Assessment of cyclin D1 activity in tumors and tumor budding and its prognostic significance in tumor budding in colorectal carcinomas.

BACKGROUND: The most important prognostic parameter is staging in colorectal cancers, and tumor budding (TB) is among the independent prognostic parameters that are increasing in significance. Cyclin D1 expression has been associated with poor prognosis as a marker of various tumors. AIMS AND OBJECTIVES: In this study, the aim was to determine the activity of cyclin D1 in colon adenocarcinomas, tumors, and tumor buds and to compare the results with prognostic parameters. MATERIALS AND METHODS: This study included 167 patients who were operated on for colorectal tumors. In subjects, tumor budding was evaluated on hematoxylin and eosin-stained slides, and cyclin D1 was applied immunohistochemically. The cyclin D1 intensity of staining was studied in both tumors and TB and its correlation with prognostic parameters in TB was examined. RESULTS: Lymph node (LN) metastasis was present in 93 (55.7%) of the cases, and distant metastasis in 35 (21%) cases. Tumor budding was present in 152 (91%) of the cases, and high-grade TB was detected in 55 (36.2%). The incidence of TB was higher in patients with LN metastasis (P = 0.02) and in patients with Stages 3 and 4 (P = 0.07). The intensity of cyclin D1 in intermediate and high-grade TB staining was higher. Cyclin D1 staining was more intense in patients with LN metastases and distant metastases as we determined, but it was not statistically significant. CONCLUSION: Thus, based on our study findings, the increased expression of cyclin D1, which is more concentrated in TB than tumors, may indicate a poor prognosis. In contrast, we found no statistically significant correlation between cyclin D activity and prognostic parameters in TB.

Updated endometrial cancer FIGO staging: the role of MRI in determining newly included histopathological criteria.

PURPOSE: Endometrial cancer (EC) is among the prevalent malignancies in gynecology, showing an increasing occurrence and mortality rate. The updated 2023 FIGO staging integrates both histopathological and molecular analyses, which significantly impact the prognosis and treatment approaches. This research aims to examine the effectiveness of MRI in identifying essential histopathological tumor features, including histological subtype, grade, and lymphovascular space invasion. METHODS: A total of 106 patients diagnosed with EC from February 2018 to December 2023 underwent preoperative pelvic MRI. Surgical procedures followed ESMO guidelines, with histopathological assessments using FIGO 2009 criteria. Two radiologists independently evaluated MRI images, measuring maximum tumor size, minimum tumor ADC value (using a free-hand ROI technique), and ADC tumor/myometrium ratio. MRI findings were compared with histopathological data. RESULTS: Peritoneal implant presence and tumor size exhibited significant differences between endometrioid adenocarcinoma (EAC) and non-endometrioid endometrial carcinoma (NEEC), with p values of < 0.001 and 0.003, respectively. Significant differences in age, tumor size, ADC tumor, and ADC tumor/myometrium between low-grade and high-grade tumors were observed, with p values of < 0.001, 0.004, 0.006, and 0.011, respectively. Increased tumor size, reduced ADC tumor, ADC tumor/myometrium, and pelvic peritoneal implant presence were significantly associated with LVSI, with p values of < 0.001, 0.001, 0.002, and 0.001, respectively. The AUC values for tumor size, ADC tumor, and ADC tumor/myometrium were 0.842, 0.781 and 0.747, respectively, in distinguishing between low and high-grade endometrial tumors. Similarly, obtained AUC values for predicting LVSI were 0.836, 0.719, and 0.696, respectively. CONCLUSION: Our study emphasizes MRI's role in predicting tumor characteristics such as histological subtype, grade, and LVSI based on updated FIGO criteria. By highlighting the potential of MRI, this research contributes to our comprehension of improving diagnostic and clinical management for EC. Further multicenter studies are warranted to validate these findings and establish MRI's role in EC management.

Predictive significance of intraprostatic volumetric parameters derived from early and standard time 68Ga-PSMA PET/CT images in newly diagnosed prostate cancer patients.

OBJECTIVE: To investigate the relationship between intraprostatic 68Ga-prostate-specific membrane antigen (PSMA) uptake values and volumetric parameters derived from early pelvic and standard-time whole-body 68Ga-PSMA PET/computed tomography (CT) images in untreated prostate cancer (PCa) patients, and to assess the predictive significance of these data in relation to disease prognosis, comparing them with the Gleason score, clinical risk classification and the presence of metastatic disease detected in 68Ga-PSMA PET/CT imaging. METHODS: Eighty-one newly diagnosed PCa patients underwent early phase pelvic imaging at the 5th minute and standard time whole-body imaging at the 60th minute. Various threshold values were used in intraprostatic delineations to compute maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), intraprostatic PSMA tumor volume and intraprostatic total lesion PSMA uptake. Correlations between early and standard time measurements, as well as changes in SUV parameters over time, were examined. The association of these values with Gleason score, clinical risk status (National Comprehensive Cancer Network), and metastatic disease was explored. RESULTS: SUVmax measurements from both early and standard time images distinguished all three groups (clinical risk scores, Gleason score and metastatic group), with standard imaging demonstrating statistical superiority in receiver operating characteristic analyses. Strong correlations were observed between early and standard-time PET parameters. Changes in intraprostatic SUVmax and SUVmean values over time did not exhibit predictive value. CONCLUSION: Although intraprostatic PSMA PET parameters generally aligned at both early and standard times, parameters obtained from standard time images showed more robust correlations with clinical risk scores, Gleason score and metastasis status in newly diagnosed, untreated PCa patients.

The relationship between nutritional status and white matter integrity in older adults: A diffusion tensor imaging study.

OBJECTIVES: The purpose of this study to determinate whether there is a relationship between the nutritional status and white matter integrity in older patients by using Diffusion Tensor Imaging (DTI). METHODS: The patients were evaluated by Mini-Nutritional Assessment Scale. The patients are categorized in the groups of well-nourished, risk of malnutrition, or malnourished, depending on the overall score> 23.5, 17-23.5, or 17; respectively. All patients had brain MRI and DTI. The mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) values were calculated by ROI-based method in white matter tracts. RESULTS: Total of the 224 patients; 86 patients had normal nutrition status (group 1), 107 patients were diagnosed with malnutrition risk (group 2) and 31 patients were diagnosed with malnutrition (group 3). Significantly decreased FA values of genu of corpus callosum, forceps minor and significantly increased MD values of middle cerebellar peduncle, and superior frontooccipital fasciculus were detected in group 2 in comparison to group 1 (p < 0.05). After adjusting for the folate and age, MD and RD values of cingulum remained significantly higher and the AD values of superior cerebellar peduncle remained significantly lower in group 3 (p < 0.05). CONCLUSIONS: Malnutrition was associated with deteriorated DTI values, especially in cingulum and superior cerebellar peduncle. Assessing the nutritional status of older individuals is crucial to avoid its negative impact on brain. ADVANCES IN KNOWLEDGE: Early diagnosis of malnutrition-related impaired WM integrity is important for prevention and intervention, and DTI is a useful non-invasive technique to be used for this purpose.

Diagnostic role of gray-scale and shear-wave elastography in pediatric patients with undescended testes: a prospective controlled study.

Aim: Ultrasound elastography is a simple non-invasive method for measuring tissue elasticity in relation to tissue fibrosis. The aim of this study was to compare echogenicity, volume and shear wave velocities of undescended vs normally descended testes. Material and methods: Sixty-six boys with undescended testes were included in this study. The median age range was 35.5 (10-118) months old. The cases included in this prospective study consisted of 66 patients with non-operated undescended testes, with 51 of them being affected unilaterally and 15 affected bilaterally, as diagnosed by physical examination. The control group consisted of 31 healthy boys without any particular health problems. This prospective study was performed by gray-scale ultrasonography and shear wave elastography in boys with undescended testes and healthy testes. The testicular volumes were established by ultrasound measurement, the echogenicity and shear wave elastography values were measured in boys with unilateral and bilateral undescended testes, and the results were compared with healthy boys' testes and their contralateral testes. The stiffness values were recorded for speed (m/s) and elasticity (kPa), and the stiffness values of undescended testes were compared with the healthy control group. Results: Echogenicity values were lower in the bilateral undescended testes group than in the healthy group, and the healthy group's echogenicity was normal (p <0.001). The ROC curve was used to identify a cut-off shear wave elastography value for predicting decreased testicular echogenicity by using average shear wave elastography values. The area under the curve for the undescended testes was 0.78 (95% CI: 0.70-0.85, sensitivity 83.7%, specificity 68.7%, p <0.001), with an average shear wave elastography value of 2.32 (m/s) for above the cut-off point indicates. This was found to be significantly associated with reduced echogenicity on gray-scale ultrasonography, suggesting that it may be correlated with fibrosis developing in patients with undescended testes. Conclusion: The study provides interesting findings in that it proposes an alternative non-invasive method for the assessment of testicular tissue in undescended testes. We used shear wave elastography to compare the stiffness of normal testes in both heathy patients and in the contralateral healthy testes of boys with undescended testes, with the values obtained for the undescended testes reflecting the level of fibrosis of the parenchyma. Another outcome of this study was observed in patients with unilateral undescended testes, where the normally descended testes showed increased shear wave elastography values, which could be an early indication of parenchymal change.

Diffusion tensor imaging findings in the hunger and satiety centers of the brain after bariatric surgery: a preliminary study.

PURPOSE: To investigate the alterations in the diffusion tensor imaging (DTI) parameters measured in the hunger and satiety centers of the brain before and after bariatric surgery (BS) in morbidly obese patients. METHODS: Fourty morbidly obese patients were evaluated before and after BS. Mean diffusivity (MD) and fractional anisotropy (FA) values were calculated from 14 related brain locations, and the DTI parameters were analyzed. RESULTS: After the BS, the mean BMI of the patients decreased from 47.53 ± 5.21 to 31.48 ± 4.21. The MD and FA values in the all of the hunger and satiety centers was found statistically significant different in the pre-surgery period compared to the post-surgery period (for each; p-value < 0.001). CONCLUSION: The FA and MD changes after BS may be attributed to reversible neuroinflammatory alterations in the hunger and satiety centers. Decreased MD and FA values after BS may be explained by the neuroplastic structural recovery in the related brain locations.

Role of magnetic resonance imaging to differentiate between borderline and malignant serous epithelial ovarian tumors.

PURPOSE: We aimed to differentiate serous borderline ovarian tumors (SBOT) from serous epithelial ovarian carcinomas (SEOC) using morphological and functional MRI findings, to improve the patient management. METHOD: We retrospectively investigated 24 ovarian lesions diagnosed with SBOT and 64 ovarian lesions diagnosed with SEOC. Additional to the demographic and morphological findings T2W signal intensity ratio, mean apparent diffusion coefficient (ADCmean) and total apparent diffusion coefficient (ADCtotal) values were analyzed and compared between two groups. RESULTS: Bilaterality, pelvic free fluid presence, serum CA-125 level (U/mL), presence of pelvic peritoneal implant were in favor of SEOC. Lower maximum size of solid component and solid size to maximum size ratio, dominantly cystic and solid-cystic appearance, exophytic growth pattern, presence of papiller projection and papillary architecture and internal branching pattern, higher T2W signal intensity ratio, ADCmean and ADCtotal values were in favor of SBOT. CONCLUSION: Our study revealed that morphological and functional imaging findings were valuable in differentiating BSOT from SEOC.

Evaluation of the white matter integrity in morbidly obese patients before and after bariatric surgery; a diffusion tensor imaging study.

PURPOSE: To investigate the difference in FA (Fractional anisotropy), ADC (Apparent diffusion coefficient), RD (Radial diffusivity) and AD (axial diffusivity) values of white matter (WM) tracts in morbidly obese subjects before and after bariatric surgery (BS). MATERIALS AND METHODS: A group of thirty-nine morbidly obese subjects are evaluated before and 4-6 months after BS. ADC, FA, RD and AD values of 17 distinct neuroanatomic localizations are measured and DTI parameters are analyzed. RESULTS: Following the BS, the patients' mean BMI decreased from 47.665.21 to 31.723.97. A significant difference is displayed between the pre-surgery and post-surgery FA values of SLF, SFOF, ALIC, fornix, ILF, CST, MCP (p = 0.010, p < 0.001, p = 0.048, p = 0.014, p = 0.012, p = 0.012, p = 0.040 respectively). Following BS, decrease in FA values in the mentioned areas are detected. ADC values obtained from MCP are significantly lower in the post-BS period compared to pre-BS period (p = 0.018). There was a statistically significant difference between the pre-surgery and post-surgery AD values of SLF, SFOF, ILF, ALIC, EC, CST, and MCP (p = 0.001, p = 0.022, p = 0.001, p = 0.011, p = 0.001, p = 0.000, p = 0.000, respectively). Following the BS, AD values of the SLF, SFOF, ILF, ALIC, EC, CST, and MCP are decreased. RD values measured from GCC are significantly lower in the post-BS period compared to pre-BS period (p = 0.008). CONCLUSION: Our study supported the hypothesis of the BS-induced reversibility of the low-grade inflammation in WM tracts in the morbidly obese group following BS. Our DTI results may represent the subacute period findings of the reversal of low-grade inflammation after BS.

Evaluation of sex dimorphism of the mandible with geometric morphometric analysis: conventional and reconstructed panoramic radiography study.

PURPOSE: The purpose of the study was to investigate the mandible shape dimorphism between males and females both on conventional panoramic radiographs (cPR) and reconstructed panoramic radiographs obtained from cone beam computed tomography (rPR) with geometric morphometric method. METHODS: Panoramic radiographs and cone beam computed tomography scans were performed on 33 males and 35 females with median age 23.0 (13.0-57.0) years old. The mandibular shape comparisons between genders were examined with Procrustes analysis, mandible shape classification analysis was made with principal component analysis and shape deformations were concluded from thin plate spline (TPS) analysis. RESULTS: Age had no statistically significant difference between gender (p = 0.580). For the shape of mandible on cPR and rPR, there were statistically significant differences between males and females (p = 0.002, p = 0.032, respectively). The shape variabilities of mandible on cPR for females were 0.054 and for males 0.053. The shape variabilities of mandible on rPR for females were 0.051 and for males 0.049. Both on cPR and rPR, the shape variability of the females' mandible was similar within their group, the shape variability of the males' mandible was similar within their group. In the examination of mandibular dimorphism in cPR, maximal deformations were seen in the region between the mandibular notch, posterior ramus, anterior ramus, gonion, in both sides, in TPS graphs. On the other hand, a high level of deformations was observed in all landmarks that define the mandibular shape on rPR. CONCLUSIONS: The mandible dimorphism can be detected in the examination performed with geometric morphometric methods on cPR and rPR. While mandible shape differences according to gender are seen most in the ramus region in cPR, differences can be detected in all landmarks in rRP.

Evaluation of white matter integrity by diffusion tensor imaging in the deficiencies of vitamin B12 and folate in older patients.

OBJECTIVES: The aim of this study is to investigate whether white matter (WM) integrity is impaired in vitamin B12 and folate deficiency with Diffusion Tensor Imaging (DTI) in older patients. METHODS: All the patients aged ≥65 years admitted to the geriatric clinic and performed DTI-MRI were included in the study. DTI parameters (fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity) were calculated by ROI-based method in white matter tracts. Deficiency threshold for vitamin B12 were defined as <200 pg ml-1 and <400 pg ml-1 separately; and for folate as <3 ng ml-1 and <6 ng ml-1, separately. RESULTS: DTI was performed to older patients having serum vitamin B12 level (n = 106, mean age = 80.7±7.7, 66% female) and folate level (n = 101, mean age = 80.7±7.5, 67.3% female). Significantly lower FA and higher MD and RD levels were observed in multiple WM areas including superior and middle cerebellar peduncles, cingulum and genu of corpus callosum in patients with vitamin B12 <400 pg ml-1 (p < 0.05). DTI indices also showed significant changes in the genu of corpus callosum, and right and left superior longitudinal fasciculus in patients with folate <6 ng ml-1 (p < 0.05). CONCLUSIONS: Deficiencies of vitamin B12 and folate may be associated with impaired white matter integrity in elderly even at high laboratory levels, and DTI is a useful method to detect it. ADVANCES IN KNOWLEDGE: Early detection of impaired WM integrity caused by micronutrient deficiencies poses a great significance in terms of prevention and intervention, and DTI is an effective non-invasive method to be used for this purpose.

The correlation between skeletal muscle index and anxiety in patients with lung cancer on the first day of chemotherapy.

Aim: To evaluate the relationship between anxiety and skeletal muscle index (SMI) levels in lung cancer patients on the first day of chemotherapy. Materials & methods: This cross-sectional study included 108 patients. We analyzed patient characteristics, SMI levels, pain status and predicted anxiety factors. Results: Anxiety was detected in 61% of patients. SMI levels were significantly lower in the high anxiety group than the low anxiety group (p < 0.001). A significant correlation was observed between anxiety and SMI levels (r = -0.292; p = 0.002). Anxiety levels were significantly correlated with trait anxiety (r = 0.618; p < 0.001) and visual analog scale-pain (r = 0.364; p < 0.001). SMI (odds ratio: 0.94), trait anxiety (odds ratio: 1.12) and visual analog scale pain (odds ratio: 1.28) were independent risk factors for anxiety after adjusting for sex, stage and Eastern Cooperative Oncology Group performance status. Conclusion: Our study highlighted that higher anxiety scores were significantly correlated with lower SMI levels. We found that SMI, pain and trait anxiety were independent risk factors for anxiety.

Microstructural alterations in hypoxia-related BRAIN centers after COVID-19 by using DTI: A preliminary study.

PURPOSE: To investigate whether the diffusion tensor imaging (DTI) parameters alterations in the in hypoxia-related neuroanatomical localizations in patients after COVID-19. Additionally, the relationship between DTI findings and the clinical severity of the disease is evaluated. METHODS: The patients with COVID-19 were classified into group 1 (total patients, n = 74), group 2 (outpatient, n = 46), and group 3 (inpatient, n = 28) and control (n = 52). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from the bulbus, pons, thalamus, caudate nucleus, globus pallidum, putamen, and hippocampus. DTI parameters were compared between groups. Oxygen saturation, D dimer and lactate dehydrogenase (LDH) values associated with hypoxia were analyzed in inpatient group. Laboratory findings were correlated with ADC and FA values. RESULTS: Increased ADC values in the thalamus, bulbus and pons were found in group 1 compared to control. Increased FA values in the thalamus, bulbus, globus pallidum and putamen were detected in group 1 compared to control. The FA and ADC values obtained from putamen were higher in group 3 compared to group 2. There was a negative correlation between basal ganglia and hippocampus FA values and plasma LDH values. The ADC values obtained from caudate nucleus were positively correlated with plasma D Dimer values. CONCLUSION: ADC and FA changes may reveal hypoxia-related microstructural damage after COVID-19 infection. We speculated that the brainstem and basal ganglia can affected during the subacute period.

CT-based, robotic-arm assisted total hip arthroplasty (Mako) through anterior approach provides improved cup placement accuracy but no difference in clinical outcomes when compared to conventional technique.

BACKGROUND: With the restoration of the natural hip biomechanics, a successful total hip arthroplasty (THA) and long-term survival is pursued. Although robotic THA (rTHA) has been developed to increase accuracy of implant positioning, leg lengths and offsets, discussions about its radiological and clinical advantages over conventional THA (cTHA) continues. OBJECTIVE: The aim of this study was to compare clinical and radiological outcomes of robotic and conventional THA. METHODS: This retrospective study compares functional and radiological outcomes of 82 rTHA with a matched group of 82 cTHA in terms of age, sex, body mass index and preoperative functional scores. The minimum follow up was 12 months for all patients. Functional outcomes were Harris Hip Score (HHS) and the Western Ontario and McMaster University Osteoarthritis index (WOMAC) evaluated pre- and postoperatively. Radiological evaluations included position of cup placement according to Lewinnek and Callanan safe zones, Canal Fill Ratio (CFR), Leg Length Discrepancy (LLD), Lateral offset (LO) and Femoral Component Alignment (FCA). Complications were also evaluated. RESULTS: In the rTHA group, 91.5% (75 out of 82) of the acetabular cups were positioned within the safe zone whereas it was 63.4% (52 out of 82) for the cTHA group (p< 0.001). According to Callanan, they were 84.1% and 50%, respectively (p< 0.001). Between the groups, no statistically significant difference was found in CFR, LLD, HO, FCA, AI, AA, WOMAC, HHS and major complication rates. CONCLUSION: rTHA is superior to cTHA in terms of accuracy and reproducibility of the cup placement, however no apparent clinical benefit was found in short term follow.

Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases.

OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negative but assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings. METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngeal swabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodies were analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, the patients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as <5% lung involvement versus ≥5% lung involvement. RESULTS: The patients' mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgG positive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases (p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively). CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgG antibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lung parenchymal involvement.

Significance of CD47 expression in endometrial carcinoma.

Objectives: CD47 is a membrane protein that belongs to the immunoglobulin superfamily and regulates macrophage phagocytosis negatively. As CD47 expression at the cancer cell membrane would inhibit the phagocytic activity of immune cells, it is connected to an unfavorable prognosis in leukemia and malignancies of various solid organs. Materials and. Methods: In this study, retrospectively evaluated 72 patients who had been diagnosed with endometrial carcinoma at Pathology Department and had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO) and/or lymphadenectomy. CD47 expression was evaluated in tumorous and nontumor areas in all patients considering cytoplasmic and membranous brown staining in cells. The proportion of expression was evaluated as well as the intensity and an "h score" was obtained. This score was compared with known prognostic parameters. Results: CD47 expressions showed a statistically significant correlation with tumor grade (P < 0.05); however, no significant relationship was observed with myometrial invasion depth and lymph vascular invasion status (P = 0.923 and P = 0.754, respectively). Conclusions: As with other tumors, anti-CD47 antibody may be an alternative treatment option in patients with high-grade endometrial carcinoma.

Comparison of clinical findings and electromyography results in patients with preliminary diagnosis of carpal tunnel syndrome.

OBJECTIVE: To evaluate the link between EMG findings and clinical status, the Boston questionnaire and the severity of pain in patients with pre-diagnosis of carpal tunnel syndrome. METHODS: A total of 85 patients (133 hands) who presented to the Physical Therapy and Rehabilitation outpatient clinic consecutively with complaints of numbness, tingling, pain and weakness in their hands were evaluated for their demographic and clinical features. After the initial evaluation, the diagnosis of CTS was confirmed by EMG. Visual analog scale (VAS), the Boston Questionnaire (Symptom Severity Scale = SSS, Functional Status Scale = FSS) and nerve conduction study results (sensory conduction velocity = SCV, distal motor latency = DML, compound muscle action potential = CMAP) were enrolled. RESULTS: Eighty-five patients (58 female and 27 male) participated in this study yielding 133 hands (73 right hands, 60 right hands) with CTS. The mean age was 48.3 ± 10.41 years. Of all patients, 68.2 % were female and 31.8 % were male. A statistically significant relationship was found between SSS and duration of symptoms, VAS, both right and left SCV, DML and CMAP. A statistically significant relationship was found between FSS and duration of symptoms, VAS and only right SCV, DML and CMAP. CONCLUSION: The diagnosis of CTS should be evaluated not only as an electrodiagnostic finding, but also the clinical picture of the patients. According to our results, both SSS and FSS had good correlations with VAS and the findings of EMG. Therefore, the Boston Questionnaire can provide a standardized measure of symptom severity and functional status in patients with CTS.

Thorax computed tomography findings and anti-SARS-CoV-2 immunoglobulin G levels in polymerase chain reaction-negative probable COVID-19 cases

SUMMARY OBJECTIVE: This study aimed to evaluate the SARS-CoV-2 immunoglobulin G (IgG) levels after 6 months of polymerase chain reaction (PCR) negative but assumed to be COVID-19 positive cases to investigate the relationship between IgG levels and thoracic computed tomography (CT) findings. METHODS: This was a single-center study that included patients whose PCR test results were negative at least three times using nasopharyngeal swabs but had clinical findings of COVID-19 and thoracic CT findings compatible with viral pneumonia. Six months after discharge, the IgG antibodies were analyzed. The cutoff value for negative and positive serology was defined as <1.4 (index S/C) and ≥1.4 (index S/C), respectively. In addition, the patients were categorized according to their thoracic CT findings as high (typical) and low (atypical). Also, the patients were grouped into classes as <5% lung involvement versus ≥5% lung involvement. RESULTS: The patients' mean age was 49.78±12.96 years. PCR was negative, but patients with COVID-19 symptoms who had SARS-CoV-2 IgG positive were 81.9% (n=95). The antibody titer and lung involvement ≥5% were statistically significantly higher in SARS-CoV-2 IgG positive cases (p<0.001 and p=0.021). Age and chest CT findings were the risk factors for lung involvement (OR=1.08, p<0.001 and OR=2.19, p=0.010, respectively). CONCLUSION: This study is valuable because increasing severity (≥5%) of lung involvement appears to be associated with high and persistent IgG antibody titers. In probable cases of COVID-19, even if the PCR test is negative, high IgG titers 6 months after discharge can predict the rate of lung parenchymal involvement.

Prognostic evidence of LEF1 isoforms in childhood acute lymphoblastic leukemia.

INTRODUCTION: The lymphoid enhancer factor 1 (LEF1) is a DNA-binding transcription factor that functions in the Wnt signaling pathway. Increased LEF1 activity is associated with progression of several types of cancer including leukemia. Here, we investigated LEF1 isoform expression and genomic variations in acute lymphoblastic leukemia (ALL). METHODS: LEF1 isoform expression was evaluated by quantitative real-time PCR in 87 newly diagnosed childhood ALL patients and controls. Moreover, Western blot analysis was performed for detection of LEF1 expression and the hotspot region of LEF1 was screened by deep sequencing. RESULTS: The LEF1 mRNA expression of B cell ALL patients was higher than the controls (LEF1-total P = .011, LEF1-long P = .026). Moreover, B-ALL samples showing higher total LEF1 expression had significantly shorter relapse-free survival (P = .008) and overall survival (P = .011). Although full-length LEF1 expression was similar to the controls in T-ALL, 50% (n = 15) of the ALL patients had increased full-length LEF1 protein expression. Imbalance between short- and full-length LEF1 isoforms may lead to cell survival in ALL. Beside the LEF1 activation, LEF1 gene variations were rarely observed in our cohort. CONCLUSION: The results indicate that the Wnt pathway may have a pathogenic function in a group of ALL patients and high LEF1-total expression might be a marker for shorter relapse-free survival time in B cell ALL.