Prognostic factors of breast cancer brain metastasis

In this editorial we comment on the article by Chen et al published in the recent issue of the World Journal of Clinical Oncology.Brain metastasis is one of the most serious complications of breast cancer and causes high morbidity and mortality.Brain metastases may involve the brain parenchyma and/or leptomeninges.Symptomatic brain metastases develop in 10%-16%of newly recognized cases each year,and this rate increases to 30%in autopsy series.Depending on the size of the metastatic foci,it may be accompanied by extensive vasogenic edema or may occur as small tumor foci.Since brain metastases are a significant cause of morbidity and mortality,early diagnosis can have significant effects on survival and quality of life.The risk of developing brain metastases emerges progressively due to various patient and tumor characteristics.Patient variability may be particularly important in the susceptibility and distribution of brain metastases because malignant blood must cross the brain barrier and move within the brain parenchyma.Some characteristics of the tumor,such as gene expression,may increase the risk of brain metastasis.Clinical growth,tumor stage,tumor grade,growth receptor positivity,HER2 positivity,molecular subtype(such as triple negative status,luminal/nonluminal feature)increase the risk of developing breast cancer metastasis.Factors related to survival due to breast cancer brain metastasis include both tumor/patient characteristics and treatment characteristics,such as patient age,lung metastasis,surgery for brain metastasis,and HER2 positivity.If cases with a high risk of developing brain metastasis can be identified with the help of clinical procedures and artificial intelligence,survival and quality of life can be increased with early diagnosis and treatment.At the same time,it is important to predict the formation of this group in order to develop new treatment methods in cases with low survival expectancy with brain metastases.

Circulating tumor cells as prognostic marker in pancreatic cancer

In this editorial we comment on the article by Zhang et al published in the recent issue of the World Journal of Clinical Oncology.Pancreatic cancer is the fourth most common cause of cancer-related mortality and has the lowest survival rate among all solid cancers.It causes 227000 deaths annually worldwide,and the 5-year survival rate is very low due to early metastasis,which is 4.6%.Cancer survival increases with better knowledge of risk factors and early and accurate diagnosis.Circulating tumor cells(CTCs)are tumor cells that intravasate from the primary tumor or metastasis foci into the peripheral blood circulation system spontan-eously or during surgical operations.Detection of CTC in blood is promising for early diagnosis.In addition,studies have associated high CTC levels with a more advanced stage,and more intensive treatments should be considered in cases with high CTC.In tumors that are considered radiologically resectable,it may be of critical importance in detecting occult metastases and preventing unnecessary surgeries.

University Campus Gates as a Tool of Identity Representation

With information age, it has become one of the primary aims of universities to contribute to transforming knowledge into social power. The university institution has to establish a domain of influence spreading out from the micro-scale without isolating itself, because the knowledge produced must respond in social life and enter public circulation. This micro scale should be the urban environment in which the university is physically located. Therefore, today's universities should first strengthen their relationship with their immediate surrjoundings, starting from the nearest. Within the plurality, fluidity and complexity of social life, the process of building identities for individuals is an obligation. Similarly, public institutions also have to separate themselves from the context they are part of and establish their own identities. While doing so, university institutions put their special qualities in the foreground and design the representation of their institutional structures for the outside world. In this sense campus gates have great importance as the interface between city and university. These architectural constructions, which are designed as introductory buildings to repre-sent the university, are the places where physical interaction between city and university first takes place. The aim of this study is to discuss the architectural qualities of campus gates of universities in Turkey and tiy to decipher the forms in which identity formation takes place through given examples. In order to create a general panorama the examples were chosen without any distinctions such as private/state University, urban/ noil-urban University, old/new university, etc.

Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections

Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases Pub Med(June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications(required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar(discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.

Exact solutions of nonlinear fractional differential equations by (G'/G)-expansion method

In this paper, we use the fractional complex transform and the （G＇/G）-expansion method to study the nonlinear fractional differential equations and find the exact solutions. The fractional complex transform is proposed to convert a partial fractional differential equation with Jumarie＇s modified Riemann-Liouville derivative into its ordinary differential equation. It is shown that the considered transform and method are very efficient and powerful in solving wide classes of nonlinear fractional order equations.

Bright and dark soliton solutions for some nonlinear fractional differential equations

In this work, we propose a new approach, namely ansatz method, for solving fractional differential equations based on a fractional complex transform and apply it to the nonlinear partial space-time fractional modified Benjamin-Bona- Mahoney （mBBM） equation, the time fractional mKdV equation and the nonlinear fractional Zoomeron equation which gives rise to some new exact solutions. The physical parameters in the soliton solutions： amplitude, inverse width, free parameters and velocity are obtained as functions of the dependent model coefficients. This method is suitable and more powerful for solving other kinds of nonlinear fractional PDEs arising in mathematical physics. Since the fractional deriva- tives are described in the modified Riemann-Liouville sense.

采用硫酸浸出和添加酒石酸钾钠的氢氧化钠浸出从Yahyali非硫化浮选尾矿中回收锌和铅

采用硫酸浸出和添加酒石酸钾钠的氢氧化钠浸出从Yahyali非硫化浮选尾矿中回收锌和铅。在酸浸阶段,研究pH值、固液比和温度对尾矿中锌溶出的影响。在pH值为2、温度为40°C、固液比为20%、浸出时间为2 h的条件下,锌的溶出率达到82.3%,而铁和铅的溶出率低于0.5%。硫酸消耗量为110.6 kg/t(干尾矿)。浸出温度对尾矿中锌的溶出无有益的影响。酸浸液的电积试验结果表明,阴极产物含99.8%的Zn和0.15%的Fe。在碱浸阶段,添加酒石酸钾钠时铅的溶出率略有增加,浸出温度从40°C升高到80°C时,超过60%的Pb进入浸出液中。利用XRD和XRF分析最终的浸出渣。XRD分析结果表明,主要衍射峰来自针铁矿和石英,次要衍射峰属于菱锌矿和白铅矿。XRF分析结果显示,浸出渣含有70.3%的氧化铁。基于顺序浸出实验结果,浮选尾矿中的锌和铅可以被很好地浸出,而大量的铁留在浸出渣中。

Direct synthesis of La-Mg-Ni-Co type hydrogen storage alloys from oxide mixtures

(La;Mg;);(Ni;Co;);（x = 0.125, 0.25, 0.5） alloys were synthesized from the sintered mixture of La;O;+ Ni O + Co O + Mg O in the molten CaCl;electrolyte at 750 °C and the electrochemical hydrogen storage capacities of the synthesized alloys were measured. Non-hygroscopic LaNiO;phase formed during sintering（at 1200 °C for 2 h） as a result of the reaction of hygroscopic La;O;with NiO. Another sinter product was Mg;Ni;O phase. Both mixed oxide sinter products facilitated the La-Ni and Mg-Ni phase formations. X-ray diffraction peaks indicated that the first stable phase appeared in the alloy structure was LaNi;which formed upon reduction of La;NiO;phase. Increase in Mg content caused formation of La;Mg;Ni;phase in the alloy structure and the presence of this phase improved the hydrogen storage performance of the electrodes. It was observed that(La;Mg;);(Ni;Co;);（x = 0.125, 0.25, 0.5） alloys have promising discharge capacities change between 319 m Ah/g and 379 m Ah/g depending on the alloy Mg content.

Long-term aspirin pretreatment in the prevention of cerulein-induced acute pancreatitis in rats

AIM:To investigate the effects of long term pretreatment with low-,medium-and high-dose aspirin(acetylsalicylic acid,ASA) on a model of acute pancreatitis(AP) induced in rats.METHODS:Forty male Wistar rats were used.Three experimental groups,each consisting of eight animals,received low-(5 mg/kg per day),medium-(150 mg/kg per day) and high-dose(350 mg/kg per day) ASA in supplemented pellet chow for 100 d.Eight animals,serving as the AP-control group,and another eight,serving as reference value(RV) group,were fed with standard pellet chow for the same period.After pretreatment,AP was induced in the experimental animals by intraperitoneal administration of cerulein(2 × 50 μg/kg),while the RV group received saline in the same way.Twelve hours after the second injection,the animals were sacrificed.Pancreatic tissue and plasma samples were collected.One part of the collected pancreatic tissues was used for histopathological evaluation,and the remaining portion was homogenized.Cytokine levels [tumor necrosis factor,interleukin(IL)1β,IL-6],hemogram parameters,biochemical parameters(amylase and lipase),nuclear factor-κB,aspirin triggered lipoxins and parameters related to the antioxidant system(malondialdehyde,nitric oxide,hemeoxygenase-1,catalase and superoxide dismutase) were measured.RESULTS:Cerulein administration induced mild pancreatitis,characterized by interstitial edema(total histopathological score of 5.88 ± 0.44vs 0.25 ± 0.16,P < 0.001).Subsequent pancreatic tissue damage resulted in an increase in amylase(2829.71 ± 772.48 vs 984.57 ± 49.22 U/L,P = 0.001) and lipase(110.14 ± 75.84 U/L vs 4.71 ± 0.78 U/L,P < 0.001) in plasma,and leucocytes(6.89 ± 0.48 vs 4.36 ± 0.23,P = 0.001) in peripheral blood.Cytokines,IL-1β(18.81 ± 2.55 pg/μg vs 6.65 ± 0.24 pg/μg,P = 0.002) and IL-6(14.62 ± 1.98 pg/μg vs 9.09 ± 1.36 pg/μg,P = 0.04) in pancreatic tissue also increased.Aspirin pretreatment reduced the increase in the aforementioned parameters to a certain degree and partially improved the histopathological alterations caused by cerulein.No evidence of side effects related to chronic ASA administration(e.g.,inflammation or bleeding) was observed in the gastrointestinal tract in macroscopic and histopathological examination.CONCLUSION:Long term ASA pretreatment could prevent and/or ameliorate certain hematological,serological and histological alterations caused by ceruleininduced AP.

Vasoactive intestinal peptide,a promising agent for myopia?

AIM： To investigate the role of vasoactive intestinal peptide（VIP） in form-deprivation myopia（FDM）.METHODS： FDM was created in three groups of eight chicks by placing a translucent diffuser on their right eyes.Intravitreal injections of saline and VIP were applied once a day into the occluded eyes of groups 2 and 3,respectively.Retinoscopy and axial length（AL） measurements were performed on the first and 8^th days of diffuser wear.The retina mR NA levels of the VIP receptors and the ZENK protein in right eyes of the three groups and left eyes of the first group on day 8 were determined using real time polymerase chain reaction（PCR）.RESULTS： The median final refraction（D） in right eyes were-13.75（-16.00,-12.00）,-11.50（-12.50,-7.50）,and-1.50（-4.75,-0.75） in groups 1,2,and 3,respectively（P〈0.001）.The median AL（mm） in right eyes were 10.65（10.00,11.10）,9.90（9.70,10.00）,and 9.20（9.15,9.25） in groups 1,2,and 3,respectively（P〈0.001）.The median delta-delta cycle threshold（CT） values for the VIP2 receptors were 1.07（0.82,1.43）,1.22（0.98,1.65）,0.29（0.22,0.45） in right eyes of groups 1,2,and 3,and 1.18（0.90,1.37） in left eyes of group 1,respectively（P=0.001）.The median delta-delta CT values for the ZENK protein were 1.07（0.63,5.03）,3.55（2.20,5.55）,undetectable in right eyes of groups 1,2,and 3 and 1.89（0.21,4.73） in left eyes of group 1,respectively（P=0.001）.CONCLUSION： VIP has potential inhibitory effects in the development of FDM.

Nasobronchial interaction

Upper and lower airways can be considered as a unifiedmorphofunctional unit. In this paper, nasobronchial interactions are evaluated based on literature.To discuss nasobronchial interactions, literature review from Pub Med since 1982 is evaluated. Data base was including the terms "nasobronchial interaction, nasal and bronchial". Asthma and rhinosinusitis may be associated with environmental factors and immunological predisposition. Treatment of rhinosinusitis may decrease asthma exacerbations. It was concluded that "one airway, one disease"-concept may be accepted when considering naso-bronchial interaction. Asthma treatment should also mean treating the nose as good as treating patients with nasal symptoms. To reach the succesful results it should be associated with evaluation of lung functions.

Success rates for various graft materials in tympanoplasty e A review

Objectives:The aim of this paper is to review how successful each type of grafts is in tympanoplasty.Methods:Pubmed,Google and the Proquest Central Database at Kırıkkale University were queried using the keywords“graft”,“success”“tympanoplasty”,“success rate”with the search limited to the period 1955 to 2017.Results:Various types of graft materials including temporalis fascia,cartilage,perichondrium,periosteum,vein,fat or skin have been used in the reconstruction of tympanic membrane(TM)perforation.Although temporalis fascia ensures good hearing is restored,there are significant concerns that its dimensional stability characteristics may lead to residual perforation,especially where large TM perforations are involved.The“palisade cartilage”and“cartilage island”techniques have been stated to increase the strength and stability of a tympanic graft,but they may result in a less functional outcome in terms of restoring hearing.Smoking habits,the size and site of a perforation,the expertise level of the operating surgeon,age,gender,the status of the middle ear mucosa and the presence of myringosclerosis or tympanosclerosis are all important in determining how successful a graft is.Conclusion:Although temporal fascia is the most commonly used graft material for tympanoplasty,poor graft stability may cause failure.This failure is due to the inclusion of connective fibrous tissue containing irregular elastic fibers present in the grafted fascia.Cartilage grafts offer better ability to resist infection,pressure,and cope with insufficient vascular supply.This means that cartilage grafts are suitable for use in revision cases.

以抗坏血酸作协同试剂时红土镍矿在硫酸溶液中的溶解（英文）

研究硫酸与抗坏血酸联用对恰尔达红土镍矿中镍和钴的溶解作用。作为比较,也研究柠檬酸、马来酸和硬脂酸等有机酸作为协同试剂的应用情况。结果表明,抗坏血酸和柠檬酸的使用显著改善了钴的溶解,而其他两种有机酸对浸出率的协同作用很小。对于镍的溶解,抗坏血酸是最有效的协同试剂,其次是柠檬酸、马来酸和硬脂酸。在本研究获得的最优条件下,即1 mol/L硫酸中加入4 g/L抗坏血酸、80°C、固液比1/10,浸出4 h后钴和镍的浸出率分别达到99%和98%以上。此外,浸出行为对抗坏血酸浓度的变化(2~4 g/L)较不敏感,这从操作角度来看是非常理想的。

Protective effects of vitamin E on ethane dimethane sulfonate-induced testicular toxicity in rats

Aim： To evaluate the protective/ameliorative effects of vitamin E （vit E） on ethane dimethane sulfonate （EDS） induced testicular toxicity in rats. Methods： The rats were assigned to eight groups, seven rats in each, and were injected intraperitoneally with vehicle, a single dose of ethane dimethane sulfonate （EDS） （75 mg/kg bodyweight）, vit E （100 mg/kg bodyweight） or EDS ＋ vit E for 3-7 days. Thereafter, the rats were weighed, anaesthetized with ether and killed by cervical dislocation. The left testis weights were recorded and the relative testis weights were calculated. The left testes were processed for routine paraffin embedding. Three right testes from each group were taken randomly and then processed for routine electron microscopy. Tissue sections were examined using light and electron microscopy, and were scored for histopathological changes. Results： Vit E coadministration did not prevent the bodyweight loss on days 3 and 7. However, vit E administration prevented the EDS-induced testicular-weight loss in rats that received vit E for 3 days but not 7 days. The relative testis weight was higher on day 3 （instead of on day 7） than other groups. Nevertheless, the testis histology was not markedly protected by vit E in the EDS-treated rats. Detailed microscopic assessment showed few Leydig cells and abundant fibroblast-like cells indicating only some protection. Conclusion： Vit E cotreatment showed partial protective effects on the testicular weight and testicular histology in rats that received EDS.

A diagnostic approach to abdominal tuberculosis

TO THE EDITOR We read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method which can provide the diagnosis in most cases. If this tests negative or not feasible, laparotomy should be performed.

Effect of vasoactive intestinal peptide on the wound healing of alkali-burned corneas

AIM： To study the effect of vasoactive intestinal peptide （VIP） on wound healing in experimental alkali burns of the cornea. METHODS： Twenty-seven albino rabbits, weighing 3.2 -0.75 kg were used. Alkali burns were induced on corneas by applying 10 mm Whatman paper No：50 soaked in 1 mol/L NaOH. They have further classified into 5 groups as follows： 1） control group given no treatment （n=5）; 2） VIP given subconjunctivally （n=6）; 3） VIP injected into anterior chamber （n=6）; 4） NaCI 0.9% given subconjunctivally （n=5）; 5） NaCI 0.9% given into the anterior chamber （n=5）. All treatment protocols except control group were followed by topical eye drops composed of VIP at two hourly intervals for one week from 8 a.mo to 6 p.m, RESULTS： VIP treated groups of rabbits with alkali burns were found to have better wound healing findings histo-pathologically when compared to those of control group who have received no treatment on day 30. No differences were observed between groups in respect to degree of polymorphonuclear leukocytes （PMNL） infiltration and degree of loss of amorphous substrate on day 15. However, PMNL infiltration and degree of loss of amorphous substrate were lower in Groups 2 and 3 when compared to that of control group on day 30 （P〈0.05）. CONCLUSION： We have shown that VIP has positive effects on alkali induced corneal burns. VIP may inhibit PMNL migration to cornea through an immunomodulatory effect. Inhibition of PMNL migration might reduce the release of collagenaees and this might prevent the extracellular amorphous substance loss.

Prevalence of pseudoexfoliation syndrome and its association with ocular and systemic diseases in Eskisehir,Turkey

AIM： To investigate the prevalence of pseudoexfoliation syndrome （PEX） and its associations with ocular and systemic diseases in a population sample aged over 40y. METHODS： A total of 2356 subjects were randomly chosen for the sample population based on the database of the Turkish Statistical Agency in Eskisehir. Of the invited 2356 subjects, 2017 subjects participated, out of which 2009 were eligible for the study. Systemic diseases, drug use, smoking and body mass index were assessed using questionnaires. Measurements of central corneal thickness （CCT）, anterior chamber depth （ACD） and intraocular pressure （IOP） were performed during June to December, 2015. After pupillary dilation, the anterior segment and lenses were evaluated using a slit lamp.RESULTS： Prevalence of PEX in this sample was 5.0% （n=100）. Of patients with PEX, 26% also had glaucoma. Incidence of cataracts, and using drugs for hypertension, cardiac and psychiatric conditions was higher in patients with PEX compared to normal cases （P〈0.05）. Hearing loss was more common in PEX cases （34.0% vs 5.4%; P〈0.001）. The mean CCT, ACD and IOP were not significantly different between PEX and non-PEX cases.CONCLUSION： This study is the first population-based, randomized trial in Turkey. Prevalence of PEX in patients over 40 years old was found to be 5.0%. Besides glaucoma and cataract, hypertension, hearing loss, using drugs for cardiac and psychiatric diseases were associated with PEX.

Comparison of trifocal toric and bifocal toric intraocular lens implantation in patients with cataract and high corneal astigmatism

AIM:To investigate and compare the quality of life,satisfaction,contrast sensitivity,glare,depth perception,and intraocular lens(IOL)rotation in patients who underwent trifocal toric and bifocal toric IOLs.METHODS:A total of 80 eyes of 40 patients were included in this prospective study.Twenty patients in each group were implanted with trifocal toric and bifocal toric IOL,respectively.Preoperative and postoperative 6-month measurements were recorded for both patient groups.Comprehensive anterior and posterior segment examinations,distance-intermediate-near visual acuity values and the visual function scale questionnaire results were evaluated at these examinations.Patient satisfaction,contrast sensitivity,glare,intermediate-near and distance stereopsis and IOL rotation were also evaluated.RESULTS:No significant difference was found between the groups in terms of distance and near visual acuities(P=0.269,P=0.451).Intermediate visual acuity was significantly increased in the trifocal toric group(P<0.001).The visual function scale results were increased after surgery in both groups(P=0.001 and P<0.001),with no difference determined between them(P=0.158 and P=0.691).The number of patients wearing glasses was low in both groups and there was no significant difference between the groups(P>0.05).The overall satisfaction in the trifocal toric group was significantly higher than in the bifocal toric group(P=0.03).The highest sensitivity was observed at 6 cpd spatial frequency in all patients under photopic conditions(1.80±0.24 logU,1.74±0.20 logU).Distance-intermediate-near binocular depth perception results in both groups were higher in the trifocal toric group(P=0.02,0.048,0.003,respectively).Although there was no significant difference for 3 meters stereopsis,the trifocal toric group had higher depth perception(P=0.577).Mean rotation was 5.76°±3.93°in the trifocal toric group and 12°±7.1°in the bifocal toric group.CONCLUSION:Better results in the middle distance are obtained in the trifocal toric group and less IOL rotation due to digital system-coordinated surgery.Moreover,the overall satisfaction in the trifocal toric group is significantly higher than in the bifocal toric group.

Effects of slag fineness on durability of mortars

In recent years, the usages of by-products and wastes in industry have become more important. The importance of the sustainable development is also of increasing. The utilizations of wastes, as mineral admixture or fine aggregate, reduce the consumption of the natural resources and improve the durability of concrete. In this study, the effect of the fineness on the high temperature and sulphate resistances of concrete mortar specimens, produced with ground granulated blast-furnace slag (GBFS) replacing cement, is investigated. The compressive and flexural strength test results for all series related to durability effects, exposing temperature and solutions, exposure times for these durability effects, slag content and fineness are discussed. Conse- quently, the optimum slag contents are determined for producing the sulphate and high temperature resistant mortars.

Detection of Promoter Hypermethylation of GSTP1 and CDH1 Genes and the Relationship of Histopathological Parameters of the Breast

Background: Breast cancer is the most common cancer in women. Histopathology plays an important part in determining the treatment strategy for women with breast cancer. GSTP1 plays an important role in protecting cells from cytotoxic and carcinogenic agents and it is expressed in normal tissues at variable levels in different cell types. CDH1 plays a critical role for establishment and maintenance of polarity and differentiation of epithelium during the development period. Also, it plays an important role in signal transduction, differentiation, gene expression, cellmotility and inflammations. Methods: In this study the promoter methylation levels of GSTP1 and CDH1 gene which are associated with breast cancer were investigated by technique of Methylation Sensitive High Resolution Melting Analysis (MS-HRM). We analysed primary tumor core biopsies from 80 high-risk primary breast cancer patients (tumors ≥ 2 cm and/or lymphatic metastase and/or distant metastases and/or under 40 years). Also the patients’ histopathologic types were associated with the methylation levels. Results: In our study the promoter hypermethylation status was observed at different rates;GSTP1 and CDH1 hypermethylation frequencies were 82% and 95% respectively. The promoter hypermethylation levels of the genes were found to be significant with lymph node positivity, ER positivity and HER2/neu negativity. Conclusion: Our study is important as being the first study that analyzes association between histopathologic type and GSTP1 and CDH1 gene promotor methylation status in Turkish population.