Does single receptor positive breast carcinoma differ with regard to age, tumor grade, and HER2 amplification status?

PURPOSE: To investigate whether there is a difference in patient and tumor characteristics in cases with single receptor positive (SRP) (ER-/PR+ and ER+/PR-) breast carcinoma in comparison with the double receptor positive (DRP) (ER+/PR+) and double receptor negative (DRN) (ER-/PR-) tumors. METHODS: A total of 255 breast cancer patients were categorized on the basis of their tumor hormonal receptor phenotype, age, grade, and HER2 amplification status. The study focused on the SRP phenotype (ER+/PR- and ER-/PR+) and compared it with the DRP (ER+/PR+rpar; and DRN (ER-/PR-) tumors. RESULTS: There were 103 (40.3%) DRP tumors, 98 (38.4%) DRN tumors and 54 (21%) SRP tumors, 41 (16.1%) of which were ER+/PR- and 13 (5.1%) were ER-/PR+. Compared to DRP tumors, the SRP group was more likely to be associated with grade 3 tumors and higher frequency of HER2 amplification status. ER-/PR+ tumors were more likely to be associated with younger age at diagnosis compared to ER+/PR- tumors. HER2 amplification, age, and grade were not significantly different between ER-/PR+ and DRN groups. Compared to the DRN group, the ER+/PR- group had lower grade. CONCLUSIONS: Our findings demonstrated that SRP phenotype including ER+/PR- and ER-/PR+ tumors is different from DRP group with regard to age, grade, and HER2 amplification status. Moreover, our data showed that ER-/PR+ tumors are associated with younger age.

Prediction of Meningioma Grade Using Hematological Parameters.

OBJECTIVE: Predicting the aggressiveness of meningiomas may influence the surgical strategy timing. Because of the paucity of robust markers, the systemic immune-inflammation (SII) index is a novel biomarker to be an independent predictor of poor prognosis in various cancers including gliomas. We aimed to investigate the value of SII as well as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) indices in predicting prognosis. METHODS: Records including demographic, clinical, and laboratory data of patients operated on due to intracranial meningioma in 2017-2023 were retrospectively reviewed. RESULTS: A total of 234 patients were included in this study. All of SII index, NLR, and PLR values at presentation were significantly higher in grade ≥2 meningiomas. A positive correlation was observed between SII index and Ki67 index (r=0.313; P<0.001); between NLR and Ki67 index (r=0.330; P<0.001); and between PLR and Ki67 index (r=0.223; P<0.01). SII index (optimal cutoff level >618), NLR (optimal cutoff level >3.53), and PLR (optimal cutoff level >121.2) showed significant predictive values. CONCLUSIONS: This is the first study to assess the prognostic value of the SII index in patients with intracranial meningiomas. Increased SII index, NLR and PLR were correlated with higher grade and higher Ki-67 index. They also harbor the potential to screen patients that may need more aggressive treatments or more frequent follow-up examinations.

Unusual localization of an unusual tumor: calcifying pseudoneoplasm of the foramen magnum.

OBJECTIVE: We report a rare case of calcifying pseudoneoplasm in the foramen magnum. A large variety of tumors can be found in the foramen magnum; meningiomas, neurofibromas, chordomas, chondrosarcomas and metastases are among those that have been reported. Based on the histopathological structure of the tumor, radical excision or, in the case of tumors with good behavioral pattern, only decompressive debulking can be applied, in an effort to avoid unnecessary morbidities. Thus, it is important to know the nature of the tumor before planning the surgery. CASE REPORT: A 53-year-old man with a 1-year history of pain on the left side of his face was admitted to our service. Magnetic resonance imaging revealed a calcific mass at the left side of the spinal cord at the level of the foramen magnum. Median suboccipital craniectomy and total tumor resection were performed and there was no additional neurological deficit postoperatively. CONCLUSION: We report, to our knowledge, the second case of a calcifying pseudoneoplasm of the foramen magnum. We emphasize that these tumors are pathologically benign and do not require aggressive surgical treatment and suggest that asymptomatic cases can be followed radiologically.

Comparison of unilateral hemilaminotomy and bilateral hemilaminotomy according to dural sac area in lumbar spinal stenosis.

INTRODUCTION: Unilateral hemilaminotomy (ULH) and/or bilateral hemilaminotomy (BLH) with limited facetectomy are defined approaches to decompress the thecal sac and exiting lumbar nerve roots without increasing the risk of subsequent spinal instability. METHODS: We retrospectively analyzed 18 cases with degenerative lumbar spinal stenosis (LSS) with BLH or ULH that was performed in 11 and 7 cases, respectively. Magnetic resonance imaging (MRI) was performed at the follow-up examination and dural sac area (DSA) was calculated on T(2)-weighted MRI images and then compared statistically. In addition, the economic and functional status of the patients were evaluated with the Prolo scale. RESULTS: The mean preoperative values on the visual analogue scale (VAS) were 7.1 for lumbalgia and 7.0 for leg pain, respectively. These values were calculated as 4.8 and 4.4 at the follow-up, respectively. The VAS was significantly improved after operation compared to preoperative values (p=0.001). The mean value of the DSA was 84 (+/-32) mm(2) before the operation and 126 (+/-35) mm(2) at the follow-up and the comparison was statistically significant (p=0.001). No statistical correlation was found between VAS and DSA or between VAS and ULH-BLH groups, however, DSA of the BLH cases was significantly higher than in the ULH group (p=0.035). There was a significant negative correlation between VAS scores (back and leg pain) and Prolo status. However, there was no significant difference between DSA and Prolo scores, and between ULH or BLH groups in terms of Prolo scores. CONCLUSION: A unilateral approach with bilateral decompression and bilateral approach with bilateral hemilaminotomy are both minimal invasive, adequate and safe approaches with excellent prognosis. However, BLH leads to a bigger expansion of DSA.

Frequency and temperature-dependent electric modulus spectroscopy of osmium-doped YbFeO3 structure.

Orthoferrites have occupied important place in the material science and condensed matter physics investigations due to their unique features such as electrical, magnetic and optical. The present investigation illuminates light on the electrical properties of osmium (Os) doped YbFeO3 (YbFO) rare-earth orthoferrite. The undoped YbFO and YbFe1-x Os x O3 (YbFOO) (x = 0.01 and 0.05) powders were synthesized via solid-state. X-ray diffractometer (XRD) has been utilized to examine the crystal structure of the YbFO and YbFOO powders. The cross sectional morphology of the obtained pellets was inspected via scanning electron microscope (SEM). Moreover, x-ray photoelectron spectroscopy was exploited to determine the oxidation states of the constituted elements. The electrical features for instance electrical modulus, dielectric constant and conductivity of the synthesized pellets were detailed at different frequencies and temperatures by dielectric/impedance spectroscopy studies. The x = 0.01 Os doped sample exhibits higher dielectric constant and conductivity compared to other samples. Moreover, in order to explain conductivity mechanism of the studied samples, multiple conduction models are needed to employ.

The temperature induced current transport characteristics in the orthoferrite YbFeO3-δ thin film/p-type Si structure.

The perovskite ytterbium ferrite is a new ferroelectric semiconductor material. We presented the temperature induced current-voltage (I-V) characteristics of the Al/YbFeO3-δ/p-Si/Al hetero-junction. The orthoferrite YbFeO3-δ thin films were deposited on a single crystal p-type Si substrate by a radio frequency magnetron sputtering system. The potential barrier height (BH) [Formula: see text] and ideality factor n of the heterojunction were obtained by thermionic emission current method based on the recommendations in the literature. The fact that the calculated slopes of I-V curves become temperature independent implying that the field emission current mechanism takes place across the device, which has been explained by the presence of the spatial inhomogeneity of BHs or potential fluctuations. Moreover, a tunneling transmission coefficient value of 26.67 was obtained for the ferroelectric YbFeO3-δ layer at the Al/p-Si interface.

Usefulness and Radiological Evaluation of Accuracy of the Innovative "Smart" Hand Technique for Pedicle Screw Placement: An Anatomical Study.

AIM: To use a smartphone application (app) during pedicle screw placement navigation and examine the accuracy of this application on an anatomical dry vertebrae model. MATERIAL AND METHODS: Seventy-six dry vertebrae were used for this study, and pedicle entry points and projections of pedicle screw trajectory lines in the lateral and superior aspects of the vertebral body were identified and drawn for each vertebra bilaterally. In each position, all angulations were measured directly before the procedure manually. One hundred and fifty two pedicle screws were inserted as a simulation of screw placement with the guidance of the angle-meter smart app. Accuracy of the method was tested according to the occurrence of bone penetration while the angular deviation of the inserted screws was evaluated in computed tomography images. RESULTS: The mean deviation for 76 pedicle screws on the right side was 2.30°±1.78° in the horizontal plane and 2.17°±1.57° in the sagittal plane; and on the left side, 3.01°±1.83° in the horizontal plane and 2.38°±1.68° in the sagittal plane. No bone penetration occurred during 152 pedicle screw placements. According to the t-test results, there were significant differences between the two groups in the craniocaudal direction of the right side pedicle screws and in the craniocaudal direction of left sided pedicle screws. CONCLUSION: The free smartphone app presented here as an angle-meter is a safe digital device for spinal instrumentation procedures. As a prototype of future pedicle screw fixation systems, it should be improved in terms of its feasibility and compatibility with screw probes. This may lead to a useful mobile digital angle-meter for spinal procedures.

Management of Spinal Arteriovenous Fistulae with Intraarterial Indocyanine Green Angiography: A Case Report.

We describe herein intraoperative effectiveness of indocyanine green (ICG) video angiography to confirm dural arteriovenous fistulae. A 62-year-old man with a residual symptomatic dural arteriovenous fistula that was previously embolized at another institution is presented. On neurological examination, the motor strength in his both lower extremities was documented as grade 4 and the patella reflex was slightly increased. After verifying the presence of abnormal early venous drainage and retrograde flow with indocyanine green video angiography, the fistula was repaired. Postoperatively there was no additional neurologic deficit. Five days after the operation, the patient was discharged. Intraoperative ICG video angiography provides non-invasive and realtime information, reduction of spinal cord ischemic damage, rapid identification of feeding artery and confirmation of its complete disconnection during surgery, reduction of operative time, and improved outcome with no radiation hazard.

Homocysteine levels in plasma and sensorineural hearing loss in patients with pseudoexfoliation syndrome.

PURPOSE: To determine the incidence and severity of hearing loss in different frequencies in patients with pseudoexfoliation. Furthermore, possible links between homocysteine and pseudoexfoliation were evaluated. METHODS: Seventy-five consecutive patients with pseudoexfoliation and 75 sex- and age-matched subjects without pseudoexfoliation as control group were included in this prospective case-control study. Pure-tone audiometry was obtained in all subjects in both groups. Blood samples were obtained from 70 patients with pseudoexfoliation after overnight fasting for levels of homocysteine and analyzed by routine laboratory measurements. RESULTS: Fifty-two (69%) patients with pseudoexfoliation and 39 (52%) controls had sensorineural hearing loss in speech frequencies. The difference between pseudoexfoliation and control group with regard to the frequency of sensorineural hearing loss in speech frequencies was statistically significant (p=0.03). No relationship was found between the degree of glaucomatous damage and hearing threshold variables in the patients with pseudoexfoliation glaucoma. Plasma homocysteine levels showed no significant difference when patients with pseudoexfoliation and hearing loss were compared with patients with pseudoexfoliation and normal hearing threshold (p=0.5). Hyperhomocysteinemia was found in 58% (29/50) of pseudoexfoliation patients with hearing loss, and 55 % (11/20) of pseudoexfoliation patients with normal hearing threshold (p=0.8). No statistically significant correlation was found between plasma homocysteine and hearing loss in patients with pseudoexfoliation. CONCLUSIONS: These findings suggest an association between sensorineural hearing loss and pseudoexfoliation in patients with pseudoexfoliation and glaucoma. The severity of hearing loss was not correlated with the degree of glaucomatous damage. There is no association between increased homocysteine levels and hearing loss in patients with pseudoexfoliation.

A comparison of travoprost, latanoprost, and the fixed combination of dorzolamide and timolol in patients with pseudoexfoliation glaucoma.

PURPOSE: To compare the intraocular pressure (IOP) lowering effect and safety of latanoprost, travoprost given every evening, and the fixed combination dorzolamide + timolol (DTFC) given twice daily in pseudoexfoliation glaucoma (PXG). METHODS: This randomized, prospective, investigator-masked study has been conducted with 50 PXG patients. Patients were assigned to one of three groups: travoprost 0.004%, fixed combination of dorzolamide 2%+timolol 0.5%, or latanoprost 0.005% for 6 months. At baseline and 0.5, 1, 2, 3, 4, 5, and 6 months of therapy, IOP (8 am, 10 am, 4 pm), blood pressures, and pulse rates were measured, and ophthalmologic examination was performed. The side effects were recorded at each visit. RESULTS: Forty-two of the 50 patients initially enrolled completed this study. Withdrawn patients included one (latanoprost) for lack of efficacy, five (three travoprost, one latanoprost, one DTFC) for adverse events, and two (one latanoprost, one DTFC) for loss of follow-up. Each of the three drugs considerably reduced the IOP in PXG cases throughout the 6 months. Mean IOP reduction at 6 months was -9.3+/-2.9 mmHg in the travoprost group, -8.2+/-1.2 mmHg in the latanoprost group, and 11.5+/-3.3 mmHg in the DTFC group. Comparing the groups, DTFC is more effective than latanoprost and travoprost in lowering IOP (p<0.05). There was no difference between travoprost and latanoprost. The most common treatment-related adverse event was conjunctival hyperemia. Intensity of ocular hyperemia was greater in the travoprost group compared with the latanoprost and DTFC groups (p<0.05). There were no significant effects on systemic safety parameters. CONCLUSIONS: The results demonstrated that DTFC is more effective in reducing IOP than latanoprost and travoprost. Latanoprost and travoprost had similar ocular hypotensive effects in patients with PXG. All three drugs were well tolerated; there were fewer ocular side effects attributable in the latanoprost group.

Comparison of the effectiveness of mitomycin-C and Viscoat on delayed adjustable strabismus surgery in rabbits.

PURPOSE: To determine a way to prevent the formation of adhesions and delay the time of suture adjustment in the course of adjustable strabismus surgery, an animal study was performed to assess and compare the effects of mitomycin C (Mit-C) and viscoelastic material Viscoat (sodium hyaluronate 3% and chondroitin sulphate 4%, Alcon, Fort Worth, TX). METHODS: Right eyes of 47 rabbits were divided into three groups. After recession of the superior rectus muscle (SRM), Mit-C was administered beneath and over the SRM in Group M (16 eyes), Viscoat was administered beneath and over SRM in Group V (16 eyes), and ringer lactate was administered in Group C (15 eyes). SRM then recessed 5 mm with adjustable strabismus surgery technique. Animals in each group were subdivided into 1 and 2, where 1 = adjustment 1 week postoperatively and 2 = adjustment 3 weeks postoperatively. Delayed adjustment was performed in M1 group (6 eyes), V1 group (6 eyes), and C1 group (7 eyes) after 1 week; in M2 group (6 eyes), V2 group (6 eyes), and C2 group (6 eyes) after 3 weeks. Histopathologic examinations were performed for the remaining 10 eyes without suture adjustment at the end of first and third weeks after adjustable strabismus surgery. The possible length and the necessary force to adjust and the degree of adhesions were recorded. RESULTS: When length and strength of the adjustment, adhesions between muscle and sclera, and adhesions between muscle and conjunctiva were taken into consideration, there was no statistically significant difference among M, V, and C groups at postoperative weeks 1 and 3. The force needed for adjustment in M1 group was statistically lower than M2 group. CONCLUSIONS. The intraoperative use of Mit-C (0.4 mg/mL) may decrease adhesion formation in the early postoperative period, especially in the first week. The intraoperative use of Viscoat was not effective in reducing postoperative adhesions and delaying adjustment.

Ultrastructural evaluation of the effect of endosulfan on mice kidney.

In this study, the effect of the endosulfan on mice kidney was investigated at ultrastructural level. Moreover, biochemical analyses (G6PD, CAT, SOD, GSH and MDA) were determined in supernatant of kidney tissue. Endosulfan (13mg/kg/day body weight) was administered orally to mices via intragastric-during 10 days. The presence of mitochondrial degeneration in cytoplasm of proximal convoluted tubule cells were a striking feature. Furthermore, there was lipofuscin granules and membranous structures in some of proximal convoluted tubule cells. In some glomeruli, ultrastructural changes such as fusion in pedicels and focal thickening at glomerular basal membrane were seen. There were cytoplasmic bulges in some distal convoluted tubule cells. The biochemical results of the experimental group were significant when compared to the control. The effect of the endosulfan was mainly on the proximal convoluted tubule cells. Morever, the other parts of the nephron were effected. Thus, this degeneration in kidney may be thought that oxidative stress may play a role to the mediator in changing configuration of cell membrane and seem to account for the morphologic alteration of kidney.

Intraoperative mitomycin C in the treatment of pterygium.

PURPOSE: To evaluate the effectiveness of intraoperative mitomycin C in preventing the recurrence of primary pterygium. METHODS: In this prospective, randomized study, 38 eyes of 35 patients with primary pterygium were evaluated. In 19 eyes, the "bare sclera technique" combined with intraoperative application of 0.2 mg/mL (0.02%) mitomycin C for five minutes was performed (mitomycin C treated group). The other 19 eyes--taken as control group--underwent surgical excision alone. Statistics were analyzed using the Mann-Whitney U test and the Fischer's exact test. RESULTS: Patients were 20-38 years of age. The mean age was 25.29 +/- 5.08 in the mitomycin C treated group and 25.00 +/- 5.19 in the control group. During the mean follow-up of 17.04 months (range, 12-36 months; SD = 5.89), 4 recurrences (21%) were observed in the mitomycin C treated group and 11 (57.8%) in the control group. The difference between the two groups was significant (p = 0.045). No postoperative complication was encountered in both groups except for recurrences. CONCLUSION: Intraoperative mitomycin C was found to be effective in preventing the recurrence of primary pterygium.

The effect of povidone iodine on the corneal endothelium.

PURPOSE: Povidone iodine has been proven to be a valuable antiseptic solution in preparing the eye for surgery and is an alternative to postoperative topical antibiotics. No study has addressed the intraocular toxicity of povidone iodine after injection into the anterior chamber. We investigated the potential toxicity of povidone iodine on the corneal endothelium after injections into the anterior chamber in a rabbit model. METHODS: In this study we used 24 eyes of 12 albino rabbits. The eyes were divided into the following three groups according to the drugs tested: group A, 5% povidone iodine; group B, 10% povidone iodine; group C, balanced salt solution. The injected eyes were evaluated by biomicroscopy, specular microscopy, corneal pachymetry, and transmission and scanning electron microscopy. RESULTS: Corneal edema was observed in all eyes of groups A and B. In groups A and C, the endothelial cell morphology was not significantly changed and the mean endothelial cell count of the eyes did not change significantly (p = 0.5054). There was no significant difference in corneal thickness between groups A and C (p = 0.3823), but there was a significant difference between groups B and C ( = 0.0002). Transmission and scanning electron microscopy results were normal in group C but not in groups A and B. CONCLUSION: Povidone iodine in both 5% and 10% concentrations demonstrates severe toxicity when one drop of either concentration is placed directly in the anterior chamber. When povidone iodine is used in preparing the eye for intraocular surgery and as an alternative to postoperative antibiotics, the inadvertent leakage of povidone iodine into the anterior chamber must definitely be prevented.

The V2 segment of the vertebral artery and its branches.

OBJECT: The goal of this study was to demonstrate the origins, courses, anastomoses, and target tissues of the arterial branches that arise from the V2 segment of the vertebral artery. METHODS: Ten adult cadaveric necks (20 V2 segment specimens) were examined (magnification x 40) after injection of colored silicon. The branches at each cervical level were classified in a new system according to anatomical features and target tissues-anterior, posterior, medial, and lateral. Incidence with which each branch category was observed at each cervical level was calculated. Anterior branches were observed at C-3 in all 20 V2 segment specimens. The incidence with which the posterior branch was present at C-4 was 45%, whereas the corresponding rates at segments superior and inferior were lower. The medial V2 segment branches were assessed in four subcategories. The anterior spinal artery was present at C-3 in all specimens, whereas the mean incidence at the C4-6 level was 46.7%. The posterior spinal artery was most frequently detected at C-3 (60%). The anterior radicular artery (RA) was present at C-5 in 50% of the specimens, whereas the posterior RA was detected at C-5 in only 35%. Lateral branches were most frequently detected at C-3. CONCLUSIONS: The authors provide detailed anatomical information about the origins, courses, anastomoses, and target tissues of the vessels that arise from the V2 segment. This new classification allows for better understanding of the vasculature of the C3-6 region.

Chondroblastoma of the thoracic vertebra.

A 48-year-old patient with interscapular pain was admitted to our clinic. MRI revealed a mass infiltrating the second thoracic vertebra and adjacent structures. No other clinical manifestations were observed in general examination. The patient underwent surgery and subtotal removal was achieved while anterior and posterior stabilisations were performed. Diagnosis was pathologically confirmed. As thoracic chondroblastoma cases are not frequent, we decided to present this case.

Ultrastructural evaluation of the effects of the contrast media on the rat kidney.

In this study, the ultrastructural observations in rat kidneys were studied 2, 24 and 48 h after intravenous injection of 1, 3 and 9 g iodine per kg body of ioxaglate and iohexol. The effect of the contrast media was mainly on the proximal convoluted tubule cells, the presence of vacuoles containing granular and membranous structures was a striking feature. In the distal convoluted tubular cells, pycnotic nuclei and cytoplasmic bulges toward the lumen were observed. In some glomeruli, membranous structures in cytoplasm of podocytes and thickening of glomerular basal membrane were seen. Values of biochemical analysis were slightly higher especially at high doses in experimental groups when compared to the control. The results suggest that iohexol causes more degeneration than ioxaglate. Not only proximal convoluted tubule cells but also the other parts of the nephron were affected by contrast media.

A comparative study of the effectiveness of disinsertion and anterior transposition of the inferior oblique in the treatment of unilateral superior oblique palsy.

PURPOSE: To compare the effectiveness of disinsertion of the inferior oblique muscle (DIO) with anterior transposition of the inferior oblique muscle (ATIO) in the treatment of vertical deviations resulting from superior oblique palsy. METHODS: In this prospective randomized study, 22 patients with unilateral superior oblique palsy were evaluated. Eleven patients underwent the DIO procedure (DIO group), and the other eleven underwent the ATIO procedure (ATIO group). Statistics were analyzed using the Wilcoxon and Mann-Whitney U tests. RESULTS: The mean preoperative primary-position hypertropia was 22.2 +/- 6.2 prism diopters (Delta) in the DIO group and 23.1 +/- 6.6 Delta in the ATIO group; the mean preoperative hypertropia in adduction was 31.7 +/- 6.9 Delta in the DIO group and 31.8 +/- 8.1 Delta in the ATIO group. The mean follow-up was 18.8 months (SD: 10.2, range: 6-40 months). The mean reduction of hypertropia in primary-position in the ATIO group (mean: 18.5 +/- 3.9 Delta) was found to be significantly greater than in the DIO group (mean: 13.3 +/- 1.9 Delta) (p = 0.001). Even though the mean reduction of hypertropia in adduction in the ATIO group (mean: 27.7 +/- 9.6 Delta) was greater than in the DIO group (mean: 20.6 +/- 6.2 Delta), no statistically significant difference was found (p = 0.067). There was residual hypertropia in three (27.3%) patients who underwent the DIO procedure. No major postoperative complication was encountered in any of the patients. CONCLUSION: In vertical deviations resulting from superior oblique palsy, ATIO was found to be more effective than DIO in the reduction of primary-position hypertropia.