Variaciones en los parámetros cuantitativos y en la puntuación de la escala de Deauville aplicando diferentes algoritmos de reconstrucción en las imágenes PET/TC con [18F]FDG de pacientes con linfoma / The variation of quantitative parameters and Deauville scores with different reconstruction algorithms in FDG PET/CT imaging of lymphoma patients

Objetivos La escala de Deauville (DS) en la tomografía de emisión de positrones (PET) con [18F]fludeoxiglucosa ([18F]FDG) es un método semicuantitativo único para la evaluación del linfoma. Sin embargo, el tipo de algoritmo de reconstrucción empleado para el cálculo de los valores de captación estándar (max, medio y pico) podría afectar a la DS. Comparamos el algoritmo de reconstrucción de probabilidad penalizada bayesiano (BPL) con el de maximización de expectativas de subconjuntos ordenados (OSEM) respecto a los parámetros cuantitativos y en la DS en el linfoma. Investigamos el efecto del tamaño del ganglio linfático sobre la variación cuantitativa. Métodos Se reconstruyeron por separado los resultados de la PET sin procesar de 255 pacientes con linfoma utilizando la aplicación Q.Clear (General Electric Healthcare, Milwaukee, WI, EE. UU.), un algoritmo BPL, y la aplicación SharpIR (General Electric Healthcare, Milwaukee, WI, EE. UU.), un algoritmo OSEM. En ambas imágenes, para cada paciente, se valoró hígado, el pool sanguíneo mediastínico y los valores de captación estándar (SUV) (SUVmáx, SUVmedio y SUVpico) de un total de 487 lesiones seleccionadas. Se compararon DSmáx, DSmedio y DSpico. Resultados En nuestro estudio hubo un aumento significativo de la DS con el BPL (p<0,001) que pasó a una puntuación de 4 a 5 en 30 pacientes inicialmente catalogados como 1-2-3 mediante el algoritmo OSEM. Se observó que los valores cuantitativos de los ganglios linfáticos aumentaban de forma estadísticamente significativa con el BPL (p<0,001), mientras que la disminución de los valores de hígado fue notable respecto a las regiones de referencia (p<0,001). Además, la diferencia en los ganglios linfáticos se asoció de forma independiente con el tamaño de la lesión y fue considerablemente más pronunciada en las lesiones de pequeño tamaño (p<0,001) (AU)

Introduction and Objectives 18F-FDG PET with the Deauville score (DS) is a unique semiquantitative method for lymphoma. However, type of standard uptake values (max, mean, and peak) reconstruction algorithms could affect DS. We compared the Bayesian Penalized Likelihood reconstruction algorithm (BPL) with Ordered Subsets Expectation Maximization (OSEM) on quantitative parameters and DS in lymphoma. We investigated the effect of the size of the lymph node on quantitative variation. Patients and Methods Raw PET data of 255 lymphoma patients were reconstructed separately with Q.Clear (GE Healthcare), a BPL, and SharpIR (GE Healthcare), an OSEM algorithm. In both images, each patient's liver, mediastinal blood pool, and SUVs (SUVmax, SUVmean, and SUVpeak) of a total of 487 lesions selected from the patients were performed. DSmax, DSmean, and DSpeak were compared. Results In our study, DS increased significantly with BPL (p<0.001), and the DS increased to 4-5 in 30 patients evaluated as 1-2-3 with OSEM. It was found that the quantitative values of the lymph nodes increased statistically with BPL (p<0.001), and the liver from the reference regions were significantly decreased (p<0.001). In addition, difference in lymph node was independently associated with size of lesion and was significantly more pronounced in small lesions (p<0.001). The effects of BPL algorithm were more pronounced in SUVmax than in SUVmean and SUVpeak. DS-mean and DS-peak scores were less changed by BPL than DS-max. Conclusion Different reconstruction algorithms in FDG PET/CT affect the quantitative evaluation. That variation may affect the change in DS in lymphoma patients, thus affecting patient management (AU)

An investigation of bovine papillomaviruses from ocular squamous cell carcinomas in cattle.

Background: Ocular squamous cell carcinomas (OSCCs) in cattle has been studied for many years, but no definite etiology has been established. Squamous cell carcinomas (SCCs) may occur in different body parts of cattle. Depending on the location, it can cause an economic loss of varying degrees. Aims: The aim of this study was to investigate the causes of OSCCs in the eye region of cattle. Methods: Sixty tumoral masses taken form 60 cattle with proliferation in the eye region that were collected between the years 2012-2022 were used. These cases were admitted to our department for routine diagnosis. The tissues were diagnosed as OSCC using histopathological methods. The presence of bovine papillomavirus (BPV), one of the causative factors, was investigated using immunohistochemical and polymerase chain reaction (PCR). Results: Macroscopically masses were nodular or cauliflower-like and fragile and had hemorrhagic surfaces. Considering the keratin pearls, tumoral islands, and squamous differentiation, 20 out of 60 cases were classified as well, 20 as moderately, and 20 as poorly-differentiated OSCCs. 47 of the 60 cases were BPV positive using immunohistochemical methods. However, BPV nucleic acid was detected in only two cases with PCR. Only one of the cases could be sequenced. After phylogenetic analysis, virus strain was identified as BPV-1. Conclusion: Our results indicated that papillomaviruses can contribute to the development of OSCCs, in both precursor lesions and also advanced stage OSCCs. We found that BPV-1 has a possible causative role; however, more studies are needed to investigate the role of other viral agents and their interaction with secondary factors.

COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission.

OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.

Association of 18F-FDG PET/CT textural features with immunohistochemical characteristics in invasive ductal breast cancer. / Asociación de características de textura de la PET/TC con [18F]FDG con las características inmunohistoquímicas en el cáncer de mama ductal infiltrante.

OBJECTiVES: This study investigates whether textural features (TFs) extracted from F-18 FDG positron emission tomography/computed tomography (PET/CT) are associated with IHCs of invasive ductal breast carcinoma (IDBC). MATERIALS AND METHODS: The relationship of TFs with IHCs [estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), Ki-67 proliferation index, and histological grades] from solely excised primary tumors were evaluated for a more accurate assessment. Therefore patients with early-stage IDBC who underwent pre-operative F-18 FDG PET/CT scan for staging were included in this retrospective study. The clinical staging was performed according to the 8th edition of the American Joint Committee on Cancer. Maximum standardized uptake value (SUVmax) and 37 TFs of the primary tumor were extracted from F-18 FDG PET/CT. Spearman's rank correlation test was used to evaluate the correlation between TFs and SUVmax. Receiver operating characteristic curves were generated to define the diagnostic performance of each parameter. Among these parameters, those with the highest diagnostic performance were included in the multivariate logistic regression model to identify the independent predictors of histopathological characteristics. RESULTS: A total of 124 patients were included. Histogram-uniformity, GLCM-energy, and GLCM-homogeneity showed a strong negative correlation with SUVmax, while GLRLM-SRHGE, GLZLM-HGZE, GLRLM-HGRE, GLCM-entropy, GLCM-contrast, histogram-entropy, and GLCM-dissimilarity showed a strong positive correlation. Some of the TFs were independently associated with ER-negativity, PR-negativity, HER-2-positivity, and increased Ki-67 proliferation index (GLCM-contrast, GLZLM-GLNU, histogram-uniformity, and shape-sphericity respectively). While SUVmax had an independent association with high-grade and triple-negativity, GLZLM-SZLGE, a high-order TF that shows the distribution of the short homogeneous zones with low grey-levels, had an independent association with axillary lymph node metastasis. CONCLUSIONS: ER-negative, PR-negative, HER-2-positive, triple-negative, high-grade, highly proliferative, and high-stage tumors were found to be more glycolytic and metabolically heterogeneous. These findings suggest that the use of TFs in addition to SUVmax may improve the prognostic value of F-18 FDG PET/CT in IDBC, as certain TFs were independently associated with many IHCs and predicted axillary lymph node involvement.

Long-term study (2005-2010) on the vaccination with BoHV-1 glycoprotein E-deleted marker vaccine in selected two dairy herds in Turkey.

A follow-up study from 2005 to 2010 was carried out in two herds where eradication programme for the bovine herpes virus-1 (BoHV-1) infection depends on the vaccination with inactivated glycoprotein E-deleted vaccine that was started in 2001 following the vaccination with inactivated conventional vaccine between 1999 and 2001. For serological screening, a total of 12,976 sera sampled over several sampling times approximately 6 months of interval during 5 years (2005-2010) were tested for glycoprotein E (gE)- and glycoprotein B-specific antibodies using ELISA. According to the serological evidence, the long-term persistence of BoHV-1 antibodies, success of marker vaccine, first vaccination time of the calves in herds regularly vaccinated, etc. were discussed in this paper. In conclusion, the vaccination programme using gE (-) marker vaccines, with making efforts to prevent the other factors about transmission of infection, was suggested for the eradication of BoHV-1 infection in Turkey as many EU countries. This is the first report on the BoHV-1 eradication programme in some dairy cattle in Turkey.

Frequency of atopy and allergic disorders among adults with Type 1 diabetes mellitus in the southern Marmara region of Turkey.

AIM: Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients. METHODS: Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test. RESULTS: Patients' mean age were similar in diabetic patients and controls (28.2+/-8.9 and 28.1+/-5.2 yr; respectively). In skin-prick test, the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy. CONCLUSION: We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.

Clinical and laboratory aspects of a trichinellosis outbreak in Izmir, Turkey.

Epidemiological, clinical and laboratory data were collected during an outbreak of trichinellosis, which occurred in Izmir, Turkey, between January and March 2004. The source of the infection was raw meatballs made with a mixture of uncooked beef and pork. Of 474 persons who were admitted at the Ataturk Training and Research Hospital during this period with a history of raw meatball consumption, the diagnosis of trichinellosis was confirmed for 154 (32.5%, 87 males and 67 females; mean age 31 years, range 6-67 years). Among persons with a confirmed diagnosis, 79% had myalgia, 77% weakness and malaise, 63% arthralgia, 40% jaw pain, 68% fever, 63% periorbital and/or facial oedema, 49% oedema at the trunk and limb, 42% abdominal pain, 40% nausea and vomiting, 28% diarrhoea, 23% subconjunctival haemorrhage, 25% macular or petechial rash, 4% subungual haemorrhage, 15% cardiac complaints and 0.2% neurological complaints. Nine patients (5.8%) were hospitalised due to severe myalgia (n = 2), high fever (n = 3), neurological manifestations (n = 1), thrombophlebitis (n = 2) and palmar erythema (n = 1). Eosinophilia was present in 88% of the confirmed cases at the admission. Elevated levels of serum creatine phosphokinase, lactic dehydrogenase and aspartate aminotransferase were detected in 72%, 70% and 16% of the confirmed cases, respectively. The seroconversion occurred in most of the infected people between the 4th and 6th weeks after the infection. All of the confirmed cases were treated with mebendazole. People with severe symptoms were treated also with prednisolone (60 mg/day for three days) and those with a moderately severe clinical pattern received a non-steroid anti-inflammatory drug (naproxen sodium, 550 mg/day). All confirmed cases recovered without any clinical sequela.

Co-existence of the pectoralis quartus and pectoralis intermedius muscles.

During the routine dissection studies on the right side of a 56-year-old female cadaver we encountered co-existence of the pectoralis quartus and pectoralis intermedius muscles. The pectoralis quartus originated from the costochondral junction of the fifth and sixth ribs, and then extended laterally under the border of pectoralis major muscle, but it was entirely separate from it. The pectoralis quartus formed a long flat band with an average width of 1.5 cm. It then inserted as an aponeurosis to the both of lateral lip of the intertubercular groove of the humerus and tendon of the short head of the biceps brachii muscle. Furthermore, the pectoralis intermedius muscle was a fleshy slip between the pectoralis minor and pectoralis quartus muscles and arose from the third and fourth ribs. It then united to the tendon of the short head of the biceps brachii muscle two cm below the coracoid process.

Reiter syndrome accompanied by Terry nail.

We present a case of Reiter syndrome (RS) associated with Terry nail in a 32-year-old male patient who also had subungual keratosis and onycholysis. The case had all the characteristic findings of complete RS including urethritis, conjunctivitis, arthritis and skin lesions, and based on these findings a clinical diagnosis was established. The patient complained of milky-white coloured leakage that was more frequent in the mornings, and dysuria. Urinary analysis revealed leucocytes and erythrocytes. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were high. The case was considered as RS due to gonococcic urethritis. However, there was no growth in the culture. Self-report of the patient revealed that he had had continued symptoms and 9 months after the development of RS he developed Terry nail. To the best of our knowledge this is the first case of RS associated with Terry nail.

Arterial, neural and muscular variations in the upper limb.

During our routine dissection studies we observed arterial, neural and muscular variations in the upper limbs of an adult male cadaver. In this case we observed the superficial brachial artery origination from the third part of the axillary artery, communications between the musculocutaneous and median nerves, variant formation of the brachial plexus, origination of the profunda brachii artery from the posterior circumflex humeral artery and supernumerary tendons of the abductor pollicis longus muscle. We think that such variations should be kept in mind during surgical and diagnostic procedures.

A case with multiple anomalies in the upper limb.

During routine educational dissection studies, we encountered multiple nervous and arterial anomalies in a 60-year-old embalmed male cadaver. The arterial anomalies were observed on the right side. The superficial brachial artery originated from the axillary artery under the pectoralis minor muscle. There was an arch between the superficial brachial and brachial arteries in the cubital fossa. Additionally, a communication was observed between the musculocutaneous and median nerves. Moreover, the coracobrachialis muscle was innervated by an accessory nerve branch originating from the lateral cord of the brachial plexus. All of the nervous anomalies were on the left side. A combination of these variations in the same case has not, to our knowledge, been previously described in the available literature.