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OBJECTIVE: This study aims to determine the indicators of tobacco use in Türkiye within a multidimensional context as socio-demographic, physical, behavioural, and psychological as a response to the tobacco control policies. METHODS: The Turkish Health Survey data in 2014 and 2019 are employed within a probit model approach and the differences in tobacco are decomposed use by gender in order to reveal the gender differences. The samples in 2014 (total n = 19,129; males = 8 721, females = 10,408) and 2019 (total n = 17,084; males = 7 784, females = 9300) were restricted to 15-year-old and above. RESULTS: The findings indicate that being in the 30-49 age cohort, having lower education, and being married increase the likelihood of tobacco use. Future policies and campaigns should specifically target the single, pre-obese, employed males who consume alcohol. For females, the gender-specific policies should aim to reduce the prevalence of smoking, especially among separated or widows, obese, and out of the labour force. The contribution of mental health indicators on tobacco use has declined over the 5 years, which could be a result of the supportive free health services in Türkiye. The findings provide evidence for a significant and increasing gender difference in tobacco use in Türkiye along with reporting that the most significant contributors to gender differences in tobacco use are alcohol consumption and education level. CONCLUSION: Even though the Ministry of Health and the government have been implementing anti-tobacco policies, legislations, and campaigns for years, the tobacco use prevalence has remained high and even increased in Türkiye.
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Uso de Tabaco , Humanos , Masculino , Femenino , Adolescente , Adulto , Uso de Tabaco/epidemiología , Turquía/epidemiología , Persona de Mediana Edad , Adulto Joven , Factores Sexuales , Política de Salud , Encuestas Epidemiológicas , Prevalencia , Control del TabacoRESUMEN
The incidence and prevalence of neuroendocrine neoplasms (NENs) in many organs are increasing. Although such NENs have similar grades, they may exhibit quite different behaviors. In this multicenter study, we aimed to investigate the prevalence and distribution of different morphological NEN variants in the non-pancreatic gastrointestinal (GI) tract and determine whether they can guide prognosis prediction. Two hundred and fifty-six patients diagnosed with NENs originating from the GI tract from 7 different centers were included in the study. In 89 (36.6%) cases, different morphological variants were detected. When the variants were grouped according to their aggressiveness as described in the literature, a statistically significant relationship between aggressiveness and the variables organ and age was found ( p < 0.05). The oncocytic variant was found to metastasize more than the other aggressive types (42.9%). The paraganglioma-like variant was found to have a smaller size, lower proliferation index, and a more benign clinical course. This study demonstrated that well-differentiated GI neuroendocrine tumors (GI-NETs) have considerable morphological diversity. Generally, case reports of rare morphological variants of GI-NETs are available in the literature. We believe that our study contributes to a better understanding of the prevalence, localization, and significance of morphological variations in GI-NETs.
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Neoplasias Gastrointestinales , Tumores Neuroendocrinos , Humanos , Tumores Neuroendocrinos/patología , Tumores Neuroendocrinos/epidemiología , Femenino , Persona de Mediana Edad , Masculino , Prevalencia , Neoplasias Gastrointestinales/patología , Neoplasias Gastrointestinales/epidemiología , Anciano , Adulto , Pronóstico , Anciano de 80 o más Años , Adulto Joven , AdolescenteRESUMEN
INTRODUCTION: Tetramethylpyrazine (TMP) is a chemical compound, which has been shown to possess numerous biological features such as anticoagulation, inhibition of platelet aggregation, anti-inflammation, capillary dilatation, improvement in microcirculation, and protection against reactive oxygen radicals. The aim of the present study was to investigate the protective effect of TMP against radiation-induced ototoxicity. MATERIALS AND METHODS: 40 rats were divided into four groups. The first group was irradiated for 5 days. The second group received a single dose of 140 mg/kg/day intraperitoneal TMP given to the rats 30 min before radiotherapy (RT) for 5 days. The third group received a single dose of 140 mg/kg/day i.p. TMP for 5 days, whereas the fourth group was administered saline. All rats underwent distortion product otoacoustic emission (DPOAE) and auditory brainstem response measurements before and after the application. The temporal bulla of animals was removed for immunohistopathological examination. RESULTS: Signal-noise ratio values were significantly decreased in the RT group for the frequencies of 2-32 kHz after RT (p < 0.05), whereas the difference was not significant in terms of pre- and posttreatment values for the other groups. Also in the RT group, the ABR thresholds were significantly increased after treatment. In H&E staining, the mean scores for outer hair cells (OHCs), stria vascularis (SV), and spiral ganglion (SG) injuries were significantly higher in RT and RT + TMP groups than in the other groups. The mean OHCs and SV injury scores were also significantly higher in the RT group than in the RT + TMP group (p < 0.05). The number of cochleas that showed cytoplasmic caspase-3 immunoreactivity in the OHC, SV, and SG was significantly higher in RT and RT + TMP groups than in the other groups. CONCLUSION: The findings of the present study suggest that TMP may have a therapeutic potential for preventing sensorineural hearing loss (SNHL) related to RT.
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Cisplatino , Ototoxicidad , Pirazinas , Ratas , Animales , Ototoxicidad/etiología , Ototoxicidad/prevención & control , Cóclea , Emisiones Otoacústicas Espontáneas , Potenciales Evocados Auditivos del Tronco EncefálicoRESUMEN
In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.
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Obesidad , Adulto , Humanos , Masculino , Femenino , Adulto Joven , Índice de Masa Corporal , Factores Sexuales , Turquía/epidemiología , Obesidad/epidemiología , Encuestas y Cuestionarios , Factores Socioeconómicos , PrevalenciaRESUMEN
Background/aim: PD-1 (programmed death-1) is an immune checkpoint receptor that modulates T-cell activity in peripheral tissues via interaction with its ligands, PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2). Tumor cells upregulate PD-L1 or PD-L2 to inhibit this T lymphocyte attack. Our goal was to determine the PD-1 and PD-L2 expression rates of various hematologic malignancies, and evaluate whether PD-1 and PD-L2 expressions have an impact on prognosis. Materials and methods: For this purpose, pretreatment bone marrow biopsy specimens of 83 patients [42 multiple myeloma (MM), 21 acute leukemia, and 20 chronic lymphocytic leukemia (CLL)] were stained with monoclonal antibody immunostains of PD-1 and PD-L2. Results: As a result, the overall expression rate of PD-1 was 26.2%, 4.8%, and 60% in patients with MM, acute leukemia, and CLL, respectively, whereas the PD-L2 expression rate was 61.9%, 14.3%, and 10% in patients with MM, acute leukemia, and CLL, respectively. Conclusion: Finally, we concluded that the role of the PD-1 pathway can be demonstrated by immunohistochemistry (IHC). Since we evaluated whether there is a correlation between the (IHC) results and survival of patients with MM, acute leukemia, and CLL, we could not demonstrate meaningful evidence that these markers have an impact on prognosis.
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Antígeno B7-H1/análisis , Neoplasias Hematológicas/química , Neoplasias Hematológicas/diagnóstico , Proteína 2 Ligando de Muerte Celular Programada 1/análisis , Adulto , Anciano , Anciano de 80 o más Años , Médula Ósea/química , Médula Ósea/patología , Femenino , Neoplasias Hematológicas/epidemiología , Neoplasias Hematológicas/patología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios RetrospectivosRESUMEN
Verruca vulgaris is a cutaneous disease manifested with a single or multiple, small painless lesions that may involve keratinized or nonkeratinized epithelium. It can be localized at skin or mucosa. It is a benign lesion; however, it is of importance to discriminate from verrucous carcinoma to plan treatment, especially in those with laryngeal localization. Total excision is adequate in the management of verruca vulgaris; thus, accurate differential diagnosis is essential to avoid unnecessary surgical interventions. Here, the authors presented a patient with verruca vulgaris which was totally excised by cold-blade surgical excision.
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Carcinoma Verrugoso/complicaciones , Manejo de la Enfermedad , Ronquera/etiología , Neoplasias Laríngeas/complicaciones , Laringe/diagnóstico por imagen , Adulto , Carcinoma Verrugoso/diagnóstico , Carcinoma Verrugoso/cirugía , Diagnóstico Diferencial , Ronquera/diagnóstico , Ronquera/terapia , Humanos , Neoplasias Laríngeas/diagnóstico , Laringoscopía , MasculinoRESUMEN
OBJECTIVE: To assess both solid and cystic pancreatic lesions using endoscopic ultrasound (EUS), and the effect of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in patient management. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Gastroenterology, Division of Internal Diseases, Sivas Cumhuriyet University Hospital, Sivas, Turkiye, from January 2018 to 2022. METHODOLOGY: Patients with pancreatic mass, who underwent EUS-FNA were inducted in the study. EUS-FNA was performed using a 22-gauge needle via both transgastric and transduodenal routes. The size of the pancreatic lesion, its location, and whether there was SMA or CA invasion were evaluated on CT and EUS scans. Biopsy results of 64 patients who received EUS-FNA due to pancreatic lesions were considered. The results were divided into malignancy or benign pathology. RESULTS: A total of 64 cases were compared. Crosstable Chi-square analysis showed a statistically significant difference between CT and EUS (p <0.001). EUS-FNA results revealed that out of the 64 patients with pancreatic mass detected in EUS, 46 had adenocarcinoma, 7 were negative for malignancy, 4 had intraductal papillary mucinous neoplasia (IPMN), 3 had neuroendocrine tumour (NET), 2 had lymphoma, and 2 had solid pseudopapillary neoplasia (SPN). In the 2-year follow-up of the seven patients who were negative for malignancy in EUS-FNA, there were no clinical, laboratory or imaging findings indicating pancreatic malignancy or distant metastasis. CONCLUSION: Tissue sampling through EUS-FNA has minimal side effects and remains useful in managing preoperative patients with resectable or suspicious pancreatic masses. KEY WORDS: Pancreatic cancer, Abdominal CT, Endoscopic ultrasound (EUS), Ultrasound-guided fine-needle aspiration (EUS-FNA).
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Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico , Neoplasias Pancreáticas , Humanos , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/diagnóstico por imagen , Masculino , Femenino , Persona de Mediana Edad , Anciano , Adulto , Páncreas/patología , Endosonografía/métodos , Tomografía Computarizada por Rayos XRESUMEN
Early detection of colon adenomatous polyps is pivotal in reducing colon cancer risk. In this context, accurately distinguishing between adenomatous polyp subtypes, especially tubular and tubulovillous, from hyperplastic variants is crucial. This study introduces a cutting-edge computer-aided diagnosis system optimized for this task. Our system employs advanced Supervised Contrastive learning to ensure precise classification of colon histopathology images. Significantly, we have integrated the Big Transfer model, which has gained prominence for its exemplary adaptability to visual tasks in medical imaging. Our novel approach discerns between in-class and out-of-class images, thereby elevating its discriminatory power for polyp subtypes. We validated our system using two datasets: a specially curated one and the publicly accessible UniToPatho dataset. The results reveal that our model markedly surpasses traditional deep convolutional neural networks, registering classification accuracies of 87.1% and 70.3% for the custom and UniToPatho datasets, respectively. Such results emphasize the transformative potential of our model in polyp classification endeavors.
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Pólipos Adenomatosos , Pólipos del Colon , Humanos , Pólipos del Colon/diagnóstico por imagen , Redes Neurales de la Computación , Diagnóstico por Computador/métodos , Diagnóstico por ImagenRESUMEN
BACKGROUND: We aimed to investigate effect of radiotherapy (RT) applications with different dose rates on cytogenetic damages, which focused on micronucleus (MN) formation, and evaluate how this damage varies by cisplatin in rats receiving head-neck RT. MATERIAL AND METHODS: Thirty-six Sprague Dawley rats were divided into five groups. The first and second groups were irradiated at a dose rate of 300 monitor unit/minute (MU/min) and 600 MU/min, respectively. The third group was irradiated at a dose rate of 300 MU/min and given cisplatin. The fourth group was irradiated at a dose rate of 600 MU/min and given cisplatin. The fifth group received neither irradiation nor cisplatin (control group). One thousand polychromatic erythrocytes were scored, and MN frequency in polychromatic erythrocytes was determined for each rat. RESULTS: There was a significant difference among five groups in terms of the number of MN (p: 0.001). The number of MN was significantly higher in the 600 MU/min + cisplatin group (fourth group) compared to the control group [9.5 (1.0-23.0) vs. 1.5 (1.0-2.0), respectively]. It was also significantly higher in 600 MU/min + cisplatin group (fourth group) compared to 300 MU/min group (first group) [9.5 (1.0-23.0) vs. 2.0 (1.0-3.0), respectively]. On the other hand, there was no significant difference among other groups. CONCLUSIONS: Our findings suggest that RT given at a higher dose rate causes more cytogenetic damage, and this damage is increased by concurrent administration of cisplatin.
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Cisplatino , Neoplasias de Cabeza y Cuello , Pruebas de Micronúcleos , Animales , Cisplatino/farmacología , Ratas , Pruebas de Micronúcleos/métodos , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/genética , Masculino , Ratas Sprague-Dawley , Antineoplásicos/farmacología , Micronúcleos con Defecto Cromosómico/efectos de la radiación , Micronúcleos con Defecto Cromosómico/efectos de los fármacos , Eritrocitos/efectos de la radiación , Eritrocitos/efectos de los fármacos , Eritrocitos/patología , Relación Dosis-Respuesta en la RadiaciónRESUMEN
BACKGROUND: Diffusion Magnetic Resonance Imaging (MRI) is a useful method to evaluate tumor biology and tumor microstructure. The apparent diffusion coefficient (ADC) value correlates negatively with the cellular density of the tumor. OBJECTIVE: This study aimed to investigate the effectiveness of the ADC histogram analysis in showing the relationship between breast cancer prognostic factors and ADC parameters. METHODS: This study is a retrospective observational descriptive study. ADC histogram parameters were evaluated in all tumor volumes of 67 breast cancer patients. Minimum, 5, 10, 25, 50, 75, 90, 95 percentiles, maximum, mean, median ADC values, kurtosis, and skewness were calculated. Breast MRI examinations were performed on a 3T MR scanner. We evaluated the fibroglandular tissue density of bilateral breasts, background enhancement, localization of masses, multifocality-multicentricity, shape, rim, internal contrast enhancement, and kinetic curve on breast MRI. BIRADS scoring was performed according to breast MRI. Pathologically, histologic type, histologic grade, HER 2, Ki 67, ER-, and PR status were evaluated. RESULTS: A significant correlation was found between tumor volume and ADC scores. There is a significant correlation between min ADC values (p< 0.031), max ADC (p< 0.001), and skewness (p< 0.019). A significant correlation was found between tumor kurtosis and lymph nodes (p< 0.029). There was a significant difference in ADC values depending on ER-and PRstatus. (for ER p = 0.004, p = 0.018, p = 0.010, p = 0.008, p = 0.004, p = 0.004, p = 0.02, p = 0.02 and p = 0.038, for PR p < 0.001, p = 0.028, p = 0.011, p = 0.001, p < 0.001, p =<0.001, p < 0.001, and p < 0.001, respectively; p < 0.05). These values were lower in ER-and PR-positive status than in ER-and PR-negative receptor status. According to HER2 status, there was a statistically significant difference in ADC
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Neoplasias de la Mama
, Imagen de Difusión por Resonancia Magnética
, Humanos
, Neoplasias de la Mama/diagnóstico por imagen
, Femenino
, Imagen de Difusión por Resonancia Magnética/métodos
, Estudios Retrospectivos
, Persona de Mediana Edad
, Pronóstico
, Adulto
, Anciano
, Carga Tumoral
, Mama/diagnóstico por imagen
, Mama/patología
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This study aims to analyse the subjective well-being of university students during the early days of the COVID-19 pandemic process and to examine how students have been affected economically, psychologically and socially. Other subjects included in the scope of the study are the suitability of the physical conditions during the process of online education, the students' motivation, and their expectations towards the future. The study also analyses the connection between these factors and the subjective well-being concepts of happiness and life satisfaction. The study focuses on students of the Faculty of Economics at Marmara University in Turkey. In total, 428 students took part in the survey prepared for the study. Descriptive analyses indicate that students have been negatively affected in terms of psychological and socio-economic factors along with subjective well-being. Ordered probit models show a statistically significant relationship between a major part of these changes and subjective well-being variables.
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BACKGROUND AND OBJECTIVE: Early detection of colon adenomatous polyps is critically important because correct detection of it significantly reduces the potential of developing colon cancers in the future. The key challenge in the detection of adenomatous polyps is differentiating it from its visually similar counterpart, non-adenomatous tissues. Currently, it solely depends on the experience of the pathologist. To assist the pathologists, the objective of this work is to provide a novel non-knowledge-based Clinical Decision Support System (CDSS) for improved detection of adenomatous polyps on colon histopathology images. METHODS: The domain shift problem arises when the train and test data are coming from different distributions of diverse settings and unequal color levels. This problem, which can be tackled by stain normalization techniques, restricts the machine learning models to attain higher classification accuracies. In this work, the proposed method integrates stain normalization techniques with ensemble of competitively accurate, scalable and robust variants of CNNs, ConvNexts. The improvement is empirically analyzed for five widely employed stain normalization techniques. The classification performance of the proposed method is evaluated on three datasets comprising more than 10k colon histopathology images. RESULTS: The comprehensive experiments demonstrate that the proposed method outperforms the state-of-the-art deep convolutional neural network based models by attaining 95% classification accuracy on the curated dataset, and 91.1% and 90% on EBHI and UniToPatho public datasets, respectively. CONCLUSIONS: These results show that the proposed method can accurately classify colon adenomatous polyps on histopathology images. It retains remarkable performance scores even for different datasets coming from different distributions. This indicates that the model has a notable generalization ability.
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Pólipos Adenomatosos , Pólipos del Colon , Humanos , Pólipos del Colon/diagnóstico por imagen , Colorantes , Redes Neurales de la Computación , Aprendizaje AutomáticoRESUMEN
An extensive literature providing information on published materials in machine learning exists. However, machine learning is still a rather new concept in the fields of economics and econometrics. This study aims to identify different properties of published documents about machine learning in economics and econometrics and therefore to draw a detailed picture of recent publications from bibliometric analysis perspectives. For the aim of the study, the data are collected from the publications indexed by Web of Science and Scopus databases from the period 1991 to 2020. Inthe study, the data have been illustrated by VOSviewer for science mapping. The analysis of variance has also been used to identify the links between the number of citations of articles and years. The findings obtained provides information about the studies on machine learning in the relevant field conducted in the past, as well as providing an opportunity to gain knowledge about the researched area by shedding light on what the future research areas would be. There is no doubt that it attracts attention has increased significantly on machine learning in the field of economics and econometrics and academic publications on machine learning in the relevant field have increased over the last decade.
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Background: Low-grade appendiceal mucinous neoplasms (LAMN) of the appendix have bland cytological features and well-differentiated morphology. Despite this, they may cause a pseudomyxoma peritonei (PMP) disease characterized by mucinous deposits in the peritoneal cavity and may exhibit malignant behavior. Aims and Objectives: In this study, we evaluated the clinical course and histopathological findings of LAMN. The rate of progression to PMP, factors affecting its development, and the clinical course of cases with PMP were investigated. Materials and Methods: Twelve thousand and forty-seven cases who underwent appendectomy were reviewed, and 71 mucinous lesions cases whose slides are in our archive were included in the study. Histopathological findings were re-evaluated. Morphological findings that guide the differential diagnosis, the clinical course of the patients, and factors affecting PMP development were determined. Results: The cases were divided into group 1 non-neoplastic (9.9%), group 2 benign (18.3%), group 3 LAMN (60.6), and group 4 malignant neoplasms (11.3%). Age, gender, appendix diameter, gross appearance, epithelial characteristics, and presence of microcalcification were significantly different between the patient groups. The presence of mucin in the ileocecal region was found to be significant in the development of PMP. It was observed that the additional procedure performed after the appendectomy did not prevent a recurrence. Conclusion: LAMNs are lesions with characteristic findings and different behaviors. The only method to distinguish from the lesions included in the differential diagnosis is to interpret the histopathological findings correctly. Additional operations after appendectomy do not contribute to preventing recurrence.
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Neoplasias del Apéndice , Neoplasias Glandulares y Epiteliales , Neoplasias Peritoneales , Seudomixoma Peritoneal , Neoplasias del Apéndice/diagnóstico , Neoplasias del Apéndice/patología , Neoplasias del Apéndice/cirugía , Diagnóstico Diferencial , Humanos , Neoplasias Peritoneales/patología , Pronóstico , Seudomixoma Peritoneal/diagnósticoRESUMEN
OBJECTIVES: This study aimed to investigate the effectiveness of topical allantoin application on wound healing in a rat chronic tympanic membrane perforation (TMP) model. METHODS: A chronic TMP model was established with 25 healthy, female, 6-month-old, Sprague Dawley rats with chemical damage (trichloroacetic acid 50%). The rats were randomly assigned into 3 groups as follows: Group 1 (10 rats, 20 ears) was administered intratympanic (IT) 20 µL/day 0.57% allantoin solution 7 times, every other day; Group 2 (5 rats, 10 ears) received no substance; Group 3 (10 rats, 20 ears) received IT 20 µl/day distilled water 7 times, every other day. After tympanic membrane (TM) examination with an otoendoscope, histopathological examination of the TM was performed to evaluate neutrophil activity, chronicity, histiocytes, keratin accumulation, subepithelial edema, congestion, fibroblast proliferation, neovascularization, and tympanic membrane thickness. RESULTS: Two TM perforations, 1 in Group 1 and 1 in Group 3, were not healed whereas TM perforations in 48 ears demonstrated closure at the end of the study. According to the histopathological examination, neutrophil activity and fibroblast proliferation were significantly higher in Group 1. There was no significant difference between the groups in terms of other histopathological parameters. CONCLUSION: To the best of our knowledge, this is the first study investigating the effect of allantoin in an experimental chronic TMP model. According to the histopathological findings, allantoin may have positive effects on the wound healing process of chronic TMP.
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Alantoína/farmacología , Fármacos Dermatológicos/farmacología , Perforación de la Membrana Timpánica , Membrana Timpánica , Animales , Femenino , Ratas , Ratas Sprague-Dawley , Cicatrización de HeridasRESUMEN
OBJECTIVE: To investigate the effects of clinicopathological features on disease-free survival (DFS) and overall survival (OS) in in-patients with local advanced rectal cancer (LARC) who received neoadjuvant chemoradiotherapy (nCRT). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Clinic of Radiation Oncology, Kayseri Training and Research Hospital and Kayseri City Hospital, Turkey, between January 2014 and June 2019. METHODOLOGY: The pre-nCRT, post-nCRT, and postoperative imaging methods of 51 patients, who were operated upon, were examined. Radiological images (CT and MRI) of the patients were reviewed using the hospital's PACS system. Pathology reports and preparations were re-evaluated, and TNM staging and the pathological tumour regression grade (pTRG) were graded according to the American Joint Committee on Cancer's (AJCC) 2018 version. For the descriptive statistics of the data, the mean, standard deviation, lowest-highest median, frequency, and ratio values were used. Cox regression (univariate-multivariate analysis) and Kaplan-Meier curves were used for survival analysis. RESULTS: In the univariate model, the postoperative pathological T and N stages (ypT and ypN), pathological stage, positive lymph node count (pLN+, pathological sampling) and lymphovascular invasion (LVI) positivity had a significant effect (p <0.05) on DFS. In the multivariate reduced model, a significant independent (p <0.05) effect of the ypT and pLN+ number was observed on DFS. In the univariate model, the pathological tumour diameter after nCRT, the ypT, perineural invasion (PNI) positivity, and relapse presence had a significant effect (p <0.05) on OS. In the multivariate reduced model, a significant independent (p <0.05) effect of recurrence was observed on OS. CONCLUSION: LVI, the ypTN stage, and the pLN+ number affected the disease-free survival, while the residual tumour diameter after nCRT, ypT stage, and PNI affected the overall survival. The predicted DFS time decreased as the ypT stage increased and the predicted OS time decreased as the recurrence increased. Key Words: Rectal cancer, Neoadjuvant chemoradiotherapy, Disease-free survival, Overall survival.
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Terapia Neoadyuvante , Neoplasias del Recto , Quimioradioterapia , Supervivencia sin Enfermedad , Humanos , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Pronóstico , Neoplasias del Recto/terapia , Estudios Retrospectivos , TurquíaRESUMEN
BACKGROUND: The present study aimed to investigate the healing of articular cartilage with boric acid (BA) injection in an experimental cartilage defect model of rabbit knee. METHODS: Nine skeletally mature female New Zealand White rabbits were used. The right knees of the rabbits were assigned as the study group and injected with the BA solution and the left knees of the rabbits as the control group. Under anesthesia, a cylindrical full-thickness osteochondral defect (4 mm in diameter and 3 mm in depth) was formed using a drill on the anterior side of the articular surface of the medial femur condyle. The BA solution was administered to the right knees of rabbits in the form of an intra-articular injection (8 mg/kg) for 6 weeks, at the same day and hours each week. The animals were euthanized at the end of the 2nd month. RESULTS: In both macroscopic evaluation and microscopic evaluation, statistically significant differences were observed in the BA injection group compared with the control group (p<0.05). In the macroscopic examination of the defect area, statistically significant differences were observed between the groups in terms of degree of defect repair, integration to border zone, and macroscopic appearance (p<0.05). The averaged results of all evaluated parameters of the International Cartilage Repair Society visual histological assessment score were better for the BA group. CONCLUSION: The healing process of the cartilage injury could be improved by BA injection administration. In future, BA may safely be used as an additional treatment modality in clinical practice to enhance the healing process of cartilage injuries, which are commonly observed orthopedic problem.
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Cartílago Articular , Animales , Ácidos Bóricos , Femenino , Fémur , ConejosRESUMEN
BACKGROUND/AIMS: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been accepted as a reliable tool in diagnosing and staging intra-abdominal tumors. In this study, we aimed to investigate the performance of EUS-FNA in the evaluation of liver masses and its impact on patient management and procedure-related complications retrospectively. METHODS: Data of patients who underwent EUS-FNA biopsies due to liver masses between November 2017 and July 2018 were retrieved retrospectively. Biopsies were performed using 22-G needles. The demographics, EUS-FNA results, sensitivity and specificity of the procedure, negative predictive value, positive predictive value, and specimen sufficiency rates were assessed. RESULTS: A total of 25 patients (10 females) were included in the study. The mean age was 62.73±15.2 years. The mean size of the masses was 34.50±16.04 mm. The technical success rate was 88%. During the EUS-FNA procedure, each patient had only one pass with 94.45% of aspirate sufficiency rate and 86.3% of biopsy sufficiency rate. The diagnostic accuracy rate was 86.3%. There were no complications. CONCLUSION: For the evaluation of liver masses, EUS-FNA using a 22-G needle with even one pass had high aspiration and biopsy success rates accompanied with high diagnostic accuracy rates.
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The purpose of this paper is to measure the systemic risk contributions of Turkish banks and to identify the systemically important banks of Turkey during the period from 2005 to 2016. We apply the conditional value-at-risk (CoVaR) method proposed by Adrian and Brunnermeier (2009) using quantile regression. The study includes thirteen major banks of Turkey, including both public and private banks, out of a total of 52 banks. The banks are ranked in terms of their systemic risk contribution to the Turkish financial system based on their asset returns, macroeconomic variables and individual bank variables. The study reveals that Akbank, Garanti, Yapi Kredi and Isbank have the highest systemic risk contribution to the financial system when adding macroeconomic variables to the model. This ranking is changed to Yapi Kredi, Garanti, TEB, Sekerbank and Akbank when taking into account bank-specific variables. One surprising result is that risk in isolation and the spillover risks of public banks are smaller than in large private banks. Furthermore, the marginal systemic risk contributions of public banks are smaller than those of private banks. In conclusion, authorities improve the regulatory framework according to the context of CoVaR in addition to monitor the idiosyncratic risks of banks.
RESUMEN
OBJECTIVES: The aim of the present study was to investigate the protective effect of tetramethylpyrazine (TMP) on cisplatin-induced ototoxicity in rats. METHODS: Forty healthy, female, 24-week-old, Sprague-Dawley rats (n = 40) were randomly assigned to four groups as follows: group one (n = 10) received intraperitoneal (i.p.) physiological saline at daily doses of 3 mg/kg for seven days; group two (n = 10) received a single dose of i.p. 15 mg/kg cisplatin; group three (n = 10) received i.p. 140 mg/kg TMP daily for seven days plus a single dose of i.p. 15 mg/kg cisplatin on the fourth day; group four (n = 10) received i.p. 140 mg/kg TMP daily for seven days. Auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) measurements were obtained from the animals (40 rats, 80 ears) under general anesthesia before and after drug administration. The temporal bulla of animals were bilaterally removed for immunohistopathological examination. RESULTS: In group two, DPOAE and ABR values were significantly deteriorated after drug administration, whereas there was no statistically significant difference between the pre- and posttreatment DPOAE and ABR values for all frequencies for groups one, three and four. The mean scores for external ciliated cells (ECCs), stria vascularis (SV) and spiral ganglion (SG) injuries in hematoxylin and eosin (H&E) staining, and also caspase-3 immunoreactivity were significantly higher in group two than in the other groups. CONCLUSION: In the present study, the protective effect of TMP on cisplatin ototoxicity was demonstrated through studies of electrophysiology and immunohistopathology. Co-administration of TMP may have potential protective effects against cisplatin-induced ototoxicity.