[Mid- to long-term functional results after Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint]. / Mittel- bis langfristige, funktionelle Ergebnisse nach Hemiresektion-Interpositions-Arthroplastik (nach Bowers) des distalen Radioulnargelenks.

BACKGROUND: Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint has been performed for decades, mainly for the treatment of osteoarthritis of the distal radio-ulnar joint. However, long-term test results are sparse. OBJECTIVE: Evaluation of a homogeneous patient population following a mid- to long-term postoperative follow-up interval after hemiresection interposition arthroplasty. PATIENTS AND METHODS: Twenty-five patients were evaluated 77.2 (±34.6) months after surgical therapy with regard to range of motion, grip strength and pain level. The subjective and objective scores DASH (Disabilities of Arm, Shoulder, and Hand) and MMWS (modified Mayo Wrist Score) were collected. RESULTS: Wrist mobility is not worse than 10.4° in relation to all directions of wrist movement compared with the healthy opposite side. Coarse grip strength is reduced by an average of 5.8 kg compared with the opposite side. The pain level decreased on average from 8.2 preoperatively to 1.8 postoperatively. Postoperatively, 22 patients (88 %) had a stable distal radio-ulnar joint. At the time of follow-up DASH averaged 26.7 (±21.4) and the MMWS averaged 78 (±15.7). DISCUSSION: Hemiresection interposition arthroplasty is a reliable and safe surgical technique with good subjective and functional outcomes in the mid- to long-term.

Imitation and mirror systems in robots through Deep Modality Blending Networks.

Learning to interact with the environment not only empowers the agent with manipulation capability but also generates information to facilitate building of action understanding and imitation capabilities. This seems to be a strategy adopted by biological systems, in particular primates, as evidenced by the existence of mirror neurons that seem to be involved in multi-modal action understanding. How to benefit from the interaction experience of the robots to enable understanding actions and goals of other agents is still a challenging question. In this study, we propose a novel method, deep modality blending networks (DMBN), that creates a common latent space from multi-modal experience of a robot by blending multi-modal signals with a stochastic weighting mechanism. We show for the first time that deep learning, when combined with a novel modality blending scheme, can facilitate action recognition and produce structures to sustain anatomical and effect-based imitation capabilities. Our proposed system, which is based on conditional neural processes, can be conditioned on any desired sensory/motor value at any time step, and can generate a complete multi-modal trajectory consistent with the desired conditioning in one-shot by querying the network for all the sampled time points in parallel avoiding the accumulation of prediction errors. Based on simulation experiments with an arm-gripper robot and an RGB camera, we showed that DMBN could make accurate predictions about any missing modality (camera or joint angles) given the available ones outperforming recent multimodal variational autoencoder models in terms of long-horizon high-dimensional trajectory predictions. We further showed that given desired images from different perspectives, i.e. images generated by the observation of other robots placed on different sides of the table, our system could generate image and joint angle sequences that correspond to either anatomical or effect-based imitation behavior. To achieve this mirror-like behavior, our system does not perform a pixel-based template matching but rather benefits from and relies on the common latent space constructed by using both joint and image modalities, as shown by additional experiments. Moreover, we showed that mirror learning (in our system) does not only depend on visual experience and cannot be achieved without proprioceptive experience. Our experiments showed that out of ten training scenarios with different initial configurations, the proposed DMBN model could achieve mirror learning in all of the cases where the model that only uses visual information failed in half of them. Overall, the proposed DMBN architecture not only serves as a computational model for sustaining mirror neuron-like capabilities, but also stands as a powerful machine learning architecture for high-dimensional multi-modal temporal data with robust retrieval capabilities operating with partial information in one or multiple modalities.

Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes.

PURPOSE: In this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. METHODS: This study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers. RESULTS: Median age was 51 (22-82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. CONCLUSIONS: Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.

Evaluation of normal tibial tubercle to trochlear groove distance in adult Turkish population.

PURPOSE: Many studies have confirmed the significance of tibial tuberosity-trochlear groove (TTTG) distance measurement for the preoperative assessment of tibial tubercle osteotomy and refixation of the patients that need surgery. TTTG distance is being used as threshold value for surgery decision. The purpose is to determine the TTTG values for the adult Turkish population and compare this with the values of other studies and establish a possible index. MATERIALS AND METHODS: This study was conducted on 200 patients (97 female, 103 male) aged between 18 and 65 years, retrospectively, who had magnetic resonance imaging at Istanbul Medipol Mega University Hospital Radiology Department. Individuals with no knee surgical history and deformation included to research group, any deformities related with knee were excluded. The scans were analyzed in Picture Archiving Communication System program and compared with other populations. Significance was evaluated with independent Student's t-test. RESULTS: The mean TTTG distance was found 10.07 ± 1.60 mm in males, 9.96 ± 1.41 mm in females, and 10.02 ± 1.51 mm for total cases. There was no statistically significant difference between sex (P > 0.05). However, overall TTTG distance of right and left knees found significantly different (P < 0.05). CONCLUSION: Obtained results are similar with the results of Caucasian population but different than Asian. It is believed that these results will be significant in evaluation of patellofemoral disorders and helpful in treatment.

Effect of pretreatment and membrane orientation on fluxes for concentration of whey with high foulants by using NH3/CO2 in forward osmosis.

Usage of forward osmosis membrane in FO mode, in which active and support layers of the membrane were in contact with the feed and the draw solutions respectively, provided higher initial water flux (12L/m2h) than the usage of membrane in PRO mode (6L/m2h) having opposite orientation but fluxes approached to each other after 4h during concentration of whey with NH3/CO2 as draw salt. High organic and inorganic foulants of whey was considered as reason for observed result in addition to lower solute resistivity. Initial water flux (8,5L/m2h) was lower when pre-treatment was applied before forward osmosis process but final flux (4L/m2h) was equal flux of non pre-treatment. Reduction of solute resistivity or absence of hydraulic pressure can be reasons for lower initial flux. Detection of organic carbon but absence of lactose in draw solution showed passage of molecules being different than lactose into draw solution.

Everolimus as an mTOR Inhibitor Suppresses Endometriotic Implants: an Experimental Rat Study.

Introduction Mammalian target of rapamycin is a pathway to block apoptosis. Recent studies showed that the activity of mammalian target of rapamycin pathway increases in endometriotic lesions. Aim of the present study was to study the effect of everolimus agent, a rapamycin analog, in an experimental endometriosis model. Materials and Methods Endometriosis established by the autotransplantation of uterine tissue in the peritoneal cavity was confirmed in 24 rats. The animals were then randomly divided into three groups to receive either everolimus (1.5 mg/kg/day, p. o.), anastrozole (0.004 mg/day, p. o.), or normal saline (0.1 mL, i. p.) for 14 days. Endometriotic foci were excised, stained with hematoxylin and eosin, and endometriosis was scored semiquantitatively. In addition, immunohistochemical examination were performed using primary antibodies of vascular endothelial growth factor, CD117, and Bax. Results Both anastrozole and everolimus lowered endometriosis scores. Significant decreases in ovarian follicles were observed following anastrozole treatment but not everolimus treatment. Conclusion Through its apoptosis-promoting effect, everolimus suppressed endometriotic foci without negatively affecting ovarian reserve. These findings support the hypothesis that everolimus merits further study on the way to developing a new endometriosis drug.

Association of SSR markers with contents of fatty acids in olive oil and genetic diversity analysis of an olive core collection.

The purpose of this research was to characterize an olive core collection using some agronomic characters and simple sequence repeat (SSR) markers and to determine SSR markers associated with the content of fatty acids in olive oil. SSR marker analysis demonstrated the presence of a high amount of genetic variation between the olive cultivars analyzed. A UPGMA dendrogram demonstrated that olive cultivars did not cluster on the basis of their geographic origin. Fatty acid components of olive oil in these cultivars were determined. The results also showed that there was a great amount of variation between the olive cultivars in terms of fatty acid composition. For example, oleic acid content ranged from 57.76 to 76.9% with standard deviation of 5.10%. Significant correlations between fatty acids of olive oil were observed. For instance, a very high negative correlation (-0.812) between oleic and linoleic acids was detected. A structured association analysis between the content of fatty acids in olive oil and SSR markers was performed. STRUCTURE analysis assigned olive cultivars to two gene pools (K = 2). Assignment of olive cultivars to these gene pools was not based on geographical origin. Association between fatty acid traits and SSR markers was evaluated using the general linear model of TASSEL. Significant associations were determined between five SSR markers and stearic, oleic, linoleic, and linolenic acids of olive oil. Very high associations (P < 0.001) between ssrOeUA-DCA14 and stearic acid and between GAPU71B and oleic acid indicated that these markers could be used for marker-assisted selection in olive.

Identification of molecular markers associated with fruit traits in olive and assessment of olive core collection with AFLP markers and fruit traits.

The purpose of this study was to characterize olive core collection with amplified fragment length polymorphism (AFLP) markers and fruit traits and to determine AFLP markers significantly associated with these fruit characters in olive. A total of 168 polymorphic AFLP markers generated by five primer combinations and nine fruit traits were used to characterize relationships between 18 olive cultivars. Although all olive cultivars were discriminated from each other by either AFLP markers (<0.75 similarity level) or fruit traits, clustering based on the AFLP markers and fruit traits was not significantly correlated (r = 0.13). Partial clustering of olive cultivars by AFLP markers according to their geographical origin was observed. Associations of AFLP markers with fruits were determined using a multiple-regression analysis with stepwise addition of AFLP markers. Significant associations between eight AFLP markers and fruit traits were identified. While five AFLP markers demonstrated significant negative correlation with fruit and stone weight, width and length and total polyphenols (P < 0.05), three AFLP markers displayed significant positive correlation with α-tocopherol and γ-tocopherol (P < 0.01). This is the first report on the association of molecular markers with fruit traits in olive. Molecular markers associated with morphological and agronomic traits could be utilized for the breeding of olive cultivars. However, the association power of these markers needs to be confirmed in larger populations, and highly correlated markers should then be converted to PCR-based DNA markers such as sequence-characterized amplified region markers for better utilization.

Evaluation of complement system in children with Crimean-Congo hemorrhagic fever.

OBJECTIVES: The complement system participates in the defense of the body against viral infections through various mechanisms. In the present study conducted on children having Crimean-Congo Hemorrhagic Fever (CCHF), the aim was to evaluate whether the complement system had a role in the pathogenesis of the disease. PATIENTS AND METHODS: Forty-one patients diagnosed with CCHF and 32 healthy controls were included in the study. Serum complement component 3 (C3), 4 (C4) and complement product Bb (Bb) levels were measured in both groups. RESULTS: Compared to the control group, serum C3 levels were lower and Bb levels were higher in CCHF patients (p < 0.01). Moreover, in the patient group, C3 levels were positively correlated with WBC and PLT counts, and Bb levels were positively correlated with AST, ALT and LDH activities. In the patient group, serum Bb levels were negatively correlated with WBC and PLT counts. CONCLUSIONS: The results of the present study suggest that increased activity of the alternative pathway of the complement system in children with CCHF may have a role in the pathogenesis of the disease.

Prognostic value of serum Tie-2 and vascular endothelial growth factor levels in cancer patients.

BACKGROUND: Angiogenesis is a very essential process in tumor biology. Vascular endothelial growth factor (VEGF), angiopoietin and its receptor (TIE-2) are very important mediators for angiogenesis. In this trial, we aimed to analyze the role of these mediators on chemotherapy response and survival. PATIENTS AND METHODS: Forty four cancer patients and 22 healthy controls were included in the study. Baseline serum samples were obtained from all participants and post-chemotherapy serum samples were obtained from the cancer patients. Serum vascular endothelial growth factor and TIE-2 levels were measured with quantitative enzyme-linked immunosorbent assay techniques. RESULTS: The baseline serum vascular endothelial growth factor level was 187.5 and 120.2 pg/ml in cancer patients and the control group (p = 0.006). The baseline serum TIE-2 level was 615.9 and 242.5 pg/ml in the patients and control group (p < 0.001). There was a significant difference between patients' baseline and post-chemotherapy VEGF levels (111.9 pg/ml; p < 0.001) and patients' baseline and post-chemotherapy TIE-2 levels (344.5 pg/ml; p < 0.001). The overall survival rate was better in patients who had lower baseline VEGF and TIE-2 levels and whose TIE-2 level had decreased with chemotherapy. CONCLUSIONS: Higher baseline TIE-2 and VEGF levels are related and worsen survival. Decreasing levels of TIE-2, but not VEGF, which, with chemotherapy, may be predictive for survival.

Complete ossification of the superior transverse scapular ligament in an Turkish male adult / Osificación completa del ligamento escapular superior transverso en un hombre adulto de Turquía

Scapula has three margins and angles and located posterolateral of thorax. One of the anatomical structures of scapula is suprascapular notch located medial to coracoid process base. Suprascapular notch can be seen in different shapes and depths. Suprascapular notch is surrounded by transverse scapular ligament which is a short and strong ligament. Suprascapular notch creates an osteofibrosis passage with this structure within suprascapular nerve passes. It has been reported that this osteofibrosis structure can intirely or partially ossify. All lesions of nerves occured in course as result of exposure to compression, tension and bending are called entrapment neuropathy. Like other peripheral nerves, suprascapular nerve can be exposed to compression while passing suprascapular notch. As a result of this compression suprascapular entrapment neuropathy may occur. There are direct trauma, repetitive microtrauma, neurit, progressive compressive lesions in suprascapular entrapment neuropathies etiology. A suprascapular notch taken foramen shape can be a predisposing factor to entrapment neuropathy. In the retrospective screening from Necmettin Erbakan University, Meram Medical Faculty, Department of Radiology archive, a male patient at age 68 with suprascapular notch variation has been detected. This patient's right suprascapular notch had became foramen by an osseous bridge. Diameters of foramen has been measured as 5.27 mm transverse 6.48 mm vertical. We believe having detailed knowledge of suprascapular notch is significant as a possible course of back and shoulder pain is entrapment of suprascapular nerve in suprascapular notch causing nerve paralyses, and it will give a right direction to clinicians in surgical practices.

La escápula tiene tres márgenes y tres ángulos, y se encuentra en la región posterolateral del tórax. Una de las estructuras anatómicas de la escápula es la incisura supraescapular situada medial a la base del proceso coracoides. La incisura supraescapular puede tener diferentes formas y profundidad. Está rodeada por el ligamento escapular transverso, un ligamento corto y fuerte. Con esta estructura, crea un pasaje osteofibroso por el cual pasa el nervio supraescapular. Se ha reportado que esta estructura osteofibrosa se puede osificar completa o parcialmente. Todas las lesiones de los nervios ocurren en su trayecto como resultado de la exposición a compresión, tensión y flexión, lo que se denomina neuropatía por atrapamiento. El nervio supraescapular puede estar expuesto a compresión al pasar por la incisura supraescapular, generando neuropatía por atrapamiento. Su etiología puede ser por traumatismo directo, microtraumatismo repetitivo y lesiones compresivas progresivas. Una incisura supraescapular de forma oval puede ser un factor predisponente para la neuropatía por atrapamiento. En un estudio retrospectivo realizado en la Universidad Necmettin Erbakan, Facultad de Medicina de Meram, Departamento de archivo de Radiología, se observó la imagen de un varón de 68 años con variación en la incisura supraescapular derecha, la cual se transformó en un foramen por un puente óseo. Los diámetros del foramen fueron 5,27 mm transversales y 6,48 mm verticales. Creemos que el conocimiento detallado de la incisura supraescapular es necesario en el diagnóstico y posible curso de dolor del hombro, debido al atrapamiento del nervio supraescapular en la incisura y la posible parálisis nerviosa, dando una guía a los clínicos en las prácticas quirúrgicas.

Clinical importance of posphatase of regenerating liver-3 expression in breast cancer

BACKGROUND: Several biomarkers have been previously studied for breast cancer to define risk of recurrence and metastasis. Phosphatase of regenerating liver-3 (PRL-3) is one of them. High PRL-3 expression has been found to be correlated with axillary lymph node metastasis and survival in breast cancer. Herein, we evaluated the prognostic significance of PRL-3 expression and the relationship between PRL-3 and other clinicopathological factors. METHODS: PRL-3 expression was analyzed immunohistochemically in 122 invasive breast cancer tissues. We evaluated the correlation between PRL-3 and other clinicopathological factors by χ² test. Kaplan-Meier test and log rank method were used to define prognostic importance of PRL-3 expression. RESULTS: Of 122 breast cancer tumor samples, 46 (37.7 %) were negative while 76 (62.3 %) were positive in respect to PRL-3 expression. There was significant correlation between PRL-3 expression and other clinicopathological factors, such as histology, lymphovascular invasion (LVI), necrosis, progesterone receptor (PR) status, and the presence of triple negative disease. Tumors with LVI and necrosis had more positive PRL-3 expression compared to tumors without LVI or necrosis (P = 0.05 and 0.03, respectively). Triple negative and cerb-B overexpressed breast cancers were found to be more positive PRL-3 expression than hormone receptor positive with cerb-B negative groups (luminal A) (P = 0.02).We could not find any relationship between PRL-3 expression and overall survival (OS) or disease-free survival (DFS) (P > 0.05). CONCLUSION: Although PRL-3 expression was related to LVI or necrosis which is important for tumor invasiveness, we could not find that PRL-3 as an important prognostic factor in breast cancer patients. In addition, triple negative and cerb-B overexpressed tumors, which had worse prognosis compared to hormone receptor positive without cerb-B expressed group, associated with also PRL-3 positivity more than PRL-3 negative group (AU)

The prevalence and significance of autoantibodies in patients with non-Hodgkin's lymphoma: are they correlated with clinicopathological features?

PURPOSE: It is well known that an association exists between the pathogenesis of lymphomas and autoimmune diseases. Autoantibodies are detected at higher frequency in lymphoproliferative diseases, but neither the precise role of the immune system nor the cause of this is comprehensively understood. In this study we evaluated the presence and significance of some autoantibodies for patients with non- Hodgkin's lymphoma (NHL). METHODS: 150 patients with NHL who had either newly diagnosed disease, or active disease being under chemotherapy or were disease-free during follow-up, were analyzed. The frequency of autoantibodies and the relationship between autoantibodies and several clinicopathological factors were evaluated. RESULTS: The majority of the patients (50%) had diffuse large B-cell lymphoma (DLBCL). Thirty-two patients (21.4%) were newly diagnosed, 81 (54%) had active disease and were receiving chemotherapy and 37 (24.6%) were disease-free and followed-up. Fifty-one patients (34%) had stage IV disease. Antinuclear antibodies (ANA) were found in 7 (4.7%) patients, perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in 10 (6.7%), anti dsDNA in 1 (0.7%), anti ssDNA in 16 (10.7%), anti Jo-1 in 3 (2%), anti-scleroderma antibody (anti Scl-70) in 4 (2.7%), and rheumatoid factor (RF) in 85 (56.7%) patients. No c7horbar;ANCA positivity was found. The mean levels of anti Jo-1 (p=0.028), anti ssDNA (p=0.014), c-ANCA (p=0.015), ANA (p=0.026) and RF (p=0.046) were significantly higher in cases with DLBCL compared to patients with non-DLBCL. In addition, in patients with newly diagnosed NHL the mean levels of anti Scl- 70 (p=0.023), anti Jo-1 (p7equals;0.017), and RF (p=0.046) were significantly higher than the other patient groups. No significant correlation was detected between the presence of autoantibodies and other clinicopathological factors. CONCLUSION: Our results show that the frequency of autoantibodies is high in NHL patients, especially in DLBCL and newly diagnosed cases. Autoantibodies may be helpful for the diagnosis of autoimmune diseases, but regular and long follow-up is needed in NHL patients with high levels of autoantibodies.

Serum M30 and M65 values in patients with advanced stage non-small-cell lung cancer compared with controls

BACKGROUND: M30 and M65 are derivatives of cytokeratin 18 and released from the epithelial cell during cell death. These markers can be used to evaluate prognosis and chemotherapy response in several tumours. We evaluated serum M30 and M65 values in patients with advanced nonsmall- cell lung cancer (NSCLC) compared with those in a healthy group. MATERIAL AND METHODS: Thirty-two patients with advanced NSCLC and thirty-two healthy people were included in the study. Serum M30 and M65 values were measured by quantitative ELISA method. The best cut-off value for serum M65 was calculated by ROC analysis and then univariate analysis was performed to determine the importance of M65 value in predicting progression-free survival (PFS). RESULTS: There were no differences between mean serum M30 values between patients and controls (445.44±536.17 vs. 340.56±345.07, p=1). The mean serum M65 values were found to be significantly higher in patients than in healthy controls (1421.30±1662.59 vs. 648.85±341.17, p<0.001). The best cut-off value for serum M65 predicting PFS was 1311.64 U/l (AUC 0.58, sensitivity and specificity were 45.5% and 85.7% respectively). The patients with serum M65 values ≥1311.64 U/l had worse PFS than patients with serum M65 values <1311.64 U/l, p=0.01). There was no correlation between serum M30 value and PFS in the patient group (p=0.4). CONCLUSIONS: Our results indicated that serum M65 values elevated in advanced NSCLC compared to a healthy control group and elevated serum M65 level can predict PFS in patients (AU)

Is there an association between blood group and survival in pancreatic cancer?

BACKGROUND: An association between the ABO groups and pancreatic cancer has been shown previously, group A being significantly commoner in affected patients. We conducted the present study to investigate the prognostic effect of ABO blood group on overall survival of pancreas cancer patients. METHODS: Patients who were diagnosed between 2005 and 2010 with pancreas cancer at Ankara Numune Education and Research Hospital were analyzed retrospectively. Patient demographics and ABO blood groups were obtained from medical charts. RESULTS: Fifty pancreas cancer patients with known ABO blood group were included, 26 (52%) group A, 12 patients (24%) group 0, 9 (18%) group B, and 3 (6%) group AB. Blood group A pancreas cancer patient median age was 61.5 (39-80) years, with the median age of the other blood groups (B, AB,O) being 55.5 (32-74) years (p=0.14). 18% of patients with blood group A and11%of the other blood group patients had metastasis (p=0.17) at the time of diagnosis. The median overall survival of blood group A pancreas patients was significantly lower than the other blood group patients, 7.6 (95%CI: 5.0-10.2) months versus 29.0 (95%CI: 0.0-68.8) months (p=0.05). CONCLUSIONS: Acccording to previously published cohort studies a relation may exist between ABO blood groups and cancer of pancreas. In this study we observed that pancreas cancer patients with blood group A have significantly worse overall survival than other blood groups.

Successful treatment of chronic hiccup with baclofen in cancer patients.

Chronic hiccup is an infrequent but distressing symptom in patients with advanced cancer. A series of drugs (chlorpromazine, haloperidol, nifedipine, metoclopramide, baclofen) have been used to treat hiccup without definitive results. Some authors have suggested a possible role of baclofen in the treatment of chronic hiccup. We report three cases of chronic hiccup in patients with cancer successfully treated with baclofen.

Gastric adenocarcinoma under the age of 40; more metastatic, less differentiated.

PURPOSE: Gastric carcinoma is relatively rare under the age of 40 years, and the mean age at presentation is 65 years. Histologically, adenocarcinoma prevails. Previous studies state that gastric adenocarcinoma under 40 is more aggressive. The present retrospective study was undertaken to clarify the clinicopathological characteristics of gastric adenocarcinoma in patients under 40 and to compare their clinical features with the patients over 40 years of age. METHODS: All of the patients with histologically diagnosed gastric adenocarcinoma who had applied to our department from March 2001 to September 2009 were retrospectively evaluated. Patients were stratified according to their age at diagnosis (≤ 40 years; group 1, and > 40 years; group 2). Their clinical, laboratory, and pathological characteristics were analyzed. RESULTS: 251 patients were studied. Sixty-eight percent of those under 40 and 46% over 40 had poorly differentiated histology (p= 0.036). Fifteen (60%) patients under 40 and 73 (32.3%) over 40 had metastatic diseases (p=0.007). CONCLUSION: Younger patients with gastric adenocarcinoma have less differentiated, more advanced and metastatic disease. Patients' complaints, tumor localization, metastatic sites and smoking did not differ significantly between the groups. Controversy for survival parameters still exists.

Is there any correlation among adiponectin levels in serum, tumor tissue and normal tissue of the same patients wih breast cancer?

PURPOSE: Adiponectin is secreted from adipose tissue and is characterized by hyperinsulinemia which is related with obesity. Although serum adiponectin levels in patients with breast cancer have been studied previously, adiponectin levels in the serum, tumor and normal tissue of the same patients have not been simultaneously investigated. The aim of this study was thus to evaluate the relationship among serum, tumor and normal tissue adiponectin levels in patients with breast cancer. METHODS: Fifty-three patients with breast cancer who were operated at the Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Surgery, between February 2008 and June 2008, were analyzed. Their serum adiponectin levels, tumor tissue and normal breast tissue adiponectin levels were compared. The correlation between postoperative histopathological parameters, insulin resistance parameters and adiponectin levels was also examined. RESULTS: The mean adiponectin levels in tumor tissue, normal breast tissue and serum were 56 ± 9.6 ng/ml, 56 ± 10 ng/ml and 43.5 ± 3.1 ng/ml, respectively. The serum adiponectin levels were inversely correlated with tumor tissue adiponectin levels (p=0.001, r=-0.43). When tumor tissue adiponectin levels were increased, serum adiponectin levels were decreased. O n the other hand, there was a positive correlation between normal breast tissue adiponectin levels and tumor tissue adiponectin levels (p=0.0001, r= 0.850). The tumor tissue adiponectin level was inversely correlated with tumor stage (p=0.037 , r= -0.29). Moreover, in early-stage and low grade tumors, both tumor tissue and normal tissue adiponectin levels were high compared with those of advanced stage or high grade tumors (p=0.027, r= -0.32 and p=0.004, r= -0.408, respectively). In the subgroup analyses, no significant relationship was found between insulin resistance parameters and adiponectin levels (p>0.05). CONCLUSION: Our results indicate that serum adiponectin levels were inversely correlated with tumor tissue adiponectin levels, but no relationship between normal breast tissue and tumor tissue adiponectin levels was demonstrated. Adiponectin levels in breast tumor tissue increase while serum adiponectin levels decrease. Adiponectin might play an important role in the prevention of tumor progression by decreasing tissue neovascularization.