ARCHITECTURAL PATTERNS FOR DIFFERENTIAL DIAGNOSIS OF PROLIFERATIVE BREAST LESIONS FROM HISTOPATHOLOGICAL IMAGES.

The differential diagnosis of proliferative breast lesions, benign usual ductal hyperplasia (UDH) versus malignant ductal carcinoma in situ (DCIS) is challenging. This involves a pathologist examining histopathologic sections of a biopsy using a light microscope, evaluating tissue structures for their architecture or size, and assessing individual cell nuclei for their morphology. Imposing diagnostic boundaries on features that otherwise exist on a continuum going from benign to atypia to malignant is a challenge. Current computational pathology methods have focused primarily on nuclear atypia in drawing these boundaries. In this paper, we improve on these approaches by encoding for both cellular morphology and spatial architectural patterns. Using a publicly available breast lesion database consisting of UDH and three different grades of DCIS, we improve the classification accuracy by 10% over the state-of-the-art method for discriminating UDH and DCIS. For the four way classification of UDH and the three grades of DCIS, our method improves the results by 6% in accuracy, 8% in micro-AUC, and 19% in macro-AUC.

Utility of superior mesenteric artery Doppler and maternal pancreatic size for predicting gestational diabetes mellitus.

AIM: The aim of this study was to assess the relationship between the maternal superior mesenteric artery Doppler, pancreatic size and gestational diabetes mellitus (GDM). METHODS: Two hundred and fifty-eight consecutive, pregnant women between 20 and 22 weeks of gestation underwent routine fetal anomaly screening. All subjects underwent maternal superior mesenteric artery Doppler and pancreatic size measurement of head, corpus and tail during screening. Screening was done with 50 g glucose challenge test (GCT) at gestational age 24-28 weeks. The patients who were having an abnormal GCT were subjected to 100 g GCT. Subjects were divided into two groups such as pregnancies with gestational diabetes and normal pregnancies. Relationship between Doppler and pancreatic measurements with GDM was analyzed. RESULTS: Out of 258 screened pregnancies, 28 (10.9 %) were diagnosed as GDM. There were significant differences between GDM positive and negative cases in terms of pancreatic body size (17.5 vs. 14.4 mm, p = 0.05), superior mesenteric artery Doppler systolic/diastolic ratio (S/D) (4.2 vs. 3.4) and resistance index (RI) (0.72 vs. 0.68) values. Superior mesenteric artery Doppler S/D (AUC = 0.761, p < 0.001) and RI (AUC = 0.762, p < 0.001) indices were significant predictors for GDM. CONCLUSION: Superior mesenteric artery Doppler and pancreatic size evaluation may be utilized to detect abnormal glucose metabolism during pregnancy care.

The importance of fecaliths in the aetiology of acute appendicitis.

AIM: Fecaliths, lymphoid hyperplasia, parasites, undigested plant residues and foreign bodies are considered as part of the aetiology of acute appendicitis. In our article we discussed about fecaliths, fecalith formation, and its aetiological value. METHODS: Patients which have been operated on for acute appendicitis between 2009-2010 are analysed retrospectively. RESULTS: The average age was 29,3. The number of cases with fecalith was 261 (36,1%). Out of these, 19 acute appendicites, 95 phlegmons, and 30 perforations were detected. CONCLUSIONS: Intraluminal pathologies probably play a major role in the development of acute appendicitis. Intraluminal pathological findings may also be seen in healthy persons without necessarily pointing to acute appendicitis. Disease progresses from intraluminal fecalith with no inflammation to perforation from the beginning. There are many explanations regarding the formation of fecaliths. Diagnosis of the fecalith may be decided with ultrasonography, computed tomography and magnetic resonance imaging techniques. In case of preoperatively demonstrated intraluminal fecalith through ultrasonographic examination with clinical symptoms of acute appendicitis, early appendectomy must be performed in our opinion. Early appendectomy lowers morbidity and mortality rates.

Subclinical neurological abnormalities in children with celiac disease receiving a gluten-free diet.

OBJECTIVES: Because clinically evident manifestations are frequent in adults with celiac disease (CD), we aimed to investigate whether early neurological abnormalities may be detected in children with CD. METHODS: Electroencephalography, electromyography, and somatosensory evoked potentials were performed in children with CD receiving a gluten-free diet. RESULTS: The neurophysiological tests revealed subclinical neurological abnormalities associated with CD in 3 (11%) of 27 children: 2 had peripheral polyneuropathy documented with electromyography, and 1 had prolonged latencies in somatosensory evoked potential. Magnetic resonance imaging showed abnormalities in 2 (7.4%) of children: pontine demyelinization in 1 and cortical atrophy in the other. CONCLUSIONS: Because the rate of neurological problems is increased in children with CD, neurological abnormalities should be carefully investigated early after the diagnosis of CD is made.

Electrophysiological evaluation of cremasteric reflex in experimental testicular torsion.

AIM: The aim of the study was the electrophysiological evaluation of the cremasteric reflex after experimental testicular torsion. MATERIAL AND METHODS: Ten male Wistar rats were enrolled into the study. Genitofemoral nerve (GFN) motor conduction and cremasteric reflex (CR) responses were evaluated electrophysiologically after being subjected to anesthesia with intramuscular ketamin hydrochloride. Testicular torsion was performed by rotating the right testicle 720 degrees in a clockwise direction from a midscrotal incision. Electrophysiological evaluations were repeated in the early (30 minutes) and late (90 minutes) periods of testicular torsion. Subsequently, detorsion of the testicles was performed and electrophysiological recordings were completed after 60 minutes of detorsion. The CR was also evaluated clinically before each electrophysiological evaluation. The latency and duration of GFN motor conduction and CR responses was compared for base, early torsion, late torsion and detorsion recordings. Friedman's test for repeated measurements was used for statistical analysis. RESULTS: The CR, which was detected clinically before torsion and after detorsion, was not detected during torsion. When base, early torsion, late torsion and detorsion recordings were compared, there was no statistical difference with respect to both latency and duration of GFN motor conduction and CR responses (p > 0.05). CONCLUSION: Although CR was not detected clinically during testicular torsion, the electrophysiological parameters of the reflex did not differ in the early and late periods of torsion in rats. The GFN motor conduction parameters also showed no differences. In conclusion, the absence of the CR after testicular torsion could not be confirmed by electrophysiological studies.

Brucellar spondylodiscitis: a case report.

Brucellosis is a common zoonosis which still remains as a major health problem in certain parts of the world. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylodiscitis is often difficult since the clinical presentation may be obscured by many other conditions. Herein, we reported an uncommon case of spondylodiscitis due to brucella in an elderly male who had diabetes mellitus and degenerative spinal disease as underlying conditions. The diagnosis was established by using magnetic resonance imaging after the brucella-agglutination test was found to be positive. The diagnosis was also confirmed by positive blood culture. A high degree of suspicion in the diagnosis of brucellar spondylitis is essential to reduce the delay for the treatment. Thus, it should be essentially included in the differential diagnosis of longstanding back pain particularly in regions where brucellosis is endemic. Screening serologic tests for brucella should be used more widely in cases with low index of suspicion, especially in endemic areas.

Identification of axonal involvement in Hallervorden-Spatz disease with magnetic resonance spectroscopy.

Hallervorden-Spatz disease is a neurodegenerative disorder associated with cysteine-iron complex accumulation typically seen as bilateral symmetrical hypointense signal changes in the medial globus pallidus on magnetic resonance imaging. We used magnetic resonance spectroscopy to identify and quantify neuronal damage in two siblings with Hallervorden-Spatz disease. The first patient presenting with a rapidly progressive extrapyramidal syndrome had markedly decreased N-acetylaspartate (NAA) to creatinine (Cr) ratios in the globus pallidi and the periatrial white matter. He also had increased myoinositol (mI) to creatinine (Cr) ratios implying glial proliferation in the affected regions. However the second patient who had the initial presentation of disease had normal NAA/Cr and mI/Cr ratios. These findings indicate that the quantification of NAA:Cr and mI:Cr ratios might be used to predict the extent of neuronal axonal loss and glial proliferation in patients with Hallervorden-Spatz disease respectively.

Reproductive health: knowledge and opinions of university students in Erzurum, Turkey.

BACKGROUND: The aim of this study was to assess knowledge of reproductive health and the opinions of university students towards reproductive health education and family planning services. METHODS: A questionnaire about reproductive health knowledge and the opinions of students was submitted to 673 systematically and randomly selected students at Ataturk University. A set of 39 questions was used to determine the level of knowledge of reproductive health. RESULTS: The level of reproductive health knowledge was below the theoretical mean value. An association was found between gender, residential area, parents' education and sibling number with the reproductive health knowledge score. Most of the students approved of formal reproductive health education (88.4%). Approval of family planning services was lower than that of reproductive health education (71.6%). The percentage of men who support family planning services and reproductive health education was lower than that of women. Students who had graduated from Islamic religious schools had more negative opinions towards family planning services. CONCLUSIONS: University students lack knowledge about reproductive health and most of them agree that reproductive health education should be given in schools. Knowledge about reproductive health differs significantly depending on some sociodemographic variables. Some students have negative opinions towards family planning services and reproductive health education.

Mercury poisoning: an unusual cause of polyarthritis.

Mercury is a toxic metal that is widely used in everyday life. It has organic and inorganic forms that are both toxic. As acute mercury poisoning is uncommon, diagnosis is difficult if the exposure is not manifest. It has usually a slow onset and non-specific symptoms. In this paper we report a patient who developed polyarthritis after mercury exposure.

Synthesis and activities of 5-substituted-2-(p-substituted phenyl)-1-dialkylaminomethyl benzimidazole derivatives.

Nine 1,2,5-trisubstituted benzimidazole derivatives were prepared and their structure have been elucidated by IR, NMR spectral data and elemental analyses. Analgesic activity of the compounds prepared was investigated in mice by modified KOSTER test. Anti-inflammatory activity of these compounds was investigated by a carregeenan-induced hind paw edema model in mice. Their antibacterial activities were examined against S. aureus, E. faecalis, E. coli, P. aeruginosa, and antifungal activity against three kinds of yeast-like fungi (C. albicans, C. parapsilosis, C. stellatoidea).

Split cord malformations: report of three unusual cases.

The unified theory, proposed by Pang et al., explains the embryogenetic mechanisms of all variants of split cord malformations (SCMs). All SCMs originate from one basic error occurring around the time when the primitive neurenteric canal closes. The basic error is the formation of an accessory neurenteric canal between the yolk sac and amnion which is subsequently invested with mesenchyme to form an endomesenchymal tract that splits the notochord and neural plate. Three cases of SCMs which support this unified theory are presented. A 3-month-old girl had a combination of both types of SCMs at the level of T11. The 2nd case, a 2-week-old girl, had type-II SCM associated with a thickened filum terminale, lipomyelomeningocele and ectopic renal tissue within lipoma. A lipomatous tract extending from a subcutaneous lipoma to the intradural fibrous septum contained lymphoid tissues and tubular epithelia in a 3-month-old boy with a type-II SCM. These 3 cases support the unified theory.