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Background/Aim: The temporomandibular joint (TMJ) is a complex anatomical region composed of the mandibular condyle located in the glenoid fossa of the temporal bone and covered with fibrous connective tissue. Excessive and continuous forces lead to progressive degeneration of the bony surfaces of the TMJ. The aim of this study is to determine the success of automatic detection of degenerative changes detected on panoramic radiographs in the TMJ region with deep learning method. Material and Methods: Panoramic images of 1068 patients (1000 with normal TMJ appearance and 68 with TMJ degeneration) over 18 years of age were included in the study. CVAT, open-source annotation tool (https://www.cvat.ai/) was used for labeling image data. All images were resized using the bilinear interpolation method. With the using data augmentation techniques, the number of images data reached 1480. BSRGAN model was applied to the data to increase the resolution of the data. YOLOv5, YOLOv7 and YOLOv8 algorithms were used for TMJ degeneration detection. TP, FP, TN, FN, accuracy, precision, recall, F1-score and AUC (Area Under the Curve) metrics were used for statistical analysis. Results: YOLOv5s training resulted in 94.40% accuracy, 81.63% precision, 86.96% sensitivity, 84.21% F1 score and 91.45% AUC. YOLOv7 training resulted in 99.63% accuracy, 97.87% precision, 100% sensitivity, 98.92% F1 Score and 99.77% AUC. YOLOv8 training resulted 96.64% accuracy, 91.11% precision, 89.13% sensitivity, 90.11% F1 Score and 93.66% AUC. Conclusions: All three algorithms have high success rates, with the best results obtained in YOLOv7.

In this work, the classifications of, fuzzy vector planes of fuzzy 4-dimensional vector space and fuzzy projective lines of fuzzy 3-dimensional projective space from fuzzy 4-dimensional vector space are given. [ABSTRACT FROM AUTHOR]

Purpose: A fast, reliable and non-invasive method is required in differentiating brain metastases (BMs) originating from lung cancer (LC) and breast cancer (BC). The aims of this study were to assess the role of histogram analysis of apparent diffusion coefficient (ADC) maps in differentiating BMs originated from LC and BC, and then to investigate further the association of ADC histogram parameters with Ki-67 index in BMs., Methods: A total of 55 patients (LC, N  = 40; BC, N  = 15) with BMs histopathologically confirmed were enrolled in the study. The LC group was divided into small-cell lung cancer (SCLC; N  = 15) and non-small-cell lung cancer (NSCLC; N  = 25) groups. ADC histogram parameters (ADC max , ADC mean , ADC min , ADC median , ADC 10 , ADC 25 , ADC 75 and ADC 90 , skewness, kurtosis and entropy) were derived from ADC maps. Mann-Whitney U -test, independent samples t -test, receiver operating characteristic (ROC) analysis and Spearman correlation analysis were used for statistical assessment., Results: ADC histogram parameters did not show significant differences between LC and BC groups ( p  > 0.05). Subgroup analysis showed that various ADC histogram parameters were found to be statistically lower in the SCLC group compared to the NSCLC and BC groups ( p  < 0.05). ROC analysis showed that ADC mean and ADC 10 for differentiating SCLC BMs from NSCLC, and ADC 25 for differentiating SCLC BMs from BC achieved optimal diagnostic performances. Various histogram parameters were found to be significantly correlated with Ki-67 ( p  < 0.05)., Conclusion: Histogram analysis of ADC maps may reflect tumoural proliferation potential in BMs and can be useful in differentiating SCLC BMs from NSCLC and BC BMs.

Objective: The aim of this study was to assess whether tumoral and peritumoral apparent diffusion coefficient values and intratumoral susceptibility signals on susceptibility-weighted imaging could distinguish between high-grade gliomas and brain metastases, and to investigate their associations with the Ki-67 proliferation index., Materials and Methods: Fifty-seven patients with pathologically confirmed diagnoses of either high-grade glioma or brain metastasis were enrolled in this study (23 with high-grade gliomas and 34 with brain metastases). The minimum and mean apparent diffusion coefficients in the enhancing tumoral region (ADC min and ADC mean ) and the minimum apparent diffusion coefficient in the peritumoral region (ADC edema ) were measured from apparent diffusion coefficient maps, and intratumoral susceptibility signal grades acquired by susceptibility-weighted imaging were calculated. Ki-67 proliferation index values were obtained from the hospital database. These parameters were evaluated using the Mann-Whitney U test, independent-sample t -test, Spearman correlation analysis, receiver operating characteristic curve, and logistic regression analyses., Results: ADC mean , ADC min values, and intratumoral susceptibility signal grades in brain metastases were significantly lower than those in high-grade gliomas (all p  < 0.05). Ki-67 proliferation index values showed significant correlations with ADC mean , ADC min , and intratumoral susceptibility signal grade in brain metastases (all p  < 0.05), but no correlation was found in high-grade gliomas (all p  > 0.05). According to receiver operating characteristic curve analysis, ADC mean achieved the highest diagnostic performance for discriminating high-grade gliomas from brain metastases. Furthermore, the combination of tumoral apparent diffusion coefficient parameters with intratumoral susceptibility signal grade provided a higher area under the curve than univariate parameters., Conclusion: The combination of tumoral apparent diffusion coefficient with intratumoral susceptibility signal grade can offer better diagnostic performances for differential diagnosis. Apparent diffusion coefficient and intratumoral susceptibility signal may reflect cellular proliferative activity in brain metastases, but not in high-grade gliomas.

Background: Accurate preoperative determination of the histological grade and cellular proliferative potential of meningioma by non-invasive imaging is of paramount importance., Purpose: To evaluate the utility of apparent diffusion coefficient (ADC) in determining the histological grade of meningioma, and to investigate the correlation of ADC with Ki-67 proliferation index (PI), progesterone receptor (PR) status, and a number of other histopathological parameters., Material and Methods: Histopathologically confirmed 94 meningioma patients (72 low-grade, 22 high-grade) who had undergone preoperative diffusion-weighted imaging were retrospectively evaluated. ADC values were obtained by manually drawing the regions of interest (ROIs) within the solid components of the tumor. The relationship between ADC and Ki-67 values, PR status, and multiple histopathological parameters were investigated, and the ADC values of high-grade and low-grade meningiomas were compared. Independent sample t-test, Mann-Whitney U test, receiver operating characteristic, Pearson correlation, and multiple logistic regression analysis were used for statistical assessment., Results: All ADC and rADC values were significantly lower in high-grade meningiomas than in low-grade meningiomas (all P  < 0.05). ADC values showed significantly negative correlations with Ki-67 and mitotic index ( P  < 0.001 for each). Numerous ADC parameters were significantly lower in meningiomas demonstrating hypercellularity and necrosis features ( P  < 0.05). ADC values did not show a significant correlation with PR score (all P  > 0.05)., Conclusion: ADC can be utilized as a reliable imaging biomarker for predicting the proliferative potential and histological grade in meningiomas.

Objective: Gleason scoring is the grading system which strongly predicts the prognosis of prostate cancer. However, even being one of the most commonly used systems, the presence of different interobserver agreement rates push the uropathologists update the definitons of the Gleason patterns. In this study, we aimed to determine the interobserver agreement variability among 7 general pathologists, and one expert uropathologist from 6 different centers., Methods: A set of 50 Hematoxylin & Eosin stained slides from 41 patients diagnosed as prostate cancer were revised by 8 different pathologists. The pathologists were also grouped according to having their residency at the same institute or working at the same center. All pathologists' and the subgroups' Gleason scores were then compared for interobserver variability by Fleiss' and Cohen's kappa tests using R v3.2.4., Results: There were about 8 pathologists from 6 different centers revised all the slides. One of them was an expert uropathologist with experience of 18 years. Among 7 general pathologists 4 had surgical pathology experience for over 5 years whilst 3 had under 5 years. The Fleiss' kappa was found as 0.54 for primary Gleason pattern, and 0.44 for total Gleason score (moderate agreement). The Fleiss' kappa was 0.45 for grade grouping system., Conclusion: Assigning a Gleason score for a patient can be problematic because of different interobserver agreement rates among pathologists even though the patterns were accepted as well-defined., Competing Interests: None

Background/aim: This study was designed to determine the characteristic features of upper urinary system urothelial carcinomas (UUSUCs) and to evaluate the clinicopathological parameters associated with prognosis., Materials and Methods: A total of 74 cases of UUSUC were included, from three different centers. Demographic data and histopathological features such as tumor localization, concomitant tumor in the urinary system, distant metastasis with overall survival and disease-free survival obtained from the hospital records were evaluated retrospectively. Histopathologic prognostic features such as grade, perineural invasion, lymphovascular invasion, tumor necrosis, and surgical margin status were also evaluated., Results: Seventy cases (94.6%) underwent open nephroureterectomy whereas 4 cases (5.4%) had laparoscopic nefroureterectomy. Thirty-eight (51.4%) cases were located in the pelvis, 7 (9.5%) in the ureter, 29 (39.2%) both in the pelvis and ureter. Fifty-six (75.7%) cases were alive; however, 18 (24.3%) patients were found to be dead. pTa, pT1, pT2, pT3, and pT4 tumors were reported in 16 (21.6%), 13 (17.6%), 4 (5.4%), 28 (37.8%), and 13 (17.6%) patients, respectively. Histopathologically, 17 cases (23%) were low-grade, 57 cases (77%) were high-grade. Statistically significant correlation was observed between overall survival and lymph node metastasis, distant metastasis, tumor necrosis, and differentiation by univariate analysis. Only distant metastasis was statistically associated with overall survival by multivariate analysis. We found no significant relationship between disease-free survival and all parameters., Conclusion: Differentiation and necrosis of tumor, lymph node involvement, and presence of distant metastasis is associated with the overall survival of urothelial carcinoma of the upper urinary system.

Background: Multiple myeloma is a plasma cell dyscrasia characterized by transformation of B cells into malignant cells. Although there are data regarding the molecular pathology of multiple myeloma, the molecular mechanisms of the disease have not been fully elucidated., Aims: To investigate the gene expression profiles in bone marrow myeloma cells via RNA-sequencing technology., Study Design: Cell study., Methods: Myeloma cells from four patients with untreated multiple myeloma and B cells from the bone marrow of four healthy donors were sorted using a FACSAria II flow cytometer. The patient pool of myeloma cells and the control pool of B cells were the two comparative groups. A transcriptome analysis was performed and the results were analyzed using bioinformatics tools., Results: In total, 18.806 transcripts (94.4%) were detected in the pooled multiple myeloma patient cells. A total of 992 regions were detected as new exon candidates or alternative splicing regions. In addition, 490 mutations (deletions or insertions), 1.397 single nucleotide variations, 415 fusion transcripts, 132 frameshift mutations, and 983 fusions, which were reported before in the National Center for Biotechnology Information, were detected with unknown functions in patients. A total of 35.268 transcripts were obtained (71%) (25.355 transcripts were defined previously) in the control pool. In this preliminary study, the first 50 genes were analyzed with the MSigDB, Enrichr, and Panther gene set enrichment analysis programs. The molecular functions, cellular components, pathways, and biological processes of the genes were obtained and statistical values were determined using bioinformatics tools and are presented as a supplemental file., Conclusion: EEF1G, ITM2C, FTL, CLPTM1L , and CYBA are identified as possible candidate genes associated with myelomagenesis.

Objective: The aim of this study was to evaluate the prognostic significance of tumor budding in muscle invasive urothelial carcinoma of bladder (MIBC)., Material and Methods: A total of 60 patients who underwent radical cystectomy and cystoprostatectomy for MIBC were included in the study. The correlations between tumor budding, and tumor necrosis, lymphovascular invasion (LVI), perineural invasion (PNI) and histopathological data with distant metastasis were evaluated. The correlation between progression free (PFS) and overall survival (OS) rates and the presence, and grade of tumor budding was investigated., Results: A statistically significant correlation was not seen between tumor budding, necrosis, LVI, and PNI. There was a strong correlation between distant organ metastasis, and presence of tumor necrosis. There was no statistically significant correlation between PFS, OS and tumor budding. A statistically significant relationship was observed between OS and tumor stage, lymph node metastasis, and distant organ metastasis., Conclusion: In our study, statistically significant effect of tumor budding on survival rates in MIBCs was not observed. Also, no significant correlation was observed between tumor budding and tumor necrosis, LVI, and PNI.

Objective: In cases presenting with lymphadenopathies (LAP) without a primary focus detected by simple radiological methods, the primary tumor can be diagnosed by a histopathological evaluation of the metastatic lymph nodes. We aimed to discuss the nonhematological malignancies presenting with lymphadenopathies and the histopathological results for primary tumors., Material and Methods: In this retrospective study, cases diagnosed with metastasis in excisional lymph nodes between January 2013 and June 2016 were assessed for a histopathological diagnostic approach., Results: Among 632 lymph node biopsies, a total of 21 cases, involving 12 male and 9 female patients with a mean age of 57.23 y (range, 33-92 y), of nonhematological solid tumors were included. The most common localizations of the involved lymph nodes were inguinal (n=8), axillary (n=6), cervical (n=4), and supraclavicular (n=3) region. The most common primary tumors were malignant melanoma (n=6), breast carcinoma (n=4), ovarian carcinoma (n=2), squamous cell carcinoma (n=2), and germ cell tumor (n=2). Others were papillary thyroid carcinoma, renal cell carcinoma, urothelial carcinoma, prostate adenocarcinoma, and endometrial adenocarcinoma., Conclusion: Nonhematological malignancies presenting with lymphadenopathies are one of the most complicated cases for clinicians. The histopathological evaluation of the excisional metastatic lymph node biopsies is an important method because of cost effectiveness and easy applicability., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare.

Background/aim: This study aimed to investigate the role of the mitochondrial apoptotic pathway in benign thyroid nodules., Materials and Methods: Paired samples of nodular and normal tissues were collected from 26 patients with nodular goiters undergoing thyroidectomy. Variable expression of Bcl-2, Bax and Bad genes were evaluated by quantitative PCR., Results: Expression level of Bad gene in nodules was found to be significantly decreased compared to normal tissues (p=0.049). A positive correlation was observed between nodule size and Bad expression levels (correlation coefficient=0.563, p=0.004); and this correlation was stronger in hot nodules (n=18, correlation coefficient=0.689, p=0.003). No significant difference was observed between nodular and normal tissue expressions of Bax and Bcl-2., Conclusion: These results suggest that Bad expression correlates with the size of benign thyroid nodules and also its relatively lower expression in nodules, warrant further investigation., (Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Phthalate plasticizers used in a wide range of common plastic products are released into the environment and may pose a risk of increased incidence of type 2 diabetes. In this work, we studied the effects of monoethyl phthalate (MEP), the metabolite of diethyl phthalate, exposure on 1.1B4 human pancreatic beta cells at low doses (1-1000 nM). We showed that MEP treatment induced proliferation in 1.1B4 cells. Also PCNA protein expression levels were increased related to proliferation induction. It has been noted that phthalates can exert estrogen mediated response by interacting with ER. In our study 24 h MEP treatment decreased ERα protein expression level conversely it increased the same protein expression level after 72 h treatment. Also MEP treatment decreased ERβ expression after 72 h at 1.1B4 cells. Our results further show that insulin content of 1.1B4 cells were increased with low dose MEP treatment. Along with our insulin content results, PDX- 1 expression levels were also increased at 1.1B4 cells with MEP treatment. These findings suggest that MEP acts as an estrogenic compound and PPARγ agonist at lower concentrations. Also it should be noted that PDX-1 may be a critical regulator of 1.1B4 cells treated with MEP., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Aim: Our objective was to evaluate the diagnostic role of dual-phase fluor-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography-computed tomography (PET-CT) and planar lymphoscintigraphy in patients with oral cavity cancer (OCC). We also investigated the combined impact of F-18 FDG PET-CT and sentinel lymph node biopsy (SLNB) in decision making for patients with OCC., Methods: Sixteen patients (4 female, 12 male; age range, 29-81 years) were included in this prospective study. F-18 FDG PET-CT [1 (early) and 2 h (delayed) after injection] and planar lymphoscintigraphy (2h before the surgery) were performed for all the patients before surgery. The sensitivity, specificity, and negative and positive predictive values in F-18 FDG PET-CT for the early and the delayed scans and tumor/liver uptake (T/L) in the lymph nodes were calculated. Receiver operating characteristic curves were obtained for standardized uptake value (SUV)max and T/L., Results: Histopathological evaluations revealed that 5 patients had metastatic lymph nodes (pN+) whereas 11 patients had benign lymph nodes (pN-). Out of 43 lymph nodes visualized as cN(+) in F-18 FDG PET-CT, 14 were pathologically positive for malignancy, whereas 29 were pathologically benign. There was no statistical difference between the N(+) and N(-) patients in terms of age, depth of primary tumor, and the number of mitoses. However, there was a significant difference between the N(+) and N(-) patients (P=.011) in terms of early and delayed F-18 FDG uptake of primary tumors. There was a statistically significant difference in the value of SUVmax between the early and the delayed scans for the malignant lymph nodes (P=.00)., Conclusion: This study indicates that F-18 FDG PET-CT is a reliable method for the correct evaluation of primary tumor and N staging in OCCs. Delayed phase of F-18 FDG imaging may increase primary lesion detectability due to higher FDG uptake in primary tumors compared to the early phase of imaging. F-18 FDG PET-CT might demonstrate skip metastasis in lymph nodes which can be missed with SLNB. Although SUV values increased in the delayed phase of F-18 PET-CT imaging in detecting lymph node metastases, the specificity and positive predictive value did not increase., (Copyright © 2015 Elsevier Inc. All rights reserved.)