Investigation of coherent/Compton scattering differential cross section ratios in Cu alloys as depending on chemical environment and scattering angle.

In this study, seven alloys with a nominal composition of (CuO2)0.5 M0.5 (M = Fe, Co, Ni, Cu, Zn, Y, and Nb wt%) were produced via the powder mixed method. Alloys and pure metals were excited with 59.54 keV photon energy emitted from Am-241 radioactive source at 25°, 35°, 45°, 55°, 65°, 75' and 85° scattering angles. The spectra of the coherent/Compton peaks were obtained by Si(Li) detector. First of all, chemical shift, (ΔE) peak energies, (E) asymmetry index (As) and full width half maximum (FWHM) values were found in the Compton/Coherent scattering spectra obtained depending on the scattering angle and the chemical environment of the transition metals. Then the ratios of the Coherent/Compton scattering differential cross-section (dσcoherent/dσCompton) were obtained experimentally. The experimental dσcoherent/dσCompton ratios of the selected 3d-4d transition metals were found to be compatible with the data in the literature. Asymmetry and chemical shifts were observed in almost all samples, especially in Compton peaks, with increasing scattering angles. The chemical shifts of Compton and Coherent peaks of the alloys were found in the range of 1-932 eV. The experimental dσkoherent/dσCompton ratios for the alloys obtained by adding Fe, Co, Ni, Cu, Zn, Y, and Nb to Cu2O were found as 0.697, 0.689 0.678, 0.698, 0.736, 0.755, 0.798, 0.835 at 45° scattering angle, respectively. It has been determined that the experimental dσcoherent/dσCompton ratio for each alloy increases with increasing atomic number, while it decreases with increasing scattering angle.

ADRENOCORTICOTROPIC HORMONE IMMUNOASSAY INTERFERENCE IN A PATIENT WITH SUBCLINICAL HYPERCORTISOLISM.

CONTEXT: Immunoassays are vulnerable to occasional analytical errors despite their sensitivity and specificity. Adrenocorticotropic hormone (ACTH) is among hormones which are vulnerable to assay interference. OBJECTIVE: In this case report, we aimed to present a case of ACTH interference in a patient with subclinical hypercortisolism. CASE REPORT: We present a case of subclinical hypercortisolism with unexpectedly elevated levels of ACTH in whom interference was shown by different biochemical methods.It is important for the clinician to keep in mind the possibility of interference when clinical and laboratory results are discordant. The communication between the clinician and laboratory staff is important while interpreting results. This case report shows that ACTH interference should be considered in patients with subclinical hypercortisolism who have unexpectedly high levels of adrenocorticotropic hormone.

Familial partial lipodystrophy linked to a novel peroxisome proliferator activator receptor -γ (PPARG) mutation, H449L: a comparison of people with this mutation and those with classic codon 482 Lamin A/C (LMNA) mutations.

AIMS: To describe the phenotype associated with a novel heterozygous missense PPARG mutation discovered in a Turkish family and to compare the fat distribution and metabolic characteristics of subjects with the peroxisome proliferator activator receptor -γ (PPARG) mutation with those of a cluster of patients with familial partial lipodystrophy with classic codon 482 Lamin A/C (LMNA) mutations. METHODS: The study involved four subjects with familial partial lipodystrophy who had a novel PPARG mutation (H449L) and six subjects with classic codon 482 LMNA mutations (R482W). RESULTS: Compared with subjects with LMNA R482W mutation, fat loss was generally less prominent in subjects with the PPARG H449L mutation. Partial fat loss was limited to the extremities, whilst truncal fat mass was preserved. The PPARG H449L mutation was associated with insulin resistance, hypertriglyceridaemia and non-alcoholic fatty liver disease in all affected subjects, but the severity was variable. Three out of four mutation carriers had overt diabetes or impaired glucose tolerance. Pioglitazone therapy in these three individuals resulted in a modest improvement in their metabolic control, and regular menstrual cycles in the two female subjects. CONCLUSIONS: We suggest that relatively modest fat loss in patients with PPARG mutations may render the recognition of the syndrome more difficult in routine clinical practice. The PPARG H449L mutation is associated with insulin resistance and metabolic complications, but their severity is variable among the affected subjects.

Radiation dose and diagnostic accuracy of high-pitch dual-source coronary angiography in the evaluation of coronary artery stenoses.

PURPOSE: "Flash Spiral" imaging is a new prospective ECG-triggered spiral scan mode that uses a very high-pitch for coronary computed tomography angiography (CTA). This enables complete image acquisition within one cardiac cycle with a very low radiation exposure. The aim of this study was to investigate the diagnostic accuracy, image quality, and effective radiation dose of prospectively ECG-triggered high-pitch spiral method (Flash spiral mode) of coronary CTA using dual-source technology for the evaluation of coronary artery stenoses. MATERIAL AND METHODS: The study included 186 consecutive patients (115men, 71women; mean age: 53.37 years) who underwent coronary CTA. Coronary CTA was performed with a 128×2-slice dual-source CT (Somatom Definition Flash, Siemens, Germany) using a prospectively ECG-triggered high-pitch spiral mode. Patients were divided into three groups according to heart rate (≤65bpm, 66-75bpm, ≥76bpm) and body mass index (BMI) (20-24kg/m(2), 25-29kg/m(2), 30-34kg/m(2)) values. The correlation between heart rates, image quality and BMI values are investigated. A four-point scale (1=excellent, 4=poor/non-diagnostic) was used to rank the comparative image quality. Effective radiation doses were calculated. Also the correlation between radiation dose, sex and BMI values were investigated. In addition, diagnostic accuracy of CTA for detection of significant (≥50%) coronary artery stenoses was compared with invasive coronary angiography findings of 612vessel segments in 38patients. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy rate were calculated. RESULTS: A total of 2976coronary artery segments were present. Of all coronary artery segments, 2381 (80%) had an image quality score of 1, and 1.5% segments were rated as "poor/non-diagnostic". When the correlation between heart rate and image quality is investigated, there was a significant difference between ≤65bpm and ≥76bpm groups. However, there was no significant difference between ≤65bpm and 66-75bpm groups. The mean effective dose was found as 1.3mSv (min: 0.5, max: 2.4mSv). The correlation between effective radiation dose and BMI was moderate. However, the correlation between gender and radiation dose was significant. Sensitivity, specificity, negative predictive value and accuracy of coronary CTA on a per-vessel segment were 90.1%, 97.4%, 98.6%, and 96.5%, respectively. CONCLUSIONS: Prospectively ECG-triggered high-pitch spiral mode coronary CTA provides high image quality and diagnostic accuracy, with very low radiation dose for evaluation and exclusion of coronary artery stenoses.

Monitoring and treatment results of 88 HBsAg-positive pregnant women.

Approximately 5% of all women in the world are HBsAg-positive. Chronic hepatitis B is a problem in women of reproductive age. This paper assessed 88 HBsAg-positive pregnant women, of whom 11 began treatment during pregnancy and five became pregnant while receiving treatment. The files of HBsAg-positive pregnant women were reviewed between January 2010 and December 2013-retrospectively. From these 88 pregnant women, 72 did not receive any treatment during their pregnancy, 11 began treatment during their pregnancy, and five became pregnant while receiving treatment. Nine of these 11 pregnant women were given tenofovir disoproxil fumarate and two of them lamivudine. Ten babies of the 11 mothers that began treatment during their pregnancy were healthy, but one was lost due to preterm birth. Of the five patients who became pregnant while receiving treatment, the treatments of four women were discontinued and they were monitored during their pregnancies because mild-moderate (less than stage 3) fibrosis was found in their liver biopsy results. It is important to screen all pregnant women for hepatitis B and to assess those found HBsAg-positive. It is possible to protect both the mother and baby using appropriate approaches.

Serum annexin A2 levels in acute brucellosis and brucellar spondylodiscitis.

Brucellosis is a chronic granulomatous infection and may present with various clinical manifestations. Brucellar spondylodiscitis symptoms are initially subtle and nonspecific. Annexin A2 (ANXA2) is involved in various biological functions, including osteoclast formation, bone resorption, and cell growth regulation. In this study, we aimed to determine the clinical significance of serum ANXA2 levels in acute brucellosis and brucellar spondylodiscitis. This prospective study included 96 acute brucellosis patients and 51 healthy controls. Acute brucellosis was diagnosed by a 1/160 or higher titer in a standard tube agglutination (STA) test or a four-fold increase in titers between two STA tests performed two weeks apart in the presence of clinical symptoms within the last eight weeks and/or growth of Brucella spp. in appropriately prepared culture media. ANXA2 levels were determined with an enzyme-linked immunosorbent assay (ELISA). Forty (41.7 %) of 96 acute brucellosis patients were male and 56 (58.3 %) were female. Serum ANXA2 levels were elevated in patients compared to healthy controls (p = 0.001). Eighteen of 96 (18.7 %) acute brucellosis patients had brucellar spondylodiscitis. The serum ANXA2 levels of patients with brucellar spondylodiscitis were higher than those of patients with acute disease without brucellar spondylodiscitis (p = 0.001). ANXA2, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) values were elevated in the brucellar spondylodiscitis group compared to patients without brucellar spondylodiscitis. Serum ANXA2 measurement together with ESR and CRP is thought to be indicative in the diagnosis of brucellar spondylodiscitis, a common complication of brucellosis.

Large Cell Neuroendocrine Carcinoma of the Ovary and Its Skin Metastases: A Case Report and Review of the Literature.

Large cell neuroendocrine carcinoma in the gynaecological organs affects the uterine cervix and ovary. Large cell neuroendocrine carcinoma of the ovary is extremely rare, and prognosis is quite poor even when diagnosed at an early stage. These tumours respond poorly to standard chemotherapy regimens. The clinical observation of skin metastasis in patients with epithelial ovarian cancer is relatively uncommon, occurring in only 3.5% of patients. These lesions are observed mostly in skin of the abdominal wall adjacent to the primary ovarian tumours. Metastatic skin lesions on extremities are much more rare; it is reported that only 12% of epithelial ovarian carcinoma skin metastases occur on the limbs. Skin metastasis due to large cell neuroendocrine carcinoma of the ovary has not been previously reported. We report the case of a large cell neuroendocrine tumour of the ovary with skin metastases on extremities appearing two months after surgery in a 68-year old woman.

The relationship of insulin resistance and metabolic syndrome with known breast cancer prognostic factors in postmenopausal breast cancer patients.

PURPOSE: The aim of this study was to investigate the effect of metabolic syndrome and insulin resistance at the time of diagnosis on the known prognostic factors of breast cancer in postmenopausal breast cancer patients. METHODS: The study included 71 patients with a recent diagnosis of postmenopausal breast cancer, admitted at the Medical Oncology outpatient clinic of the Izmir Ataturk Training and Research Hospital between June 2010 and June 2011. We determined whether the patients had metabolic syndrome and insulin resistance at diagnosis, and recorded known prognostic factors, such as tumor size, axillary lymph node involvement, presence of distant metastasis, tumor grade, estrogen receptor (ER), progesterone receptor (PR), and CerbB-2 status. RESULTS: Among 71 patients, 25 (35%) had metabolic syndrome at the time of diagnosis, and 33 (46%) had insulin resistance with Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR)>2.7. No statistically significant difference was found in the prognostic values of breast cancer, i.e. tumor size, axillary lymph node involvement, distant metastasis, tumor grade, ER, PR, and CerbB-2 status between the patients with and without metabolic syndrome. There was no statistically significant difference in the prognostic factors of breast cancer at the time of diagnosis between 33 patients with insulin resistance and 38 patients without insulin resistance. CONCLUSION: Several previous studies showed a negative relationship between metabolic syndrome and insulin resistance and prognostic factors of breast cancer in postmenopausal breast cancer patients. However, our study failed to show such a relationship. The relationship between metabolic syndrome and insulin resistance and postmenopausal breast cancer was not well demonstrated due to the small number of patients, unknown duration of the metabolic syndrome and insulin resistance, and shorter follow-up period. Further studies are required to demonstrate the effect of metabolic syndrome and insulin resistance on the prognosis of breast cancer, including larger number of patients and longer follow-up periods.

The association of hematologic parameters on the prognosis of patients with metastatic renal cell carcinoma.

PURPOSE: Metastatic renal cell carcinoma (mRCC) bears a poor prognosis. We investigated the prognostic significance of some hematologic parameters of patients with mRCC. METHODS: We retrospectively reviewed the records of 53 patients with mRCC . The mean follow up time was 34 months (range 5-142).We assessed the prognostic value of hematologic parameters (leukocytes ,neutrophils, lymphocytes, platelets, neutrophil to lymphocyte ratio/NLR, platelet to lymphocyte ratio/PLR), and other clinical parameters with univariate and multivariate analysis. RESULTS: Memorial Sloan-Kettering Cancer Center (MSKCC) risk group , lung metastases, sunitinib treatment, lymphocyte count, NLR, and anemia significantly correlated with median overall survival (OS) on univariate analysis. The median OS in patients with a NLR < 3.4 was 32.2 months , significantly higher than the 13.9 months in patients with a ratio ≥ 3.4 (p = 0.006). Multivariate analysis revealed that MSKCC risk group and the NLR were independent predictors of OS. CONCLUSION: Hematologic parameters may be associated with OS in mRCC. However, further studies are needed to establish their routine use.

The clinicopathological significance of Bax and Bcl-2 protein expression with tumor infiltrating lymphocytes in ovarian carcinoma.

The aim of the study was to establish the prognostic and predictive value of Bax and Bcl-2 proteins in conjunction with the host immune response in primary epithelial ovarian carcinoma.83 patients were evaluated. Immunohistochemical staining was performed using anti-Bcl-2 (Dako; clone 124) and anti-Bax (Springbio; E17994) monoclonal antibodies. Additionally, the number of lymphocytes within tumor stroma lymphocyte nests were counted. Bcl-2 protein expression was lower in advanced stage than early stage (p= 0.005). High (H) Bax expression was associated with longer overall survival (OS) than lower (L) Bax expression (p=0.03). The OS of the (L) Bax/(L) Bcl-2 group was shorter than (H) Bax/(L) Bcl-2 group in advanced stage (p=0.05). The platinum-sensitive group had a statistically significant tendency for high Bax expression (p=0.04). Furthermore, the intensity of the lymphocyte infiltration was associated with tumor differentiation (p= 0.003). Our data suggests that (H) Bax protein expression prolongs survival, predicts platinum sensitivity and can be used after confirmation of this hypothesis in further prospective studies. The combined evaluation of Bax and Bcl-2 protein expression may provide additional significant prognostic information. The quantity of lymphocyte infiltration could be important for prognostic outcome.

Micro-metastases into the uterine leiomyoma from invasive ductal breast cancer under adjuvant tamoxifen therapy: case report.

Metastasis of breast cancer to the uterus is extremely rare. However, breast cancer is the leading tumor metastasizing from extragenital organs to the uterus. The most common signs of uterine metastasis are bleeding and mass effect. Tamoxifen use is known to increase risk of endometrial cancer. Immunohistochemical staining with GCDFP can be useful in differentiating primary uterine tumors from breast cancer metastasis. Metastasis to the uterus has been reported to worsen the prognosis. Although hysterectomy has been effective on survival, treatment modality to be used in the presence of other systemic metastases is not clear. Locoregional treatments can be used in oligometastatic cases. In addition, removal of solitary organ metastasis together with bone metastasis provides improvement in survival.

Angular dependence of L3-subshell X-ray emission following photoionisation.

L3-subshell alignment of Th and U ionized by 59.5 keV photons has been investigated by evaluating the angular dependence of L{i}(i=l, α, η, ß and γ) X-ray lines. The angular dependence measurements were performed by measuring the fluorescence cross section, σ{Li}(i=1, η, α, ß and γ) and σ{Ll}/σ{Lγ}, σ{Lη}/σ{Lγ }, σ{Lα}/σ{Lγ } and σ{Lß}/σ{Lγ} ratios at different angles. It was observed from the measurements that L{i}(i=l and α) X rays for the L3-subshell depended on the emission angle and had an anisotropic spatial distribution. On the other hand, there was no dependence of emission angle and any significant anisotropy for other L X rays. The both Ll and Lα X-rays originate from the filling of vacancies in states L3-subshell with J =3/2. The results of measurements indicate that the L3-subshell vacancy states with J = 3/2 are aligned, whereas L{1}, and L{2}vacancy states with J =1/2 are non-aligned. Integral cross-sections for the L{i}(i=l, η, α, ß and γ) X-rays and L subshell fluorescence yields ω{i} (i= 1, 2 and 3) were also determined and results were compared with theoretically calculated values and results of others and fairly good correspondence was observed.

A study on the mean free path and half value layer at various alloys for different photon energies.

The mean free path (mfp) and half value layer (x_1 / 2) values of binary and ternary alloys consist of 3d transition metals have been have been calculated at photon energies 22.1, 25.0, 59.5 and 88.0 keV. The experimental linear attenuation coefficients (µ) for present photon energies have been used to obtain the values of mfp and (x_1 / 2) . The experimental mfp and (x_1 / 2) results have compared with the theoretically calculated results based on attenuation coefficients obtained from WinXCom program. A good correspondence has been observed among the present results and the theoretical results.

The toxicity and efficacy of Nordic-FLOX regimen as adjuvant treatment of stage III colon cancer.

PURPOSE: To evaluate the toxicity and efficacy of oxaliplatin combined with the Nordic regimen of bolus 5-fluorouracil (5-FU) and leucovorin (LV) (Nordic-FLOX) as adjuvant treatment in stage III colon cancer patients. METHODS: Fifty-three patients with resected stage III colon cancer were treated with adjuvant bolus Nordic-FLOX regimen (oxaliplatin 85 mg/m(2) on day 1, bolus 5-FU 500 mg/ m(2) and bolus LV 60 mg/m(2) days 1 and 2) every 2 weeks for 12 cycles. RESULTS: The probability of disease-free survival (DFS) at a median follow-up time of 29 months was 72%. Relapse was seen in 13 (24.5%) patients. The probability of 3-year overall survival (OS) at 36 months was 85%. Grade IV neutropenia was noticed in 15.1% of the patients, grade III-IV neurotoxicity was not encountered, while grade II neurotoxicity was 17%. Gastrointestinal toxicity (mild diarrhea) was seen in 11.3% of the patients. CONCLUSION: Adjuvant treatment of stage III colon cancer with the Nordic-FLOX regimen can be an alternative regimen to infusional and other bolus regimens due to its easy administration, lower toxicity, and similar efficacy.

Studies on effective atomic numbers, electron densities and mass attenuation coefficients in Au alloys.

The total mass attenuation coefficients (mu/rho) for pure Au and Au99Be1, Au88Ge12, Au95Zn5 alloys were measured at 59.5 and 88.0 keV photon energies. The samples were irradiated with 241Am and 109Cd radioactive point source using transmission arrangement. The gamma- rays were counted by a Si(Li) detector with resolution of 160 eV at 5.9 keV. Total atomic and electronic cross-sections (sigmat and sigmae), effective atomic and electron densities (Zeff and Nel) were determined using the obtained mass attenuation coefficients for investigated Au alloys. The theoretical mass attenuation coefficients of each alloy were estimated using mixture rule.

Valence-electron configuration of Ti and Ni in TixNi1-x alloys from Kbeta-to-Kalpha X-ray intensity ratio studies.

Kbeta-to-Kalpha X-ray intensity ratios of Ti and Ni have been measured in pure metals and in alloys of Ti(x)Ni(1-x) (x=0.7, 0.6, 0.5, 0.4 and 0.3) following excitation by 22.69 keV X-rays from a 10 mCi (109)Cd radioactive point source. The valence-electron configurations of these metals were determined by corporation of measured Kbeta-to-Kalpha X-ray intensity ratios with the results of multiconfiguration Dirac-Fock calculation for various valence-electron configurations. Valence-electron configurations of 3d-transition metals in alloys indicate significant differences with respect to the pure metals. Our analysis indicates that these differences arise from delocalization and/or charge transfer phenomena in alloys. Namely, the observed change of the valence-electron configurations of metals in alloys can be explained with the transfer of 3d electrons from one element to the other element and/or the rearrangement of electrons between 3d and 4s, 4p states of individual metal atoms.

The polarization of X-rays and magnetic photoionization cross-sections for L3 sub-shell.

The alignment of atoms with inner-shell vacancies resulting from ionization by photons was investigated by measuring the anisotropic emission of L shell X-ray lines. The X-ray line intensities were measured using an Si(Li) detector and radioisotope photon source in various emission angles. It was observed from measured intensities that Lalpha and Ll X-ray intensities for the L(3) sub-state depended on the emission angle, meaning that Lalpha and Ll X-rays had an anisotropic spatial distribution. Thus, the Lalpha to Ll intensity ratios for a set of elements were determined and alignment parameters for each element were obtained using these ratios. Also, the empirical values of the L(3) magnetic sub-state photoionization cross-sections for m(j)=3/2 and 1/2 were evaluated using the determined alignment parameters, sub-state photoionization cross-sections and the Coster-Kronig transition probabilities.

Measurement of K X-ray fluorescence cross-sections, fluorescence yields and intensity ratios for some elements in the atomic range 22

The Kalpha, Kbeta, and total K X-rays fluorescence cross-sections, as well as the average fluorescence yields for 24 elements with 22

Measurement of K X-ray fluorescence cross-sections and yields for 5.96 keV photons.

The K(alpha), K(beta), and total K X-rays fluorescence cross-sections, as well as the average fluorescence yields for six elements with 16Z23 have been measured at 5.96 keV. The areas of the K(alpha) and K(beta) spectral peaks, as well as the net peak areas, have been determined by a fitting process. Furthermore, the I(Kbeta)/I(Kalpha) intensity ratios for these elements have been investigated. The K X-rays emitted by samples have been counted by a Si(Li) detector. Experimental values of the K X-ray fluorescence cross-sections, fluorescence yields, and the I(Kbeta)/I(Kalpha) intensity ratios have been compared with theoretical values. In most cases, there is an agreement between the experimental and theoretical values within the standard uncertainties.