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Schizophrenia and bipolar disorder are disorders characterized by alterations in cellular and molecular mechanisms. Annexin A3 (ANXA3) has various effects on neural mechanisms and membrane phospholipid function and both mechanisms are thought to be associated with psychotic disorders. Our study consisted of 93 schizophrenia and bipolar disorder and 52 healthy controls. ANXA3 was analyzed by enzyme-linked immunosorbent assay (ELISA). ANXA3 levels were significantly different between the groups (p [Med-Science 2023; 12(3.000): 853-8]

In this study, xanthine oxidase (XO), malondialdehyde (MDA), myeloperoxidase (MPO) and glutathione (GSH) levels in the ovarian tissues of rats during the development of ischemia and postischemia-induced reperfusion were investigated, and the effect of ATP on ischemia-reperfusion (I/R) damage was biochemically and histopathologically examined. The results of the biochemical analyses demonstrated that ATP significantly reduced the level of XO and MDA and increased the amount of GSH in both ischemia and I/R-applied ovarian tissue at the doses administered. Furthermore, ATP significantly suppressed the increase in MPO activity that occurred following the application of post ischemia reperfusion in the ovarian tissue. The biochemical results obtained in the present study coincide with the histological findings. The severity of the pathological findings, such as dilatation, congestion, haemorrhage, oedema and polymorphonuclear nuclear leukocytes (PMNLs), increased in parallel with the increase observed in the products of XO metabolism. In conclusion, exogenously applied ATP prevented I/R damage by reducing the formation of XO in ischemic ovarian tissue.

In this study, the possible effects of exercise on hormonal secretions in some sport branches were investigated on the basis of urinary cyclic nucleotide (cAMP and cGMP) excretion, since it was thought that the total, ultimate effects of secreted hormones, under the effect of exercise stress, may be estimated by means of the changes in the second messenger, cAMP, and cGMP, concentrations in urine. A total of 60 subjects from different sport branches were included in the study, and pre- and post-training urinary cyclic nucleotide levels of them were determined by EIA method. The differences in cAMP and cGMP between pre-training and post-training periods were statistically significant (p

Background: The main complications seen in patients who have undergone modified radical mastectomy (MRM) are seroma, surgical site infection, hematoma, wound dehiscence, flap necrosis, and nerve damage. While these complications lead to some problems the most feared effect in the early period is that they cause a delay in adjuvant treatment. Incisional Negative Pressure Wound Therapy (iNPWT) decreases wound dehiscence by reducing oedema and tension, especially in the incision line. This study aim to compare recovery times and wound site complications between patients treated with conventional wound dressings and patients treated with iNPWT after MRM. Methods: A retrospective screening was made of the data of 50 patients who underwent MRM because of breast cancer in the General Surgery Clinic of XXX Hospital between 2018 and 2022, and were at high-risk of wound site complications. Two groups were formed as 30 patients applied with iNPWT and 20 patients applied with conventional dressings. Results: The mean age of the 50 female patients was 53.58 years (range, 30–80 years). The most frequently seen complications were seroma (20 patients) and partial flap ischaemia (14 patients). The mean number of iNPWT applications was 1.30 (range, 1–2), and the mean number of days of application was 4.47 (range, 2–9). Postoperative seroma was observed in 8 patients in the iNPWT group and in 12 patients in the conventional dressings group (p = 0.018). Flap ischaemia and the probability of dehiscence was determined at a statistically significantly higher rate in the patients in the conventional dressings groups (p = 0.005, p = 0.021). Conclusion: The results of this study demonstrated that the use of iNPWT significantly reduced the amount of postoperative drainage, thereby contributing to early drain removal. Furthermore, iNPWT significantly reduced postoperative seroma, flap ischaemia, and flap dehiscence compared to conventional dressings.

Necrotizing fasciitis is a rare but potentially lethal infection of the skin and soft tissue, commonly seen in the perianal and gluteal regions. Concomitant diabetes is a predisposing factor. Primary necrotizing fasciitis of the breast is rare in healthy women. In this article, we present a very rare case of breast necrotizing fasciitis in the context of the literature. We report the case of a 35-year-old female patient who had given birth two months prior to admission and developed necrotizing fasciitis of the breast during lactation. The patient presented to the emergency department with sepsis. Examination revealed widespread erythema, dark discoloration, edema, and necrotic areas indicative of wet gangrene and crepitation in the left breast. Necrotizing fasciitis is a rapid and aggressive disease that can be fatal, and delayed diagnosis may unfortunately result in death. Therefore, careful evaluation of all suspected cases, especially for patients with risk factors, is crucial for early diagnosis and timely treatment. This case highlights the importance of recognizing necrotizing fasciitis of the breast in lactating women to ensure prompt and appropriate management, potentially saving lives.

Objective: Among women, breast cancer (BC) is the most prevalent form of cancer. Many molecular targets have been discovered for BC prognosis and treatment. However, new markers still need to be identified, as cancer pathogenesis is triggered by different mechanisms. The aim of this study was to examine the changes in the paraoxonase genes (PON1, PON2, and PON 3) involved in the pathogenesis of BC. Materials and Methods: The characteristics of the mutations were evaluated with the Cbioportal database. Kaplan-Meier Plot evaluated recurrence-free survival (RFS). The UALCAN database determined the promoter methylation. Gene expression was evaluated by GEPIA2.0 database. Results: PON1 harbored the most mutations. There was a significant decrease in PON3 expression levels in BC samples compared with healthy samples. PON1 and PON2 expression levels did not differ between BC tissue and normal adjacent tissue. Elevated expression levels of PON1 and PON2 genes were correlated with longer RFS, whereas reduced expression of the PON2 gene showed an association with longer RFS. Moreover, the promoter regions of PON1 and PON 3 were found to be hypermethylated, while the promoter region of PON 2 was found to be hypomethylated. The PON3 promoter region was significantly hypermethylated in luminal and human epidermal growth factor receptor 2 (HER2) + BC subtypes. However, the PON3 promoter region was significantly hypomethylated in the triple negative breast cancer (TNBC) subtype. Conclusion: These results suggest that methylation and expression status of PON3 in BC and BC subtypes (TNBC, luminal and HER2) may indicate a poor prognosis. The PON3 gene could be a negative prognostic marker in BC. However, the results should be supported by prospective studies.

Abstract Background Functional status of T cells determines the responsiveness of cancer patients to immunotherapeutic interventions. Even though T cell‐mediated immunity is inaugurated in the tumor‐adjacent lymph nodes, peripheral blood has been routinely sampled for testing the immunological assays. The purpose of this study is to determine the immune checkpoint molecule expression and the exhaustion‐related phenotype of cytotoxic T cells in the regional lymph nodes from breast cancer patients. Patients and methods Multicolor immunophenotyping was used to determine the expression of PD‐1, TIM‐3, LAG3, CTLA‐4, CCR7, CD45RO, CD127, CD25, CXCR5, and ICOS molecules on CD3+CD4−CD56−CD8+ cytotoxic T cells freshly obtained from the lymph nodes and the peripheral blood samples of the breast cancer patients. The results were assessed together with the clinical data. Results A population of cytotoxic T cells was noted with high PD‐1 and CXCR5 expression in the lymph nodes of the breast cancer patients. Co‐expression of PD‐1, CXCR5, TIM‐3, and ICOS indicated a follicular helper T cell (Tfh)‐like, exhaustion‐related immunophenotype in these cytotoxic T cells. Only a minor population with CTLA‐4 and LAG3 expression was noted. The PD‐1+CXCR5+ cytotoxic T cells largely displayed CD45RO+CCR7+ central memory markers. The amount of CXCR5‐expressing PD‐1− cytotoxic T cells was elevated in the lymph nodes of the patients. Conclusion The regional lymph nodes of breast cancer patients harbor Tfh‐like exhausted cytotoxic T lymphocytes with high PD‐1 and TIM‐3 checkpoint molecule expression. The immunological conditions in the regional lymph nodes should be implicated for immune checkpoint immunotherapy (ICI) of cancer.

This paper presents a numerical study of topology-optimised pin-end aluminium alloy columns using finite element analysis (FEA). The FEA models integrate geometric imperfections and material nonlinearity, and are validated against experimental findings from the existing literature. ABAQUS v.6.15 (release 2020) is used in preparing the FEA models and obtaining the analysis results. Furthermore, modern design methodologies including Eurocode 9, the direct strength method (DSM), and the continuous strength method (CSM) are employed to assess the maximum load capacity of such columns. Parametric investigations encompass diverse parameters such as varied cross-sections, column lengths, and global and local imperfections. By analysing a total of 288 FE models, incorporating 16 column cross-sections across two lengths with nine distinct imperfections, this study compares results with those derived from modern design methodologies. Thus, this research elucidates the behaviour of novel cross-sections and the application of contemporary design techniques in their analysis.

Abstract Background There is an ongoing search for standardized scales appropriate for each culture to evaluate professionalism, which is one of the basic competencies of a physician. The Professionalism Mini-evaluation Exercise (P-MEX) instrument was originally developed in Canada to meet this need. In this study, it was aimed to adapt the P-MEX to Turkish and to evaluate the validity and reliability of the Turkish version. Methods A total of 58 residents at Bakirkoy Dr. Sadi Konuk Training and Research Hospital were assessed with the Turkish version of P-MEX by 24 raters consisting of faculty members, attending physicians, peer residents, and nurses during patient room visits, outpatient clinic and group practices. For construct validity, the confirmatory factor analysis was performed. For reliability, Cronbach’s alpha scores were calculated. Generalizibility and decision studies were undertaken to predict the reliability of the validated tool under different conditions. After the administration of P-MEX was completed, the participants were asked to provide feedback on the acceptability, feasibility, and educational impact of the instrument. Results A total of 696 forms were obtained from the administration of P-MEX. The content validity of P-MEX was found to be appropriate by the faculty members. In the confirmatory factor analysis of the original structure of the 24-item Turkish scale, the goodness-of-fit parameters were calculated as follows: CFI = 0.675, TLI = 0.604, and RMSEA = 0.089. In the second stage, the factors on which the items loaded were changed without removing any item, and the model was modified. For the modified model, the CFI, TLI, and RMSEA values were calculated as 0.857, 0.834, and 0.057, respectively. The decision study on the results obtained from the use of P-MEX in a Turkish population revealed the necessity to perform this evaluation 18 times to correctly evaluate professionalism with this instrument. Cronbach’s alpha score was 0.844. All the faculty members provided positive feedback on the acceptability, feasibility, and educational impact of the adapted P-MEX. Conclusion The findings of this study showed that the Turkish version of P-MEX had sufficient validity and reliability in assessing professionalism among residents. Similarly, the acceptability and feasibility of the instrument were found to be high, and it had a positive impact on education. Trial registration 2020/249, Bakirkoy Dr. Sadi Konuk Training and Research Hospital.

Abstract An effective method to make cement and concrete more sustainable is to blend them with the proper supplementary cementitious materials (SCMs). This study evaluates a pair of schist‐type materials with slightly different phase compositions, as a partial replacement for ordinary Portland cement (OPC). Materials received from several mines in ground powder form were studied by X‐ray diffraction, thermogravimetric analysis (TGA), and scanning electron microscopy. According to the TGA results, the activation procedures for the candidate SCMs were determined. The as‐received powders were heat treated in three different decomposition regimes (30%, 50%, and 80% of the total weight losses during thermal decomposition). These regimes corresponded to the activation level of the potential SCMs due to the de‐hydroxylation of the clay‐type minerals within them. Pozzolanic reactivity (pozzolanicity) of untreated as well as treated powders were estimated via electrical conductivity measurements in saturated calcium hydroxide solution. Blended cement pastes with 30 wt.% of OPC substituted with calcined clay‐type materials have developed mechanical properties equal to those of pure cement (100 wt.% OPC) paste after 28 days of hydration time. Two blended cement pastes prepared with candidate SCMs were compared to 100% OPC and OPC composite paste with metakaolin, which is regarded in the literature as a standard.

Abstract Supplementary cementitious materials (SCMs) are partial substitutes for ordinary Portland cement (OPC) to reduce cost, the production of carbon dioxide (CO2), and fossil fuel consumption. Recent studies illustrated the effectiveness of calcined kaolinite clay as a proper partial replacement for OPC. Hence, schist‐type materials containing sufficient clay contents are regarded as promising candidates for OPC replacement. This study focuses on the possible use of activated calcium carbonates (CaCO3) to augment pozzolanic reactions of schists as a substitute for OPC. The use of activated calcium carbonates proved to be successful in expediting pozzolanic reactions and facilitating the formation of additional calcium aluminosilicate hydrate (C‐A‐S‐H). In this study, the optimal strength performance for blended cement was achieved by adjusting the total carbonate content to 30 wt.% of the schist. The decision to introduce carbonate to the schist was guided by calculations determining the need for an excess of calcium ions to fully harness the potential for C‐A‐S‐H formation. Virgin and augmented schists were activated by up to 80% of their respective potentials by heat treatment. Phase content and decomposition behavior of the active components were investigated by thermogravimetric analysis (TGA), x‐ray diffraction (XRD), and scanning electron microscopy (SEM). Cement paste samples incorporating 30 wt.% replacement of OPC with activated schist SCMs were prepared. The phase distribution and compressive strengths of these samples were assessed at hydration intervals of 2, 7, 28, 50, and 90 days. Cement formulations with activated calcium‐augmented SCMs exhibited compressive strength values at 109%, 101%, 96%, 95%, and 94% compared to pure cement paste at 2, 7, 28, 50, and 90 days, respectively. These values surpassed 90% of the compressive strength of pure OPC at equivalent hydration time points.

Conclusion: The increase in the ratio of MCA to BA might have a place in the differentiation of BI-RADS 4 lesions. We foresee that artificial intelligence could also have a place in the classification of BI-RADS lesions with software to be installed on the mammography computer.

Breast cancer is the most common cancer in women. Axillary lymph node metastasis in breast cancer is the most important determinant of long-term prognosis, but isn't an independent risk factor for overall survival. Invasive breast cancer is divided into molecular subtypes according to the presence of estrogen, progesterone and Her2 receptors: these subtypes can guide systemic therapy. Our aim in the study is to compare the axillary lymph node metastasis rates statistically in breast cancer subtypes. Patients treated for breast cancer were retrospectively evaluated in Group1(LuminalA-likeERand/orPR+,Her2 -), Group2 (LuminalB-likeER and/or PR+,Her2-), Group3 (Her2+,ER and/or PR+), Group4 (Her2+,ER and/or PR-) and Group5 (Her2-,ER and PR-) analyzed for tumor type, pathological stage, lymph node metastasis.208 patients were included in the study, and the mean age of the patients was 57.3±12.8. Although the age distribution of the groups was similar, no significant difference was found between the groups in terms of menopausal status. While the lymph node distribution was highly proliferative in Group 2. Demonstrating metastasis organotropisms in the effect of molecular subtypes of breast cancer is necessary to understand tumor mechanisms. ER and PR positive tumors usually metastasize to bones, while Her2+ or triple-negative breast cancers usually tend to metastasize to the visceral system, including the central nervous system. As with distant metastasis habits, lymph node metastasis rates of molecular subtypes of breast cancer can also vary. Being aware of these metastasis possibilities is also helpful in understanding the clinical behavior of the disease. It is important to know the molecular subtypes and susceptibility of lymphatic metastases as well as trying to avoid unnecessary complications of axillary dissection using the sentinel lymph node sampling technique. [Med-Science 2023; 12(1.000): 52-7]

To develop a more reactive pozzolan for supplementary cementitious materials (SCMs), the co-calcination of kaolinite and limestone was investigated for its contribution to hydration of blended cement. Kaolinite (with ~50 wt% quartz impurity) was calcined at 700 °C, and a mixture of kaolinite and limestone was calcined at 800 °C. These activated SCMs were added to ordinary Portland cement (OPC), replacing ca. 30 wt% of the OPC. The compressive strength of these blended cement paste samples was measured after 28 and 90 days, while the hydration products and microstructural development in these blended cement pastes were analyzed by X-ray diffraction (XRD), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM). The results revealed that adding free lime to OPC, together with metakaolin, led to enhanced compressive strength. The compressive strength of this new blended cement paste reached 113% and 112% of the compressed strength of pure OPC paste after 28 and 90 days of hydration, respectively. Furthermore, this study showed that the improvement was due to the increased consumption of Portlandite (CH), the formation of calcium aluminosilicate hydrate (CASH), and the reduction of porosity in the sample containing free lime and metakaolin.

Purpose: To research whether apparent diffusion coefficient (ADC) values of solid ovarian masses are beneficial for differentiation between benign and malignant. Materials and Methods: We analyzed 50 patients with 62 solid ovarian masses retrospectively. We divided the ovarian masses into two groups as benign and malignant. Thirteen patients with 13 solid ovarian masses were identified to have benign masses, while 37 patients with 49 solid ovarian masses were diagnosed with malignancy. The Mann-Whitney U test was used for the comparisons of the sizes and the ADC values of solid ovarian mass. Receiver-operating characteristic (ROC) curves were analyzed to determine a cutoff value for ADC to differentiate benign from malignant. Results: No significant differences were found between the two groups in terms of age (p=0.06), whole lesion size (p= 0.647), and solid component size (p=0.066). ADC values of the two groups were significantly different (p=0.015). Malignant solid ovarian lesions showed significantly lower ADC values than benign lesions. The ROC curves showed an area under the curve rate of 0.722 and a cutoff value of 886 x 10-6 mm2/s. Conclusion: Diffusion-weighted imaging is a useful method for differential diagnosis of solid ovarian masses. Lower ADC values of solid ovarian lesions indicate malignancy rather than benign lesions.

Identifying Kirsten rat sarcoma (KRAS) mutation status is important for metastatic colorectal cancer treatment. Validating KRAS mutation profile on neuroimaging without histopathologic analysis would be beneficial. We aimed to differentiate Kirsten rat sarcoma (KRAS) gene mutation profile according to diffusion tensor imaging (DTI) metrics obtained from colorectal brain metastases (CRBM). Total of 8 patients with 17 CRBM included with known KRAS gene mutation status. All patients were categorized into two groups according to the KRAS mutation status as positive (+) (n: 5, 11 lesions) and negative (-) (wild type) (n: 3, 6 lesions). DTI values of the BMs were evaluated by consensus of two radiologists. Apparent diffusion coefficient (ADC), normalized apparent diffusion coefficient (nADC) and fractional anisotropy (FA) values of the two groups were compared. For comparison the Mann-Whitney U test was used. KRAS mutation (+) group showed significantly lower ADC and nADC values on CRBM rather than the wild-type. Comparison of the FA values of the two groups did not reveal any statistical significance. In conclusion, decreased ADC and nADC values of CRBM are correlated with presence of KRAS mutation. Lower ADC and nADC values obtained from CRBM can be utilized to insight KRAS mutation profile. [Med-Science 2021; 10(3.000): 886-9]

Background Idiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast disease that mimics breast cancer, and the etiopathogenesis has not yet been fully evaluated. Autoimmunity has received the most focus as a possible etiology. Our aim in this prospective clinical study was to investigate the possible association between the cytokines, interleukin IL-17, IL-22, IL-23 and IGM. Materials and Methods The current study was conducted in 26 women with histopathologically diagnosed IGM, and 15 control women of reproductive age having no breast disease history. Blood samples were collected, and serum concentrations of IL-17, IL-22, and IL-23 were determined. Results In the analysis of variables, the patients with IGM and the control group had statistically significant differences between serum IL-22 titers (p = 0.0378) and IL-23 titers (p = 0.0469. No statistically significant difference was found between IGM patients and the control group in serum IL-17 titers (p = 0.9724). Conclusion The results of the current study, especially pertaining to serum IL-22 and IL-23 levels, support the etiopathogenesis of IGM in favor of the autoinflammatory thesis. Nevertheless, this thesis should be supported by a large case number and prospective clinical studies.

In this work, an Algerian montmorillonite (Mt) is exchanged by different cations from the transition metals family, namely: Cu2+, Ni2+, Cr3+, Co2+, Fe2+ and Fe3+, it is used as a heterogeneous catalyst for Biginelli reaction. The exchanged cations are known for their catalytic properties in homogeneous catalysis. The main purpose is to study the effect of the exchanged cations on the yield and the kinetics of the reaction. The characterization of montmorillonite was carried out by XRD, which allows us to follow the evolution of the basal spacing d001 as a function of the exchanged cation and to show that the exchange operation has not altered the montmorillonite structure. The cation exchange capacity (CEC) is determined by the titration of the exchanged cation by atomic absorption. The product of the reaction is characterized by NMR, IR and by the determination of the melting point. In addition, the importance of the introduction order of the reagents into the reaction medium has been demonstrated on the yield and the kinetics. Finally, the obtained results show that the exchanged montmorillonite is competitive with other costly heterogeneous and homogeneous catalysts.

In children with Neurofibromatosis type 1 (NF1), hamartomatous lesions called FASI (focal areas of signal intensity) on brain MRI are common. The relationship between neurocognitive functions and the presence of cerebellar FASI in NF1 children is a controversial issue. Our aim in this study is to investigate whether there is a difference in fractional anisotropy (FA) and mean diffusivity (MD) values in children with NF1 with and without cerebellum FASI, and to analyze its effect on neurocognitive functions. Twenty-seven patients children were assessed using Diffusion Tensor Imaging (DTI) and MRI. According to MRI features, we classified children with NF1 as group 1 with FASI (n=14) in the cerebellum, group 2 without FASI (n=13). The WISC-R scale (a revised form of the Wechsler intelligence scale for children) was used to analyze cognitive functions. MD and FA values were measured from cerebellar FASI and white matter. The relationship between neurocognitive function test scores and FA and MD values was investigated. There was a significant difference between group 1 and group 2 in terms of MD and FA values of the cerebellum. Verbal and performance test scores were lower in group 1 and group 2. The MD values obtained from the cerebellum were positively correlated with the full-scale intelligence quotient (IQ), Verbal IQ, and Performance IQ. There was a significant difference between group 1 and group 2 in terms of information, vocabulary, digit span, picture arrangement. DTI changes in the cerebellum are associated with demyelination and loss of axonal integrity in the white matter pathways responsible for some neurocognitive functions. We think that the presence of cerebellar FASI in children with NF1 does not contribute to the severity of neurocognitive impairment. [Med-Science 2021; 10(2.000): 506-10]

In this study, the aim is to evaluate clinical transfer of unstable patient management competencies acquired by learners in simulated environment and evolution of their skills in clinical environment. Performances of 87 intern medical students of Acıbadem Mehmet Ali Aydinlar University that participated in two weeks long simulation based education program were evaluated both in simulated environment and in real clinical environment. Analyzes were performed using the MedCalc Statistical Software version 12.7.7. Observational performance scores of Group A were 18,68±1,70 over 24 point in simulated environment and 19,65±2,87 in first clinical test and 22,12±2,45 in second clinical test. Scores of Group C were 18,9±4,55 in simulated environment 16,36±4,2 in first clinical test, and 23,32±2,44 in second clinical test. Scores of Group D were 14,5±4,04 in simulated environment 19,32±3,76 in first clinical test and 21,87±2,78 in second clinical test. Scores of Group B in simulated environment were 17,68±2,73 but Group B performances could not be evaluated in clinical environment due to pandemic. Simulation-based education is effective for improving the competencies of learners for management of unstable patients.

Objective:Breast cancers in women with low serum adiponectin levels have been reported to show phenotypes that are more aggressive. In 2008, we investigated the relationship between serum adiponectin levels and breast cancer in our case-controlled study involving 83 patients, in which serum adiponectin levels were measured preoperatively. In this study, we aimed to investigate the relationship between serum adiponectin levels and breast cancer-specific survival among these 83 patients.Materials and Methods:All 83 patients with stage I-III breast cancer, whose adiponectin levels were measured preoperatively in 2008 were enrolled in this study. The patients had no history of medications influencing insulin resistance prior to collecting the blood samples. Serum adiponectin concentrations were measured after overnight fasting (≥12 hours) by drawing a venous blood sample of 30 mL from the arm. ELISA (B-Bridge Human Adiponectin ELISA kit) was used for testing.Results:The mean adiponectin level was found to be 15,300 ng/mL. When the adiponectin levels of the patients were analyzed according to the stage of the disease, adiponectin levels tended to be significantly lower as the stage increased. The stage of the disease was an important determinant for both Diseas Free Survival (DFS) (p=0.003) and Overall Survival (OS) (p=0.005). A significant relationship between adiponectin levels and OS was also observed (p=0.025), and levels of adiponectin above the mean value of 15,300 ng/mL were associated with improved DFS (p=0.001).Conclusion:Preoperative adiponectin levels may be useful to predict survival rates in breast cancer or may be used as a marker/predictor for defining patients who require more aggressive treatment. In order for adiponectin to be used as a practical clinical marker for breast cancer, large database studies are should be conducted.

Objective:Breast cancer subtypes are used as prognostic and predictive factors considering the genomic profile of the disease. This study is designed to investigate the Sentinel Lymph Node (SLN) detection rate in breast cancer for different biological characteristics.Material and Methods:Patients on whom we performed the methylene blue method alone were named as Group I, radiocolloid substance method alone as Group II and both methylene blue and radiocolloid method as Group III. The results of biological tumor characteristics and characteristics of the patients on different SLN biopsy techniques were investigated.Results:The overall SLN detecting success rate was 83.3%. When considered for each group, success rate was 80% for group I, 84.9% for group II and 90.6% for group III. While a success rate of 94.6% was achieved with radiocolloid only in the patients in Luminal A and B subgroup, 90% success rate was achieved in Her2 (+) and triple negative (TN) patients with combined method.Conclusion:While successful results could be achieved by using radiocolloid substances alone in patients with Luminal A and B subtypes, combined methods should be used in HER2 (+) and TN patients.

Objective:Invasive lobular carcinoma (ILC) of the breast makes up 5 to 15 percent of all invasive breast cancers. It has distinctive clinical and histopathological features when compared to invasive ductal carcinoma (IDC). This study intends to describe factors influencing sentinel lymph node (SLN) positivity in patients with “pure” ILC.Materials and Methods:Data of 105 patients, who were treated at a tertiary oncology center, with lobular carcinoma of the breast that were subjected to SLN biopsy was probed retrospectively. Patients were categorized as ≤60 and >60 years of age, positive or negative for estrogen receptor and progesterone, tumor grade I, II and III, Ki67≤15% and >30%, lymphovascular invasion presence and the presence of multicentricity and multifocality.Results:Mean age at the time of diagnosis was 52 (38-81). Mean tumor size was 2.7 cm (0.7-13cm). Univariate analyses revealed a significant relationship between tumor size (≤2 cm vs >2cm) and metastasis in the SLN. This relation kept its significance in multivariate analyses. (p=0.013).Conclusion:With so many different characteristics from IDC, ILC is mostly a uniform tumor. In this study, tumor size was the only independent clinical parameter that was found related to SLN metastases.

Objective: Omitting axillary lymph node dissection (ALND) in a subgroup of patients with sentinel lymph node (SLN) metastasis is becoming a widely accepted practice. Avoiding the well-known complications of ALND is the sole aim without compromising the curative intention of surgery.Materials and methods: The data were probed for breast cancer patients that were operated on between February 2014 and June 2016. SLN biopsies were performed in 507 patients and out of 157 patients who underwent ALND for a metastatic SLN, 151 were found eligible for the analyses as having macrometastatic (>2mm) SLN. MD Anderson, Memorial Sloan Kettering Cancer Center and Helsinki nomograms were also tested in our patient population.Results: Pathologic tumor size greater than 2 cm, the ratio of metastatic SLN to dissected SLN, metastatic tumor greater than 1 cm and tumors that extended outside the SLN’s capsule were found to be associated with non-sentinel node metastasis in both univariate and multivariate tests. MD Anderson nomogram performed well with an area under the curve (AUC) value of 0.72.Conclusion: Our results suggest that ALND should be considered in patients with macrometastatic SLN greater than 10 mm in size, have extracapsular extension, have metastatic SLNs at a rate of more than 50% and whose primary tumor is greater than 2 cm.

The Oncoplastic and Reconstructive Breast Surgery course was held in Izmir by the Izmir Breast Diseases Federation in collaboration with the Breast Diseases Federation of Turkey. The techniques of oncoplasty, the application details and experience in this subject were shared. In this text, the main topics and outcomes are briefly summarised. These evaluations can be considered highly valuable on both local and regional scales.

A n analytical solution to the frictional sliding contact problem for homogeneous orthotropic materials indented by a semi-circular punch is developed.The principal axes of orthotropy are assumed to be parallel and perpendicular to the contact. Coulomb friction assumption is used to model the friction between the punch and the orthotropic medium. The mixed boundary value problem is reduced into a Fredholm integral equation of the second kind by using Fourier transform technique. The singular integral equation is solved analytically using Jacobi Polynomials for the unknown surface contact stresses. Numerical results show the effect of the orthotropic material parameters, coefficient of friction on the contact stress distribution and load vs. contact length behavior

Objective:General surgeons’ approaches to breast masses in their daily practices and their perspectives for issues on breast diseases and breast surgery are investigated through a survey.Materials and Methods:Answers of 524 general surgeons for the survey “Approach to breast diseases and breast surgery” between November 2012 and February 2013 were assessed. Demographic features, approaches to the breast masses, and answers for the clinical scenerios of surgeons were questioned. Surgeons were asked about management of breast cancer and the future role of surgeons for oncoplastic breast surgery and breast diseases.Results:Participants were representing 14.6% of all general surgeons in Turkey. The survey revealed that breast diseases are the most common cause for admission in general surgery outpatient clinics. Needle biopsies were employed by 241 (60%) respondents. Three hundred and seventy-one (71%) participants indicated that breast cancer management could be accurately conducted by the general surgeons. Two hundred and seventy-three (52%) respondents think that oncoplastic breast surgery should be performed by a general surgeon and 241 (41%) respondents predict that the role of general surgeons for breast diseases and breast surgery will decrease in the future.Conclusion:Basic approaches towards breast masses need to be improved in our country despite the highest frequency of breast diseases in outpatient admissions. The views and opinions of surgeons on breast diseases and the course of breast surgery in different regions and different communities need to be defined and clarified.

Background: Oncoplastic Breast Surgery (OBS), which is a combination of oncological procedures and plastic surgery techniques, has recently gained widespread use. Aims: To assess the experiences, practice patterns and preferred approaches to Oncoplastic and Reconstructive Breast Surgery (ORBS) undertaken by general surgeons specializing in breast surgery in Turkey. Study Design: Cross-sectional study. Methods: Between December 2013 and February 2014, an eleven-question survey was distributed among 208 general surgeons specializing in breast surgery. The questions focused on the attitudes of general surgeons toward performing oncoplastic breast surgery (OBS), the role of the general surgeon in OBS and their training for it as well as their approaches to evaluating cosmetic outcomes in Breast Conserving Surgery (BCS) and informing patients about ORBS preoperatively. Results: Responses from all 208 surgeons indicated that 79.8% evaluated the cosmetic outcomes of BCS, while 94.2% informed their patients preoperatively about ORBS. 52.5% performed BCS (31.3% themselves, 21.1% together with a plastic surgeon). 53.8% emphasized that general surgeons should carry out OBS themselves. 36.1% of respondents suggested that OBS training should be included within mainstream surgical training, whereas 27.4% believed this training should be conducted by specialised centres. Conclusion: Although OBS procedure rates are low in Turkey, it is encouraging to see general surgeons practicing ORBS themselves. The survey demonstrates that our general surgeons aspire to learn and utilize OBS techniques.

Phyllodes tumors are fibroepithelial lesions and malign forms are rare neoplasms with lower than 1% of all primary breast tumors. Malign forms are usually behaves like sarcomas because they occur in the stroma of the breast. Also proliferation of epithelium occurs and even it is less often, the epithelial component of phyllodes tumors can transform into malignancy too. This epithelial malignancies are usually in the form of infiltrative carcinomas and non-invasive tumors arising in benign phyllodes tumors are much rarer but can be seen. Literature include very few cases about this situation and cases are usually old woman. We report a 19-year old patient who was diagnosed with ductal carcinoma in situ arising in benign phyllodes tumor of the breast.

Complications of modified radical mastectomy operation are bleeding, infection, necrosis and seroma. Most common complication is seroma. Evidence of seroma causes infection and increases the risk of necrosis, also increases the time of flep adjusting to chest wall and length of hospitality. We started this randomised prospective study at January 1999. Candidates of modified radical mastectomy in our clinic has been divided into two groups (decided by the usage of silicon and PVC drainage systems) (Group 1: PVC, Group 2: Silicon). For homogenisation of each group; patients who has body-mass index higher then 30 %, systemic diseases like diabetes, Neoadjuvan chemotherapy, and patients who has chestwall anomalies were excluded from the study. Overall drainage volume, evidence of infection and necrosis, and removal time of drainage system was noted. Indications of removing the drainage system for both group were; daily drainage volume under 50 ml, evidence of infection and daily drainage over 50 ml for 9 days. Mean drainage volumes of Group 1 and Group 2 were 985.4 ml and 639.1 ml, respectively. Infection was observed in 13 patients in Group 1, and 4 patients in Group 2. Evidence of necrosis was observed in 3 patients in Group 1, and none in Group 2. Group 1 and Group 2 median removal time of drainage was 6.25 and 5.18 days, respectively. Statistical significant differences was present. After examining these results, we decided the usage of closed silicon drainage systems after modified radical mastectomy operation decreases the complications of operation.