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Temel E, Elverici E, Sarı E, Özsoy A, Akbaş Doğan M, Kulaçoğlu S. Relationship of The Characteristic Imaging Findings of Breast Cancer with Molecular Subtypes in Young Women. Curr Med Imaging 2023:CMIR-EPUB-133070. [PMID: 37489787 DOI: 10.2174/1573405620666230721124048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The characteristic imaging findings of breast cancer in young women are not yet fully understood. It causes a delay in diagnosis by mixing with benign findings. OBJECTIVE To evaluate the relationship between the imaging and histopathological features of breast cancer in women aged under 40 years. METHODS In our center, 537 suspicious lesions were detected in a total of 15,223 adult female patients under 40 years who were evaluated by breast ultrasonography (US). As a result of the mammographic, histopathological, and immunohistochemical analysis, 101 lesions meeting the study criteria were included in the sample. RESULTS The luminal subtypes of breast cancer mostly visualized as irregularly shaped spiculated lesions with calcification and architectural distortion mammography and presented as masses that were sometimes accompanied by increased echogenicity in the surrounding tissue on US. The human epidermal growth factor receptor 2 (HER2) enriched subtypes mostly had microlobulated or indistinct margins with heterogeneous echoes accompanied by high calcification on mammography. The triple-negative (TN) subtypes generally appeared as microlobulated lesions with angular or indistinct margins, hypo echogenicity, posterior enhancement or shadowing, and vascularization. CONCLUSION Some radiological features of breast cancer in young women were found to be associated with molecular subtypes similar to other age groups in the literature. However, unlike other age groups, the incidences of the HER2-enriched subtype presenting with only calcification, TN subtypes presenting with circumscribed masses, and calcification were found to be low among the young women in our study.
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Affiliation(s)
- Emirhan Temel
- Ankara City Hospital Üniversiteler Mahallesi Bilkent Cad. No: 1 Çankaya/Ankara
| | - Eda Elverici
- Ankara City Hospital Üniversiteler Mahallesi Bilkent Cad. No: 1 Çankaya/Ankara
| | - Engin Sarı
- Ankara City Hospital Üniversiteler Mahallesi Bilkent Cad. No: 1 Çankaya/Ankara
| | - Arzu Özsoy
- Ankara City Hospital Üniversiteler Mahallesi Bilkent Cad. No: 1 Çankaya/Ankara
| | - Mutlu Akbaş Doğan
- Ankara City Hospital Üniversiteler Mahallesi Bilkent Cad. No: 1 Çankaya/Ankara
| | - Sezer Kulaçoğlu
- Ankara City Hospital Üniversiteler Mahallesi Bilkent Cad. No: 1 Çankaya/Ankara
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Oktay A, Aslan Ö, Taşkın F, Tunçbilek N, Esen İçten SG, Balcı P, Arıbal ME, Çelik L, Örgüç İŞ, Başaran Demirkazık F, Gültekin S, Aydın AM, Durmaz E, Kul S, Binokay F, Çetin M, Emlik GD, Akpınar MG, Kadıoğlu Voyvoda SN, Polat AV, Başara Akın I, Yıldız Ş, Poyraz N, Özsoy A, Öztekin PS, Elverici E, Bayrak İK, İkizceli T, Dinç F, Sezgin G, Gülşen G, Tunçbilek I, Yalçın SR, Çolakoğlu G, Ağlamış S, Yılmaz R, Rona G, Durhan G, Güner DC, Çelik Yabul F, Günbey Karabekmez L, Tutar B, Göktaş M, Buğdaycı O, Suner A, Özdemir N. Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study. Diagn Interv Radiol 2023; 29:579-587. [PMID: 36994925 PMCID: PMC10679644 DOI: 10.4274/dir.2022.221790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/27/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE The clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions. METHODS This retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson's chi-squared test, the Fisher-Freeman-Halton test, and Fisher's exact test were used for the statistical analyses. RESULTS The overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes. CONCLUSION ADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision.
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Affiliation(s)
- Ayşenur Oktay
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Özge Aslan
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Füsun Taşkın
- Department of Radiology, Acıbadem MAA University Faculty of Medicine; Acıbadem MAA University Senology Research Institute, Acıbadem Atakent Hospital, İstanbul, Turkey
| | - Nermin Tunçbilek
- Department of Radiology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Selma Gül Esen İçten
- Department of Radiology, Acıbadem MAA University Faculty of Medicine; Acıbadem MAA University Senology Research Institute, İstanbul, Turkey
| | - Pınar Balcı
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Mustafa Erkin Arıbal
- Department of Radiology, Acıbadem MAA University Faculty of Medicine, İstanbul, Turkey
| | - Levent Çelik
- Department of Radiology, Maltepe University Faculty of Medicine; İstanbul, Turkey
| | - İhsan Şebnem Örgüç
- Department of Radiology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | | | - Serap Gültekin
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Murat Aydın
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Emel Durmaz
- Department of Radiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Sibel Kul
- Department of Radiology, Karadeniz Techinal University Faculty of Medicine, Trabzon, Turkey
| | - Figen Binokay
- Department of Radiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Meltem Çetin
- Department of Radiology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Ganime Dilek Emlik
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | | | - Sadiye Nuray Kadıoğlu Voyvoda
- Department of Radiology, University of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Işıl Başara Akın
- Department of Radiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Şeyma Yıldız
- Department of Radiology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
| | - Necdet Poyraz
- Department of Radiology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Arzu Özsoy
- Department of Radiology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - Pelin Seher Öztekin
- Department of Radiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Eda Elverici
- Department of Radiology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - İlkay Koray Bayrak
- Department of Radiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Türkan İkizceli
- Department of Radiology, University of Health Sciences Turkey, İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Funda Dinç
- Department of Radiology, Muğla Sıtkı Koman University Faculty of Medicine, Muğla Turkey
| | - Gülten Sezgin
- Department of Radiology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
| | - Gökçe Gülşen
- Department of Radiology, University of Health Sciences Turkey, İstanbul Haseki Training and Research Hospital, İstanbul, Turkey
| | - Işıl Tunçbilek
- Department of Radiology, Medsentez Private Clinic, Ankara, Turkey
| | | | - Gül Çolakoğlu
- Department of Radiology, University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Serpil Ağlamış
- Department of Radiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Ravza Yılmaz
- Department of Radiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Günay Rona
- Department of Radiology, University of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Gamze Durhan
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Davut Can Güner
- Department of Radiology, Maltepe University Faculty of Medicine; İstanbul, Turkey
| | - Fatma Çelik Yabul
- Department of Radiology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
| | - Leman Günbey Karabekmez
- Department of Radiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Burçin Tutar
- Department of Radiology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Muhammet Göktaş
- Department of Radiology, Ministry of Health Çerkezköy State Hospital, İstanbul, Turkey
| | - Onur Buğdaycı
- Department of Radiology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Aslı Suner
- Department of Biostatistics and Medical Informatics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Necmettin Özdemir
- Department of Medical Pathology, Ege University Faculty of Medicine, İzmir, Turkey
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Elverici E, Özsoy A, Sayın B, Gökhan MB, Özkan E. Unilateral Axillary Lymphadenopathy after the Inactivated SARS-COV-2 (CoronaVac) Vaccine: Ultrasonographic Imaging. Balkan Med J 2023; 40:28-33. [PMID: 36421031 PMCID: PMC9874248 DOI: 10.4274/balkanmedj.galenos.2022.2022-4-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Currently, unilateral clinical and subclinical axillary adenopathy cases associated with the Pfizer-BioNTech and Moderna vaccines are increasingly reported. However, only one study on axillary adenopathy due to the CoronaVac vaccine is published. Aims To present the incidence, severity, and ultrasonographic findings of axillary adenopathy that developed in healthcare professionals in Turkey after they were vaccinated with CoronaVac against coronavirus disease-19. Study Design A prospective study. Methods In Turkey, the first dose of the CoronaVac vaccine for coronavirus disease-19 was administered to healthcare professionals on January 14, 2021, and the second dose on February 11, 2021. This study covered the period from January 21, 2021 (1 week after the first dose), and April 15, 2021 (9 weeks after the second dose). Individuals who had a history of COVID-19 more than 3 weeks after vaccine doses, systemic disease, and diagnosis and treatment history of breast cancer were excluded. The axillary lymph nodes of the vaccinated and contralateral arms were evaluated in 101 volunteer healthcare professionals using axillary ultrasonography. Results A significant difference was found in the cortical thicknesses of the lymph nodes between the vaccinated and contralateral axilla after both the first (*p < 0.01) and second (*p < 0.01) doses. Accordingly, the rates of subclinical lymphatic hyperplasia on the vaccinated side were 25.7% (n = 26/101) after the first and 31.1% (n = 28/90) after the second dose. Lymph nodes with pathological appearance based on a reduced echogenic hilum with marked cortical thickening were found only in 2.2%. Among the 39 cases in which antibodies (immunoglobulin G and immunoglobulin M) were measured, the antibody level was classified as <10 and ≥10. No statistically significant difference was found in the cortical thickness of the axillary lymph nodes between patients with high antibody levels (≥10) and those with low antibody levels (<10) (p > 0.05). Conclusion In this study, clinical signs of axillary lymph node hyperplasia were not detected after vaccination with CoronaVac. Mild and diffuse thickening of the CoronaVac vaccine-induced lymph nodes was more common than pathological and palpable lymph nodes.
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Affiliation(s)
- Eda Elverici
- Clinic of Radiology, University of Health Sciences Turkey Ankara City Hospital, Ankara, Turkey,* Address for Correspondence: Clinic of Radiology, University of Health Sciences Turkey Ankara City Hospital, Ankara, Turkey E-mail:
| | - Arzu Özsoy
- Clinic of Radiology, University of Health Sciences Turkey Ankara City Hospital, Ankara, Turkey
| | - Bige Sayın
- Clinic of Radiology, University of Health Sciences Turkey Ankara City Hospital, Ankara, Turkey
| | - Muhammet Batuhan Gökhan
- Clinic of Radiology, University of Health Sciences Turkey Ankara City Hospital, Ankara, Turkey
| | - Erdem Özkan
- Clinic of Radiology, Ankara Numune Training and Research Hospital, Health Application and Research Center, Ankara, Turkey
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Toz-Akalin T, Öztürk-Bozkurt F, Kusdemir M, Özsoy A, Yüzbaşıoğlu E, Özcan M. Clinical Evaluation of Low-shrinkage Bioactive Material Giomer Versus Nanohybrid Resin Composite Restorations: A Two-year Prospective Controlled Clinical Trial. Oper Dent 2023; 48:10-20. [PMID: 36508717 DOI: 10.2341/21-155-c] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 12/14/2022]
Abstract
This study evaluated the clinical performance of low-shrinkage bioactive resin composite compared with a conventional nanohybrid resin composite. A total of 35 patients (18 males, 17 females; mean age: 29±9 years old) received, randomly, 35 pairs of fillings restored with either low-shrinkage bioactive material employing Giomer filler technology (Beautifil II LS, Shofu Inc, Kyoto, Japan) or conventional nanohybrid resin composite (Clearfil Majesty Posterior, Kuraray, Japan) in Class I and Class II cavities. Two operators made all the restorations using the corresponding adhesive resins: FL-Bond II (Shofu Inc) and Clearfil SE Bond (Kuraray), according to each manufacturer's instructions. Two calibrated operators evaluated the restorations two weeks after placement (baseline), at six months, and at one and two years using FDI criteria (Scores 1-5). Data were analyzed using the McNemar test (α=0.05). Mean observation time was 27.4 ± 4.1 months (min=20.8; max=33.7). In both groups, according to FDI criteria, the restorations were mostly rated with best scores (Score 1 or 2) for biological, functional, and optical parameters. For one filling in the group restored with nanohybrid resin composite, a small and localized secondary caries lesion was observed and monitored at the one- and two-year follow-ups. One restoration in the low-shrinkage Giomer restorative group was accepted as a failure due to retention loss. Over the two-year follow-up, both the Giomer and the nanohybrid resin composite restorations' performance was clinically acceptable.
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Affiliation(s)
- T Toz-Akalin
- *Tuğba Toz-Akalin, DDS, PhD, associate professor, Bahçeşehir University, School of Dental Medicine, Department of Restorative Dentistry, Istanbul, Turkey
| | - F Öztürk-Bozkurt
- Funda Öztürk-Bozkurt, DDS, PhD, associate professor, Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - M Kusdemir
- Mahmut Kuşdemir, DDS, PhD, associate professor, Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - A Özsoy
- Alev Özsoy, DDS, PhD, associate professor, Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - E Yüzbaşıoğlu
- Emir Yüzbaşıoğlu, DDS, PhD, associate professor, Bahçeşehir University, School of Dental Medicine, Department of Prosthetic Dentistry, Istanbul, Turkey; School of Medicine and Health Sciences, BAU International University, Batumi, Georgia
| | - M Özcan
- Mutlu Özcan, Dr med dent, PhD, professor, University of Zurich, Center for Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, Zurich, Switzerland
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Akalιn TT, Bozkurt FO, Kusdemir M, Özsoy A, Özcan M. Clinical Evaluation of Sonic-Activated High Viscosity Bulk-Fill Nanohybrid Resin Composite Restorations in Class II Cavities: A Prospective Clinical Study up to 2 Years. Eur J Prosthodont Restor Dent 2018; 26:152-160. [PMID: 30063305 DOI: 10.1922/ejprd_01620akalin09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study evaluated the clinical performance of a bulk-fill resin composite in class II cavities for up to 2 years. Class II restorations (N=111) were made using a nanohybrid bulk-fill resin composite (SonicFill, Kerr Corp.) and evaluated following 1 week after placement, at 6 months, and thereafter annually up to 2 years using the United States Public Health Service (USPHS) criteria. The changes were analyzed using the McNemar test and the Kaplan-Meier method. No secondary caries was observed until the final recall. One restoration underwent endodontic treatment after 2 months following the restorative procedure and was deemed a failure. The overall success rate was 99.1%. Colour match deteriorated from a score of 0 to 1 in eight restorations from baseline to 6 months and six restorations showed marginal staining at final recall. Bulk-fill resin composite (SonicFill) showed acceptable clinical performance through 2 years of service but colour match to the tooth started to show some deterioration within the first 6 months.
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Affiliation(s)
- T T Akalιn
- Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Ataturk Bulvarι 27, 34083, Fatih, Unkapanι, Istanbul, Turkey
| | - F O Bozkurt
- Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Ataturk Bulvarι 27, 34083, Fatih, Unkapanι, Istanbul, Turkey
| | - M Kusdemir
- Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Ataturk Bulvarι 27, 34083, Fatih, Unkapanι, Istanbul, Turkey
| | - A Özsoy
- Istanbul Medipol University, School of Dentistry, Department of Restorative Dentistry, Ataturk Bulvarι 27, 34083, Fatih, Unkapanι, Istanbul, Turkey
| | - M Özcan
- University of Zurich, Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland
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Özsoy A, Sarıcaoğlu MS, Çavuşoğlu M. The effect of deep sclerectomy on ocular blood flow: a 6-month clinical trial. Turk J Med Sci 2016; 46:1773-1778. [PMID: 28081326 DOI: 10.3906/sag-1506-122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 03/20/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM To investigate the effect of deep sclerectomy on retrobulbar blood flow. MATERIALS AND METHODS This prospective study included 20 eyes of 20 patients with open angle glaucoma. Color Doppler imaging (CDI) examinations were performed before and 2, 12, and 24 weeks after deep sclerectomy. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were measured for the ophthalmic artery (OA), central retinal artery (CRA), and temporal and nasal short posterior ciliary arteries (SPCAs) at each examination and the results were compared. RESULTS A significant decrease was determined in intraocular pressure (IOP) (P < 0.001) and a significant increase in ocular perfusion pressure (OPP) (P < 0.001) at all postoperative examinations. The EDV in OA increased significantly (P < 0.001), but the change in RI was not statistically significant (P = 0.67). EDV increased and RI decreased significantly in CRA and SPCA (P < 0.001). CONCLUSION Deep sclerectomy decreases IOP and increases OPP significantly. Retrobulbar blood flow was seen to improve after deep sclerectomy.
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Affiliation(s)
- Arzu Özsoy
- Department of Radiology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Murat Sinan Sarıcaoğlu
- Department of Ophthalmology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Mehtap Çavuşoğlu
- Department of Radiology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Elverici E, Barça AN, Aktaş H, Özsoy A, Zengin B, Çavuşoğlu M, Araz L. Nonpalpable BI-RADS 4 breast lesions: sonographic findings and pathology correlation. Diagn Interv Radiol 2016; 21:189-94. [PMID: 25835079 DOI: 10.5152/dir.2014.14103] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE We aimed to evaluate ultrasonography (US) findings for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions using BI-RADS US lexicon and determine the positive and negative predictive values (PPV and NPV) of US with respect to biopsy results. METHODS Sonograms of 186 BI-RADS 4 nonpalpable breast lesions with a known diagnosis were reviewed retrospectively. The morphologic features of all lesions were described using BI-RADS lexicon and the lesions were subcategorized into 4A, 4B, and 4C on the basis of the physician's level of suspicion. Lesion descriptors and biopsy results were correlated. Pathologic results were compared with US features. PPVs of BI-RADS subcategories 4A, 4B, and 4C were calculated. RESULTS Of 186 lesions, 38.7% were malignant and 61.2% were benign. PPVs according to subcategories 4A, 4B, and 4C were 19.5%, 41.5%, and 74.3%, respectively. Microlobulated, indistinct, and angular margins, posterior acoustic features, and echo pattern were nonspecific signs for nonpalpable BI-RADS 4 lesions. Typical signs of malignancy were irregular shape (PPV, 66%), spiculated margin (PPV, 80%) and nonparallel orientation (PPV, 58.9%). Typical signs of benign lesions were oval shape (NPV, 77.1%), circumscribed margin (NPV, 67.5%), parallel orientation (NPV, 70%), and abrupt interface (NPV, 67.6%). CONCLUSION BI-RADS criteria are not sufficient for discriminating between malignant and benign lesions, and biopsy is required. Subcategories 4A, 4B, and 4C are useful in predicting the likelihood of malignancy. However, objective and clear subclassification rules are needed.
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Affiliation(s)
- Eda Elverici
- Department of Radiology, Numune Training and Research Hospital, Ankara, Turkey.
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Özsoy MH, Kızılay O, Günenç C, Özsoy A, Demiryürek D, Hayran M, Erçakmak B, Sakaoğulları A. Modified tension band wiring technique for olecranon fractures: where and how should the K-wires be inserted to avoid articular penetration? Acta Orthop Traumatol Turc 2015; 49:190-6. [PMID: 26012941 DOI: 10.3944/aott.2015.14.0155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Articular penetration of K-wires is a possible complication of the modified tension band wiring technique. However, there is no clear information or evidence regarding the entry point or introduction angle for K-wires to avoid this complication. The aim of this experimental study was to evaluate the effect of varying K-wire insertion points and angles on the risk for articular penetration during modified tension band wiring for olecranon fractures. METHODS All anatomical measurements were made on 50 cadaveric ulnas, and all other measurements were performed on exact foam replications of the 50 cadaveric ulnas. Morphometric measurements, including olecranon height and heights of the central, radial and ulnar facets of the semilunar notch, were taken. In the sagittal plane, articular angle and tubercle angle were measured. Two 1.6-mm parallel K-wires were inserted from 0, 5 and 8 mm anterior to the dorsal cortex of the olecranon process at angles of 20° and 30°. K-wire articular penetration was evaluated both visually and radiographically. RESULTS The mean central, radial and ulnar heights of the semilunar notch were 17.3 mm (14.7-20.0), 16.2 mm (12.0-21.0) and 15.8 mm (13.30-20.5), respectively. We observed no articular penetration at the 0-mm level at 20° and 30° (0 mm 20° and 0 mm 30°, respectively) or at 5 mm 20°. At 8 mm 30° wire introduction, more than 64% articular penetration was observed on either facet. The sequence from least to most likely to cause articular penetration was: 0 mm = 5 mm 20° > 5 mm 30° = 8 mm 20° > 8 mm 30°. The radial height of the semilunar notch was negatively correlated to the risk of articular penetration, when the wire was introduced at 8 mm 30°, 8 mm 20° and 5 mm 30° (all p<0.047). There were poor correlations between radiological and direct observational assessments, particularly for 8 mm 20° and 5 mm 30°. The frequency of intra-articular positioning for those observed to be radiologically extra-articular was 4/28 (14.3%) for 8 mm 30°, 4/7 (57.1%) for 8 mm 20° and 5/6 (83.3%) for 5 mm 30°. CONCLUSION When applying the modified tension band wiring technique to prevent articular penetration, K-wires should be inserted in the first 5 mm from dorsal cortex of the olecranon process at a maximum angle of 20°. Moreover, if the wires are required to be inserted more anteriorly because of the anatomical configuration of the fracture, they should be inserted at a shallow angle in the sagittal plane in relation to the proximal cortex of the ulna.
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Affiliation(s)
- Mehmet Hakan Özsoy
- Memorial Ankara Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
| | - Onur Kızılay
- Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey
| | - Ceren Günenç
- Hacettepe University Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Arzu Özsoy
- Ankara Numune Training and Research Hospital, Department of Radiology, Ankara, Turkey
| | - Deniz Demiryürek
- Hacettepe University Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Faculty of Medicine, Department of Preventive Oncology (Epidemiologist), Ankara, Turkey
| | - Burcu Erçakmak
- Hacettepe University Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Abdurrahman Sakaoğulları
- Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey
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Beşer CG, Demiryürek D, Özsoy H, Erçakmak B, Hayran M, Kızılay O, Özsoy A. Redefining the proximal ulna anatomy. Surg Radiol Anat 2014; 36:1023-31. [DOI: 10.1007/s00276-014-1340-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 06/28/2014] [Indexed: 11/27/2022]
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Zeytinoglu IU, Keser A, Yılmaz G, Inelmen K, Özsoy A, Uygur D. Security in a sea of insecurity: job security and intention to stay among service sector employees in Turkey. The International Journal of Human Resource Management 2012. [DOI: 10.1080/09585192.2011.637067] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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