"Investigation of the potential cellular changes induced by magnesium sulfate and salubrinal in a lipopolysaccharide-induced chorioamnionitis model".

Chorioamnionitis is closely associated with preterm labor and poses a significant public health concern. In this pathological process where inflammation plays a key role, intracellular mechanisms such as endoplasmic reticulum stress are crucial. In this study, we aimed to explore the potential positive outcomes of the combined use of salubrinal (SLB) with magnesium (Mg) treatment in chorioamnionitis. Thirty pregnant rats were divided into 5 groups as: Control, LPS (1 mg/kg), LPS + SLB (1 mg/kg), LPS + Mg (Dhaka protocol), LPS + SLB + Mg. Rats were sacrificed 4 h after LPS administration, then placental and fetal brain tissues were collected. LPS administration enhanced the levels of tumor necrosis factor-alpha, vascular endothelial growth factor, caspase-3 immunoexpressions, BAX, eukaryotic initiation factor 2-alpha, s100, and glial fibrillary acidic protein expressions and lowered BCL2 expressions in the placenta or fetal brains. SLB and Mg treatments were observed to reverse all these findings, and the most significant positive effect was in the LPS + SLB + Mg group. The known anti-inflammatory activity of Mg, when used with SLB, preventing the transition to apoptosis and increasing antioxidant enzyme activity, as identified in this study, can contribute significantly to the literature. However, these results need to be supported by additional molecular studies.

Serum endocan and preoperative systemic inflammatory markers in patients with epilepsy.

OBJECTIVE: The mechanisms underlying epileptogenesis are still a focus of experimental and clinical research. Inflammation and angiogenesis are the two main topics that have been an area of interest recently. The present study assessed serum levels of endocan, an inflammatory and angiogenesis-promoting molecule, and of preoperative inflammatory markers (neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR)) in adult patients undergoing epilepsy surgery. METHODS: Twenty-one patients with epilepsy and 21 healthy controls were included. From patients, serum was collected twice: before and within a week after surgery. From controls, serum was collected once. Serum endocan was studied by ELISA and preoperative NLR and PLR were obtained from preoperative hemogram parameters. RESULTS: Preoperative serum endocan levels in patients were significantly higher than in controls. There was no difference between patients and controls regarding preoperative NLR and PLR. After surgery, serum endocan levels decreased in patients, with no further difference compared to controls. Serum endocan levels, NLR and PLR correlated positively, but not significantly, with epilepsy duration and seizure frequency. CONCLUSIONS: Angiogenesis and low-grade inflammation may play a role in the development and progression of epilepsy. We suggest that larger cohort of epilepsy patients with longer-term follow-up should be studied.

Intra-erythrocyte magnesium levels and their clinical implications in geriatric outpatients.

OBJECTIVES: Magnesium deficiency has been implicated as a factor in numerous chronic diseases and previous studies suggest a greater prevalence of occult magnesium deficiency among older adults. Serum is the choice for the assessment of most analyses used in clinical medicine, although serum magnesium concentrations have been shown to be poor predictors of intracellular magnesium concentration. The aim of this study was to compare intracellular and extracellular magnesium concentrations in geriatric outpatients. Moreover, we examined whether a significant correlation between magnesium parameters and clinical outcome existed. DESIGN: Cross-sectional study. SETTING: Geriatric medicine outpatient clinic of a university hospital. PARTICIPANTS: A total of 246 patients with a mean age of 71.9 ± 5.7 years were involved. MEASUREMENTS: Intra-erythrocyte magnesium levels were analyzed with atomic absorption spectrophotometry. RESULTS: Serum magnesium levels were within normal range in all patients, whereas intra-erythrocyte magnesium measurements were low in 57% of the patients. Increase in serum levels were together with just only a slightly increase in intra-erythrocyte measurements and the relationship was very weak. Intra-erythrocyte Mg levels were not significantly correlated with many laboratory or clinical parameters. CONCLUSION: Our results confirm that intra-erythrocyte Mg does not correlate with serum levels and clinical parameters in geriatric outpatients, but further studies are needed to define the correlation.

Bone-scan-like pattern with 99Tcm(V)-DMSA scintigraphy in patients with osteomalacia and primary hyperparathyroidism.

The aim of this study was to assess the role of 99Tcm(V)-dimercaptosuccinic acid (99Tcm(V)-DMSA) scintigraphy in the evaluation of patients with metabolic bone disease. The study group comprised eight women aged 17-72 years, six with osteomalacia and two with primary hyperparathyroidism. Six patients were imaged scintigraphically before their treatments were started, whereas the other two underwent treatment during the time of examination. All six patients who had not previously been treated had prominent skeletal 99Tcm(V)-DMSA uptake, revealing a bone-scan-like pattern. In the two patients receiving medical therapy, their 99Tcm(V)-DMSA scans revealed a normal physiological distribution. Many of the fracture and pseudofracture sites detected on bone scans were also discerned with 99Tcm(V)-DMSA scintigraphy. Our results suggest that 99Tcm(V)-DMSA scintigraphy might have the potential as a screening method in patients with metabolic bone disease.

Primary neuroendocrine small cell carcinoma of the breast.

A 60-year-old Turkish woman presented with a left breast mass, which was considered for neoadjuvant chemotherapy. By the end of the treatment cycles, the tumor had decreased in size, and the patient underwent modified radical mastectomy with axillary lymph node dissection. Pathologic examination of the tumor revealed a small cell carcinoma with neuroendocrine features confirmed by immunohistochemical stains. Multiple axillary lymph nodes were involved by metastatic small cell carcinoma carrying the same morphologic characteristics noted in the primary breast tumor. We hereby present this case as a primary neuroendocrine small cell carcinoma of the breast. This entity occurs very rarely in the breast, and fewer than a dozen cases have been reported in the literature. Extrapulmonary small cell carcinoma of the breast is reportedly a very aggressive tumor for which no consensus for treatment has yet been drawn.

[Results of cervical interbody fusion with coral grafts]. / Résultats d'arthrodèses intersomatiques cervicales par greffons coralliens.

OBJECTIVES: We present the long term clinical and radiological results of a retrospective series of 46 cervical interbody fusions using coral grafts performed in 38 patients. MATERIAL AND METHODS: The patients were treated for prolapsed discs (19 cases) or cervical spondylosis (19 cases) with a clinical presentation of either radiculopathy (31 cases) or myelopathy (7 cases). We have done a post-operative clinical analysis of cervicoscapulalgia and radiculo-medullary symptoms and a radiological comparison of the change of the cervical spine angulation, the loss of height and the fusion rate at the graft site. RESULTS: The early clinical postoperative outcome showed that 10 out of 20 patients with excellent radiculo-medullary results had cervicoscapulalgia and 13 out of 18 patients with partial improvement had cervicoscapulalgia. No poor results according to our classification were noted. The late clinical outcome (average follow-up of 16 months) showed that 15 patients out of 31 had radiculo-medullary degradation and 24 presented with cervicoscapulalgia. Sixteen out of 20 patients had a loss of lordosis (range 6.2 degrees; SD 1.2) and 17 a loss of height (range 11.3%; SD 1.5). After 2 years, 13 out of 20 grafts were still hyperdense compared to the adjacent bone, and 8 had a hypodense peripheral edge. CONCLUSIONS: Coral grafts of this series have not been able to keep a physiological sagittal balance of the cervical spine, which is probably one of the essential factors to prevent postoperative cervicoscapulalgia. In the same way, the loss of height of the fused segments, by narrowing of the intervertabral foramen, may explain some further radiculo-medullary deterioration.

Successful treatment of cranial metastases of extrapulmonary small cell carcinoma with chemotherapy alone.

Extrapulmonary small cell carcinoma (EPSCC) is a distinct clinical and pathological entity other than small cell carcinoma of the lung. We present a case with EPSCC, with neurologic impairment due to brain metastases at initial diagnosis, which showed a complete response to combination chemotherapy. A 55-year-old male patient was first admitted with a mass of 6 x 6 cm in diameter in the right cervical region. The diagnosis of small cell carcinoma was entertained with immunohistopathologic and light microscopic findings. During the period of investigation the tumor showed rapid progression and the patient had neurologic dysfunction with right hemiparesia, and papilla oedema in fundoscopy. Cranial CT showed supratentorial multiple cranial metastases and peritumoral oedema. Since the patient refused radiotherapy, combination chemotherapy was started (Etoposide 100 mg/sq m i.v., days 1,3,5 and cisplatin 80 mg/sq m i.v., day 1). A fast response to the chemotherapy was observed with rapid disappearance of the cervical mass. Following six cycles of the chemotherapy the patient recovered fully and all the lesions disappeared with CT.

Malignant peritoneal mesothelioma following asbestos exposure.

Clinical, epidemiological, and pathological studies have demonstrated that asbestosis plays a major role in the etiology of mesothelioma. The direct exposure of workers in industrialized countries to asbestos fibers and nonoccupational household contact elevate the risk of malignant mesothelioma. An increased risk has been found in certain geographic areas of Turkey due to the presence of asbestos deposits and the use of the material known as "white soil" as an insulation. We present a malignant mesothelioma case from rural eastern Turkey with a history of asbestos exposure from using "white soil". We review the epidemiological aspects of asbestos as they relate to mesothelioma.

Subtypes of intestinal metaplasia and their relationship to Helicobacter pylori.

The presence of incomplete colonic type of intestinal metaplasia (IM) is regarded as a risk factor for gastric carcinoma. In this study, we attempted to classify the subtypes of IM in our patients and examine their relationship to Helicobacter pylori (HP). Gastric biopsies were obtained from 210 patients. The HP positivity and the presence and type of IM were determined by histopathologic methods. HP positivity was also tested by the CLO test. The subtypes of IM were classified according to Ming's classification. IM was present in 101 of 210 patients (48%). Complete type intestinal metaplasia was present in 72 of 101 patients (71.3%), incomplete type IM was seen in 29 of 101 patients (28.7%), and incomplete colonic type (Type IIc) was found in 7 of 101 patients (6.9%). No significant relationship was found between subtypes of IM and HP positivity (p > 0.05). Although our patient group is small, our findings suggest that the carcinogenity of HP is mostly related to its own mutagenic activity as well as the mutagenic activity of the inflammatory cells present in response to HP rather than to its supposed effect on precancerous gastric lesions.

Second primary cancer due to radiotherapy and chemotherapy.

Cancer patients are treated successfully with chemotherapy, radiotherapy, or a combination of both. However, many agents used in cancer chemotherapy as well as ionizing radiation are known carcinogens. The long survival of cancer patients treated successfully for their primary cancer made possible the observations of late effects of radiotherapy and chemotherapy and, in particular, the occurrence of second primary cancers. In this report we review the cases of five patients with second primary malignancies and wish to emphasize the importance of a thorough follow-up of patients treated successfully for and possibly cured of a primary cancer.