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Background: Primary hyperparathyroidism (pHPT) caused by a single benign parathyroid adenoma is a common endocrine disorder that is affected by regional differences. Living in different geographical regions reveals differences in the laboratory results and pathological findings, but studies on this subject are not sufficient. The article focuses on biochemical and pathological effects of geographical differences in parathyroid adenoma. In addition, the present study seeks to elaborate on treatment methods and effectiveness of screening in geographical area of Bulgaria and Turkey. Method: In this prospective study, 159 patients were included from 16 centres. Demographic characteristics, symptoms, biochemical markers and pathologic characteristics were analysed and compared between 8 different regions. Results: Patients from Turkish Black Sea had the highest median serum calcium (Ca) level, whereas patients from Eastern Turkey had the lowest median serum phosphorus (P) level. On the other hand, there was no significant difference between Ca, parathormone (PTH) and P levels according to regions. Patients from Eastern Turkey had the highest adenoma weight, while patients from Bulgaria had the lowest adenoma weight. The weight of adenoma showed statistically significant differences between regions (p < 0.001). There was a correlation between adenoma weight and serum PTH level (p = 0.05) and Ca level (p = 0.035). Conclusion: This study has provided a deeper insight into the effect of the regional differences upon clinicopathological changing and biochemical values of pHTP patients with adenoma. Awareness of regional differences will assist in biochemical screening and treatment of this patient group. (c) 2021 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

WOS: 000396361900004, PubMed ID: 28251020, Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT. Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, as well as the presence of ectopia, presence of dual adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease. Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria. Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT.

Amaç: TP53 geni temel olarak DNA tamiri, apoptozis, hücre yaşlanması ve hücre döngüsü kontrolünde görev alan en önemli tümör baskılayıcı genlerden biridir. TP53 rs1042522 (Arg72Pro) polimorfizmi tümör baskılama sırasında P53 protein yapısında değişikliğe neden olan bir polimorfizmdir. Bu verilere dayanarak, bu çalışmanın amacı TP53 rs1042522 polimorfizmi ve meme kanseri riski arasındaki ilişkiyi araştırmaktır.Yöntem: TP53 rs1042522 polimorfizmi için 508 meme kanserli kadın hastadan ve 367 sağlıklı kadından alınan periferik kanlardan DNA izole edilerek PCR-RFLP yöntemi ile genotipleme yapıldı. İstatistiksel analiz, %95 güven aralığında χ2 testi ile yapıldı ve Hardy-Weinberg eşitliği (HWE) test edilen hastalar ve kontrol popülasyonu için doğrulandı.Bulgular: Genotip frekansları sırasıyla hasta ve kontrollerde GG alleli için %48.6, %46.3, GC alleli için %40.7, %44.7ve CC alleli için de %10.6, %9.0 şeklindedir. Vaka ve control genotipleri arasında istatistiksel olarak fark olmadığı bulundu (χ2=1.591, P= 0.451). Allel frekansı G alleli için vakalarda %69.0 ve kontrollerde %69.0, C alleli için vakalarda %31.0 kontrollerde %31.0 şeklinde ortaya çıktı. Sonuçlar istatistiksel olarak anlamsız bulundu (G allel: p=0.424, C allel: p=0.501). TP53 rs1042522 genotip dağılımı kontrol popülasyonu için Hardy-Weinberg eşitliğine göre kararlı bulundu (p>0.05).Sonuç: Çalışmamızda meme kanseri ile p53 geninde yer alan rs1042522 polimorfizminin tek başına değerlendirildiğinde meme kanseri riski ile ilişkisi olmadığı bulunmuştur. P53’ün karsinogenezdeki rolünden ve özellikle de programlı hücre ölümünden sorumlu çeşitli proteinlerle etkileşime girmesinden dolayı rs1042522 polimorfizmini diğer proteinlerdeki değişimlerle birlikte çalışmak daha anlamlı olabilir. Ayrıca, farklı TP53 polimorfizmleri ile hücre döngüsünde görevli siklin, sikline bağımlı kinazlar ve p21 gibi genlerin ortak etkilerine odaklanılabilinir ya da bu polimorfizmin daha geniş bir hasta popülasyonunda tümörlerin klinikopatolojik özellikleri ile birlikte değerlendirilmesi daha anlamlı sonuçlar verebilir., Objectives: TP53 gene is one of the most important tumour suppressor gene that mainly plays a role in DNA repair, cell apoptosis, cell senescence and cell cycle control. TP53 rs1042522 (Arg72Pro) polymorphism is nonsynonymous polymorphism that alters P53 protein capacity during tumour suppression. Based on the data above, the purpose of this study is to investigate association between TP53 rs1042522 polymorphism and breast cancer risk in hospital-based Turkish women population.Methods: After DNA isolation from peripheral blood of 508 breast cancer patients and 367 healthy women the genotyping for TP53 rs1042522 polymorphism in both groups was done by a PCR-RFLP method. Statistical analysis was done by the χ2 test with 95% confidence intervals and the Hardy-Weinberg equilibrium was confirmed for tested patient and control populations.Results: Genotype frequencies were 48.6%, 46.3% for GG, 40.7%, 44.7% for GC and 10.6%, 9.0% for CC in breast cancer and controls, respectively. There was not statistical difference between genotypes in cases and controls (χ2=1.591, P= 0.451). Allele frequencies for G allele were 69.0% in cases and 69.0% in controls, for C allele 31.0% in cases and 31.0 % in controls. Also, this results were found to be not statistically significant for G and C alleles (G allele: p=0.424, C allele: p=0.501). The distribution of TP53 rs1042522 genotypes was in agreement with HWE for controls (p>0.05).Conclusion: There is no statistically significant association between rs1042522 and the risk of breast cancer in studied hospital- based Turkish women population. For further, rs1042522 polymorphism may be associated with other genetic factors due to the interaction of p53 with various proteins that play role in programmed cell death. Also, the combined effect of TP53 polymorphisms and the genes such as cyclins, cyclin-dependent kinases and p21 which are related with cell cycle control can be studied or clinicopathological characteristics of breast cancer patients might be evaluated in terms of p53 rs1042522 genotypes in larger population size.

Muscular contraction of the gallbladder is the primary determinant of bile delivery into duedonum. Gallbladder filling and emptying are influenced by both inhibitory and excitatory stimuli, and NO plays a key role in normal relaxation. In this study, to determine whether nicotine acts on the gallbladder muscle, the mechanism of its effect on strips of guinea pig gallbladder was studied in vitro.Guinea pig gallbladder muscle strips were mounted in organ bath with modified Krebs-Henseleit solution and aerated with Carbogen. Tension was measured with isometric force transducers, and muscle relaxation was expressed as percent decrease of precontraction induced by carbachol.Nicotine produced concentration dependent relaxation when preparations were precontracted by carbachol (10(-6) M). Nicotine-induced relaxation was 51.6 +/- 3.2% of phenylephrine contraction and was not affected by guanethidine (10(-5) M), propranolol (10(-6) M), hexamethonium (10(-4) M), indomethacin (10(-5) M), N(w)-nitro L-arginine methyl ester (L-NAME) (3 x 10(-5) M), methylene blue (10(-5) M), glibenclamide (10(-5) M), clotrimazole (10(-6) M), tetraethylammonium (3 x 10(-4) M), or 4-aminopyridine (10(-3) M). Nicotine did not exhibit a calcium antagonizing effect.From these results, we concluded that nicotine-induced relaxation of the guinea pig gallbladder is not mediated by the release of noradrenaline, nitric oxide (NO), prostaglandins, or a related substance, or by the activation of potassium channels, or by the stimulation of nicotinic cholinoceptors. Further work is needed to determine the cellular mechanism(s) of action by which nicotine acts on gallbladder smooth muscle.

The methylenetetrahydrofolate reductase (MTHFR) gene is a polymorphic gene involved in folate metabolism, DNA biosynthesis, methylation and genomic integrity in actively dividing cells. The MTHFR C677T and A1298C polymorphisms are likely to play an important role in the susceptibility to breast cancer. In this case-control study, we examined the role of MTHFR C677T and A1298C polymorphisms in breast cancer patients. We genotyped 118 premenopausal women with sporadic breast cancer and 193 controls, using a PCR-RFLP method. The allele frequencies of the MTHFR 677T were 31.36% in the breast cancer cases and 28.76% in the controls. The allele frequencies of the MTHFR 1298C were 37.29% in the breast cancer subjects and 31.35% in the controls. Frequencies of MTHFR C677C, C677T and T677T were 50.8, 33.9 and 14.4% in the breast cancer patients and 48.7, 45.1 and 6.2% in the controls, respectively. The results of a chi(2) analysis indicated that the MTHFR 677T allele was significantly distributed (chi(2) = 7.234; p = 0.027). Likewise, the MTHFR T677T genotype showed a 2.5-fold increased risk for breast cancer and the C1298C genotype showed a 1.9-fold increased risk for breast cancer. In the compound genotypes, T677T/A1298A and C677C/C1298C showed a 4.472- and a 2.301-fold increased risk for breast cancer (OR = 4.472, p = 0.001, and OR = 2.301, p = 0.024), respectively. In conclusion, our data suggest that the MTHFR 677T, 1298C alleles, T677T, C1298C genotypes, and C677C/C1298C and T677T/A1298A compound genotypes are genetic risk factors for premenopausal women with sporadic breast cancer.

Background Multiple breast cancers may present with different clinical and biological characteristics. The data indicate that multifocal (MF), multicentric (MC), and bilateral synchronous (BS) breast cancers (BC) are more aggressive and have an equivalent or moderately poorer survival rate compared with unilateral cases. However, a comparison of these multiple breast cancers has not been covered in the literature. The aim of this study was to describe the histopathological characteristics of patients suffering from MF, MC, and BS breast carcinoma and to compare their prognoses. Methods Retrospective data for MF, MC, and BS breast carcinoma patients treated in five different breast cancer units in Turkey between 2003 and 2012 were collected. MF and MC cancers were defined as more than one lesion in the same quadrant or in separate quadrants, respectively. Results There were 507 patients (271 MF, 147 MC, and 89 BS) treated in this time period. BS breast carcinoma patients were younger than the other groups (44.83 ± 9.6, 47.27 ± 11.6, and 51.11 ± 11.8 years for BS, MF, and MC breast carcinoma patients, respectively). MFBC and MCBC patients in this study were younger than the ages reported in Western literature, but this result was similar to the ages reported in Eastern literature. The five-year survival rates and recurrence rates were not statistically different among groups (P = 0.996 and P = 0.263, respectively). According to univariate analyses, tumor size, histological grade, and lymph node status were statistically significant factors that affected survival. However, only lymph node involvement was significant for survival according to multivariate analyses. Conclusions The clinical significance of MF, MC, and BS breast cancers is still unclear and their influence on prognosis is controversial. Disease-free and overall survival rates of BS breast cancers might be similar to MF and MC breast cancers.

Multidisciplinary approach is recommended for the diagnosis and treatment of cancer, in order to optimize quality of life and survival. Multidisciplinary cancer teams that are used for this purpose enable communication between professionals. Multidisciplinary cancer meetings are pre-programmed regular meetings where cancer patients are evaluated on an individual basis, and where the multidisciplinary treatment of patients is planned based on evidence. Currently, application of appropriate treatment in a timely manner carries as great significance as early diagnosis. For this purpose, standards of multidisciplinary approach are significant. Disease specific multidisciplinary breast cancer meetings are essential in the treatment of breast cancer. The standards and organization of these teams have been scientifically determined. It is recommended that these multidisciplinary breast cancer meetings should be held regularly and the required infrastructure should be provided.

Ozaslan, Cihangir/0000-0002-2611-4837 WOS: 000299862300009 PubMed: 22130034 Our aim was to determine the frequency of nonsentinel lymph node involvement of patients with operable triple negative breast cancer and with a positive sentinel lymph node, and to predict the likelihood of nonsentinel lymph node metastases in this cohort of patients by using 4 different nomograms. The accuracy of nomograms in patients for triple negative is yet to be determined. Background: Triple negative (TN) tumor has a relatively high rate of recurrence and distant metastasis, but results of studies revealed that triple positive tumor is an independent predictor of axillary lymph node involvement. Our aim was to evaluate the frequency of nonsentinel lymph node metastasis (NSLNM) involvement in operable TN breast cancer with positive sentinel lymph node (SLN) and predicting the likelihood of NSLNM in this cohort of patients by using 4 different nomograms. Methods: A total of 128 patients with TN and SLN+ underwent complete axillary lymph node dissection in 14 different centers in Turkey. For comparison, we used our previous multicenter MF08-01 Protocol, which identified 441 patients with estrogen receptor (ER+) who had a positive SLN biopsy and underwent subsequent complete axillary lymph node dissection. Turkish, Cambridge, and Stanford nomograms and the Tenon Score system were used to calculate the probability of NSLNM. Results: Patients with TN tumor had a larger tumor size. The actual percentage of NSLN positivity was 41% in the TN group and 47.1% in patient with ER+. The Tenon Score was