Background and Objectives: Among breast cancer molecular types, HER2 positive and triple negative (TN) subtypes have the highest likelihood of pathological complete response (pCR), which is a surrogate marker for reduced recurrence and improved patient survival after neoadjuvant systemic treatment (NST). Preoperative pathological identification of these exceptional responders is a new era. Therefore, we aimed to determine the accuracy of trucut biopsy in identifying the exceptional responders in selected molecular subtypes of breast cancer patients. Materials and Methods: This two-centre, observational, single-arm, prospective, pilot study was conducted between January and September 2024. The patients with TN or HER2 positive breast cancer whose breast tumour had completely disappeared on the radiological assessment including MRI after neoadjuvant therapy were enrolled. To assess neoadjuvant treatment response, a standardised biopsy protocol was used, consisting of 10 samples from the marked tumour area per patient by 12 G core needle. Then, all patients underwent surgery. The pathological results of both postchemo-presurgical biopsy and surgical breast specimen were compared. Results: The study included 20 patients. The mean age of the patients was 47.3 years. The median tumour size at diagnosis was 23.1 mm. All biopsy results were concordant with the findings of surgical specimen. Seventeen patients had a complete response. The remaining 3 patients had residual disease. Conclusions: Along with thorough patient selection, post-chemo radiological assessment and the reliable biopsy technique are the key points in accurately predicting response to neoadjuvant treatment. If an image-guided core biopsy confirms elimination of tumour tissue at the marked tumour area with a radiological complete response on MRI after NST in breast cancer patients with selected molecular subtypes, these may be suitable patients as exceptional responders in whom we can omit breast surgery.

OBJECTIVE: The aim of this study was to calculate a useful cut-off point of the ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography SUV_Max value to decide on a computed tomography-guided percutaneous transthoracic needle biopsy for solitary pulmonary nodules of sizes between 11 and 20 mm.

Background: Cerebral aneurysm (CA) is a focal or diffuse pathological dilation of the cerebral arterial wall that arises due to various etiological factors. It represents a serious vascular condition, particularly affecting the elderly, and carries a high risk of rupture and neurological morbidity. Clonidine (CL), an α2-adrenergic receptor agonist, has been reported to suppress aneurysm progression; however, its underlying molecular mechanisms, especially in relation to cerebral endothelial dysfunction, remain unclear. This study aimed to investigate the potential of CL to mitigate CA development by modulating apoptosis, inflammation, and oxidative stress in an Angiotensin II (Ang II)-induced endothelial injury model. Methods: Human brain microvascular endothelial cells (HBMECs) were used to establish an in vitro model of endothelial dysfunction by treating cells with 1 µM Ang II for 48 h. CL was administered 2 h prior to Ang II exposure at concentrations of 0.1, 1, and 10 µM. Cell viability was assessed using the MTT assay. Oxidative stress markers, including reactive oxygen species (ROS) and Nitric Oxide (NO), were measured using 2′,7′–dichlorofluorescin diacetate (DCFDA). Gene expression levels of vascular endothelial growth factor (VEGF), matrix metalloproteinases (MMP-2 and MMP-9), high mobility group box 1 (HMGB1), and nuclear factor kappa B (NF-κB) were quantified using RT-qPCR. Levels of proinflammatory cytokines; tumor necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6), and interferon-gamma (IFN-γ); were measured using commercial ELISA kits. Results: Ang II significantly increased ROS production and reduced NO levels, accompanied by heightened proinflammatory cytokine release and endothelial dysfunction. MTT assay revealed a marked decrease in cell viability following Ang II treatment (34.18%), whereas CL preserved cell viability in a concentration-dependent manner: 44.24% at 0.1 µM, 66.56% at 1 µM, and 81.74% at 10 µM. CL treatment also significantly attenuated ROS generation and inflammatory cytokine levels (p < 0.05). Furthermore, the expression of VEGF, HMGB1, NF-κB, MMP-2, and MMP-9 was significantly downregulated in response to CL. Conclusions: CL exerts a protective effect on endothelial cells by reducing oxidative stress and suppressing proinflammatory signaling pathways in Ang II-induced injury. These results support the potential of CL to mitigate endothelial injury in vitro, though further in vivo studies are required to confirm its translational relevance.

Objectives: The study aimed to investigate the relationship between the triglyceride-glucose (TyG) index and white matter changes in patients with migraine. Patients and methods: In this prospective case-control study, brain magnetic resonance imaging, fasting triglyceride levels, and fasting glucose levels of 80 patients (69 females, 11 males; mean age: 31.7±9.8 years; range, 19 to 57 years) with migraine and 50 controls (39 females, 11 males; mean age: 29.6±8.6 years; range, 18 to 50 years) were evaluated between January 2023 and January 2024. Headache intensity, frequency, and characteristics were recorded. Headache disability was measured using the MIDAS (Migraine Disability Assessment). White matter hyperintensities (WMHs) were assessed with the Fazekas scale. The TyG index was calculated with the following formula: fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2. Results: Based on the Fazekas score for white matter hyperintensities (WMHs), the TyG index was significantly higher in patients with Stage 1 and Stage 2 compared to those with Stage 0 (p=0.038). Conclusion: The findings suggested that an elevated TyG index was associated with the development of WMHs in patients with migraine.

Background and Objectives: Anatomical variations in the Circle of Willis (CoW) may influence cerebral collateral pathways and the interpretation of vascular imaging. This study characterized their prevalence and clinical associations in a Turkish computed tomography angiography (CTA) cohort using complementary patient-level and component-level classifications. Materials and Methods: This retrospective, single-center study included 248 patients who underwent cranial CTA during 2024. Two radiologists independently assessed CoW anatomy, with disagreements resolved by consensus. Mutually exclusive patient-level configurations and non-exclusive arterial components were recorded. Associations with demographic and clinical characteristics were evaluated using logistic regression. Results: A normal configuration was identified in 142 patients (57.3%), and 106 (42.7%) had at least one variant. Isolated posterior communicating artery (PComA) hypoplasia/aplasia was the most frequent configuration (14.5%); PComA involvement reached 19.0% when mixed configurations were included. Isolated fetal-type posterior cerebral artery, P1 hypoplasia, and A1 hypoplasia occurred in 7.3%, 6.5%, and 4.8%, respectively. Older age (adjusted odds ratio [aOR] per 10 years, 1.57; 95% confidence interval [CI], 1.23–2.01) and migraine (aOR, 5.67; 95% CI, 2.06–15.56) were associated with variant anatomy. Previous stroke/transient ischemic attack and carotid stenosis showed inverse associations. Conclusions: CoW variants were common in this Turkish clinical cohort, particularly in the posterior circulation. Reporting both overall configurations and individual arterial components provides complementary information relevant to anatomical assessment, vascular imaging interpretation, and procedural planning.

Purpose: To evaluate the angiographic outcomes of the Optima™ coil system in the endovascular treatment of saccular intracranial aneurysms to present real-world experiences.