family and its receptor (VEGFR) levels in metastatic and nonmetastatic colorectal cancer (CRC). Fluorine-18 FDG-PET/CT scans were performed for initial staging and restaging of patients with CRC. FDG-PET/CT findings of tumor (such as the presence of a primary tumor, the lymphatic or distance metastases, and the maximum standardized uptake value (SUVmax) of the primary tumor), serum VEGF A-C-D-E levels, and serum VEGF receptor 1-2-3 levels were analyzed. A total of 63 patients were included into the study (35 males, mean age 61.3 ± 11.9 years). Patients were divided into two groups, based on positive and negative PET/CT findings. Patients were also categorized according to the presence of metastasis. All evaluated parameters were significantly higher in the PET/CT-positive group than the PET/CT-negative group (p < 0.001). All those parameters were also positively correlated with each other. The highest correlation for SUVmax of primary tumor was found with VEGFR-3 (p < 0.001, r = 0.665). Patients with metastases had high levels of VEGF-D, VEGF-A, VEGF-C, VEGF-E, and VEGFR-3 than those without metastases. These parameters had better specificity and sensitivity values than the SUVmax of the primary tumor for detection of metastases. However, VEGF-D was the best indicator of metastasis in all of those parameters (VEGF-D vs SUVmax; sensitivity 100 vs 100 %; specificity 76 vs 76 %; AUC 0.903 vs 0.835; p < 0.001, respectively). Vascular endothelial growth factor family and its receptors were significantly higher in metastatic CRC patients. VEGF-D was the best indicator of metastasis than all VEGF family, VEGFR-3, and primary tumor SUVmax. VEGF family (A-C-D-E) and VEGFR-3 may help to determine the prognosis and management of CRC.

Pyoderma gangrenosum with common variable immunodeficiency.

Pyoderma gangrenosum (PG) is a rare ulcerative skin disease of unknown etiology. It can be seen on normal skin or secondary to traumas such as injections and biopsies. Half of reported cases are associated with systemic diseases such as arthritis, inflammatory bowel diseases, hematological disorders, hepatic disease, and necrotizing vasculitis. These lesions often occur on the trunk and extremities. Abscess drainage, debridement, or necrosectomy are contraindicated in PG, and false management of these indications aggravates the lesion. A diagnosis of PG is based on medical history as well as physical and laboratory examination according to standard criteria. Presented here is a case of a male patient with a medical history of recurrent abscess of injection and splenectomy due to splenic abscess. The patient presented with a subcutaneous abscess which transformed rapidly to an ulcer after abscess drainage. Consequently, the patient received the final diagnosis of PG with common variable immunodeficiency and was treated accordingly.

Laparoscopic surgery in pregnant patients with acute abdomen.

AIM: Notwithstanding the significant advantages compared to open surgery, laparoscopic surgery was considered to be contraindicated in pregnant patients. Currently, there are opposing views on the safety of laparoscopic surgery during pregnancy, especially in last trimester. The aim of this study was to examine feasibility of laparoscopic surgery in pregnant women with acute abdomen. PATIENTS AND METHODS: We retrospectively reviewed records of all patients who were admitted to the Emergency Department of Cerrahpasa Medical Faculty between January 1995 and January 2013. All clinical data of pregnant patient who underwent laparoscopic surgery were analyzed including inpatient records, operative reports, pathology records, and delivery information. RESULTS: Fourteen pregnant patients (mean gestational age 19.2 weeks, ranged from 9 to 33 weeks) who underwent laparoscopy for appendectomy (n=11), cholecystectomy (n=2), and diagnostic reasons (n=1) were included. Average time of delivery was 37.4 gestational weeks (range 35-40 weeks). Two patients had preterm labor. No complications such as uterine injury, fetal death, or maternal mortality were encountered during laparoscopic procedures CONCLUSION: Laparoscopic surgery can be safely performed at all trimesters of pregnancy. Laparoscopy may be useful in differentiation of acute abdominal pain in pregnancy and may decrease fetal loss due to delay in diagnosis. shorter operative time reduces negative effects of surgery on mother and fetus.

Changes in the elasticity of fibroadenoma during the menstrual cycle determined by real-time sonoelastography.

OBJECTIVE: Shear-wave elastography (SWE) presents quantitative data that thought to represent intrinsic features of the target tissue. Factors affecting the metabolism of the breast parenchyma as well as age, menstrual cycle, hormone levels, pregnancy and lactation, pre-compression artifact during the examination could affect these elastic intrinsic features. Aim of our study is to determine variation of fibroadenoma elasticity during the menstrual cycle (MC) by means of real-time shear-wave elastography (SWE) and identify the optimal time for SWE evaluation. METHODS: Thirty volunteers (aged 20-40 years) who had biopsy-proven fibroadenoma greater than 1cm in diameter, with regular menstrual cycle and without contraceptive medication underwent SWE (ShearWave on Aixplorer, France) once weekly during MC. Statistical data were processed by using the software Statistical Package for the Social Sciences (SPSS) 19.0. A repeated measures analysis of variance was used for each lesion where the repeated factor was the elastographic measurements (premenstrual, menstrual and postmenstrual). Pillai's trace test was used. Pairwise correlation was calculated using Bonferroni correction. Values of p<0.05 were considered statistically significant. RESULTS: The mean elasticity value of fibroadenomas in mid-cycle was 28.49 ± 12.92 kPa, with the highest value obtained in the third week corresponding to the premenstrual stage (32.98 ± 13.35 kPa) and the lowest value obtained in the first week corresponding to the postmenstrual stage (25.39 ± 10.21 kPa). Differences between the elasticity values of fibroadenomas in premenstrual and postmenstrual periods were statistically significant (p<0.001). There were no significant differences in lesion size between the different phases of the menstrual cycle (p>0.05). CONCLUSION: In this study, we found that there is significant difference between the elasticity values of fibroadenomas on premenstrual and postmenstrual period. We propose that one week after menstruation would be appropriate time to perform breast SWE.

Characteristics of patients with spontaneous splenic rupture.

In the present study, we aim to share our clinical experience in patients with spontaneous splenic rupture. Splenic rupture without trauma is known as spontaneous splenic rupture. The major problems in the management of spontaneous splenic rupture are missed or delayed diagnosis due to the lack of trauma in most cases. The records of all patients, who were admitted to Cerrahpasa Medical Faculty, Istanbul University, were retrospectively reviewed from January 2000 to March 2013. Twelve patients were admitted to the emergency department and they were diagnosed with spontaneous splenic rupture. The mean age was 47.6 years. All patients had complaints of abdominal pain. The mean hematocrit value was 22%. Radiologic assessment revealed hemoperitoneum and/or subcapsular hematoma in 8 patients while splenic abscess was diagnosed in 2 patients. Eleven patients underwent splenectomy whereas one was managed conservatively. The most common cause of spontaneous splenic rupture was determined to be use of anticoagulants. Etiology was considered to be idiopathic in 1 patient. Two patients died in the postoperative period. Although rare, spontaneous splenic rupture must be suspected in emergency patients who have used especially anticoagulants and antiaggregants and who have had no recent history of trauma. One of the important causes of mortality is missed or delayed diagnosis.

The effects on oxidative DNA damage of laparoscopic gastric band applications in morbidly obese patients.

BACKGROUND: Obesity may induce oxidative stress, causing oxidative damage of DNA. We examined associations between decreasing serum and urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels and weight loss in morbidly obese patients before and 6 months after laparoscopic adjustable gastric banding (LAGB). METHODS: We compared patients who had surgery for morbid obesity with healthy, nonobese controls. Urine and fasting blood samples were collected once from the controls and from the morbidly obese patients before and 6 months after the LAGB. The serum and urinary 8-OHdG levels were evaluated in these groups using an enzyme-linked immunosorbent assay kit. RESULTS: We included 20 patients who had surgery for morbid obesity (8 men, 12 women, mean body mass index [BMI] 46.82 ± 4.47) and 20 healthy, nonobese people (10 men, 10 women, mean BMI 22.52 ± 2.08) in our study. There was no significant difference in serum 8-OHdG levels between the groups, whereas urinary 8- OHdG levels were significantly higher in morbidly obese patients than in controls. Weight, BMI and serum and urinary 8-OHdG levels were significantly decreased in morbidly obese patients 6 months after LAGB. CONCLUSION: The LAGB provides efficient weight loss in patients with morbid obesity. The systemic oxidative DNA damage was increased by the morbid obesity, but this increase was not related to weight gain, and it was more evident in serum than urine samples. After LAGB for morbid obesity, the oxidative DNA damage declined both in serum and urine.

CONTEXTE: L'obésité peut provoquer stress oxydatif qui endommage l'ADN. Nous avons analysé les liens entre une baisse des taux de 8-OHdG (8-hydroxy-2'-désoxyguanosine) sériques et urinaires et la perte de poids chez des patients atteints d'obésité morbide avant, puis 6 mois après la pose d'un anneau gastrique ajustable par laparoscopie (AGAL). MÉTHODES: Nous avons comparé des patients qui ont subi cette chirurgie pour un problème d'obésité morbide à des témoins non obèses en bonne santé. Nous avons prélevé des échantillons d'urine et de sang à jeun chez les témoins 1 fois et chez les patients atteints d'obésité morbide, avant, puis 6 mois après l'intervention pour AGAL. Les taux de 8-OHdG sériques et urinaires ont été mesurés dans les 2 groupes à l'aide d'une trousse de test ELISA (enzyme-linked immunosorbent assay). RÉSULTATS: Notre étude a inclus 20 patients soumis à la chirurgie pour obésité morbide (8 hommes, 12 femmes; indice de masse corporelle [IMC] moyen 46,82 ± 4,47) et 20 témoins non obèses en bonne santé (10 hommes, 10 femmes; IMC moyen 22,52 ± 2,08). Nous n'avons noté aucune différence significative des taux de 8-OHdG sériques entre les 2 groupes, mais les taux de 8-OHdG urinaires étaient significativement plus élevés chez les patients souffrant d'obésité morbide que chez les témoins. Le poids, l'IMC et les taux de 8-OHdG sériques et urinaires avaient significativement diminué chez les patients atteints d'obésité morbide 6 mois après l'intervention pour AGAL. CONCLUSION: L'AGAL est une technique efficace de perte de poids chez les patients souffrant d'obésité morbide. L'atteinte oxydative systémique de l'ADN était exacerbée par l'obésité morbide, mais cette hausse n'était pas reliée au gain pondéral, et elle était plus évidente dans les échantillons sériques que dans les échantillons urinaires. Après la pose d'un AGAL pour obésité morbide, l'atteinte oxydative de l'ADN a diminué dans le sérum et dans l'urine.

Correlation of 18F-fluorodeoxyglucose uptake with histopathological prognostic factors in breast carcinoma.

OBJECTIVE: This study investigated the prognostic value of [18F]-fluorodeoxyglucose (18F-FDG) uptake in breast carcinomas by comparing 18F-FDG PET/computed tomography (CT) images with histopathological and immunohistochemical prognostic factors. METHODS: This study included 136 women and four men with positive biopsy breast carcinomas who underwent 18F-FDG PET/CT imaging for initial staging. Maximum standardized uptake values (SUVmax) and tumour-to-background SUVmax ratios were calculated and compared with histopathological and immunohistochemical tumour characteristics, patient properties and axillary lymph node involvement. Calculations of SUVmax for men were performed separately. RESULTS: For the tumours in women, the mean SUVmax was 10.06±6.91 and the median SUVmax was 9.05 (0.7-35.0). Primary tumour 18F-FDG uptake and tumour-to-background SUVmax ratios were correlated with tumour size (P<0.001), histological type (P<0.001), histological grade (P=0.004), pleomorphism (P=0.010), mitosis count (P<0.001), lymphatic invasion (P=0.009), necrosis (P=0.005), oestrogen negativity (P=0.004), high Ki-67 level (P<0.001), axillary lymph node involvement (P<0.001) and triple negativity (P=0.002). High Ki-67 level (odds ratio=16; 95% confidence interval=1.6-160; P=0.016) and tumour size (odds ratio=4; 95% confidence interval=1.5-11; P=0.007) were determining factors for high 18F-FDG uptake values. Other clinicopathological and immunohistopathological parameters including progesterone receptor (P=0.211), CerbB2 overexpression (P=0.170), perineural invasion (P=0.053), intratumoural calcification (P=0.438), desmoplasia (P=0.112), tubular formation (P=0.768) and age (P=0.675) were not significantly correlated with 18F-FDG uptake. No significant relationship was observed between the tumour/contralateral breast SUVmax ratio and mitotic count, oestrogen receptor status or triple negativity. CONCLUSION: F-FDG uptake may serve as a prognostic indicator for biological behaviour in breast tumours.

Effects of laparoscopic gastric band applications on plasma and fundic acylated ghrelin levels in morbidly obese patients.

BACKGROUND: It has been proposed that laparoscopic adjustable gastric banding (LAGB) procedure might play a role in modulation of fundic ghrelin production. To test this hypothesis, we examined plasma and tissue concentrations of acylated ghrelin in morbidly obese patients before and 6 months after LAGB. Baseline levels of acylated ghrelin in morbidly obese patients were also compared with those in age-matched, healthy, non-obese controls. METHODS: We studied 21 patients who had been operated on for morbid obesity (M/F = 9/12, BMI = 49.3 ± 5.3 kg/m(2)) and 16 healthy, non-obese persons (M/F = 7/9, BMI = 23.0 ± 1.7 kg/m(2)). Fasting blood samples were collected once from the non-obese controls as well as the morbidly obese patients before and 6 months after the LAGB. The morbidly obese patients and their respective controls underwent gastroscopy for fundic biopsy. The plasma and fundic acylated ghrelin levels were evaluated in these groups by enzyme-linked immunosorbent assay. RESULTS: The plasma and fundic acylated ghrelin concentrations were significantly lower in obese patients than in non-obese controls (2.8 ± 1.0 ng/ml, 727 ± 171.7 ng/g tissue, respectively; p = 0.000). These parameters were significantly increased in morbidly obese patients 6 months after LAGB (4.1 ± 1.2 ng/ml and p = 0.001; 999 ± 292.1 ng/g tissue and p = 0.003, respectively). CONCLUSIONS: We showed that fundic production of acylated ghrelin was significantly increased in morbidly obese patients 6 months after LAGB. Moreover, the weight loss after LAGB occurred in spite of the significant increase in the plasma and fundic acylated ghrelin levels. The potential role of ghrelin as being responsible for the weight loss after bariatric surgery needs to be elucidated in further studies.

[Case report: primary splenic hydatidosis]. / Olgu Sunumu: primer dalak kist hidatigi.

Hydatidosis, caused by Echinococcus granulosus is still an important problem in endemic areas as Middle and Eastern Europe including Turkey, South America, Avustralia, New Zealand and South Africa. Hydatid disease affects more common liver and lung. Isolated splenic hydatidoses are quite rare in the medical literature. Here we report a case of isolated primary splenic hydatid cyst which is treated by splenectomy.