Does carbon dioxide pneumoperitoneum altering pressure levels lead to ultrastructural damage of fallopian tube and ovary?

AIM: To assess carbon dioxide pneumoperitoneum and its different pressure levels related to cellular injury on ovarian surface epithelium, endothelium, and fallopian tube ciliated epithelium in laparoscopic rat model. MATERIALS AND METHODS: Twenty-four Wistar-Albino female rats were randomized into three groups. Laparotomy was applied for Group 1 (control). Groups 2 and 3 had laparoscopy with pneumoperitoneum pressures at 10 mmHg and 15 mmHg, respectively. After 150 minutes (last 30 minutes was after desufflation for Group 2 and 3) in all groups, bilateral ovariectomy and salpingectomy were performed. The ultrastructures of ovarian surface epithelium, ovarian endothelium, and fallopian tube ciliated epithelium were evaluated by transmission electron microscope. Ovarian surface epithelium changes were divided into three groups, apical surface changes, lateral surface chances, and organelle modification/damage. RESULTS: No apical or lateral surface changes or organelle modifications in ovarian surface epithelium were observed in the control group. Apical ovarian surface epithelium changes were statistically significant in Groups 2 and 3 in comparison to the control group. No significant differences were observed with regards to lateral surface changes in all groups. The organelle modification was only significant in Group 3 compared to the control group. The authors revealed that the ultrastructures of the ovarian endothelium and fallopian tube epithelium were not affected by pneumoperitoneum. CONCLUSIONS: Pneumoperitoneum may cause ischemia-reperfusion damage in ovarian cortex correlated with the amount of pressure.

Is there an association between non-functioning adrenal adenoma and endothelial dysfunction?

BACKGROUND AND AIM: Subtle changes in hypothalamic- pituitary-adrenal (HPA) axis of subjects with nonfunctioning adrenal adenoma may be associated with endothelial alterations. We sought to investigate endothelial function, visceral adiposity and osteoprotegerin (OPG) and interleukin- 18 (IL-18) levels in subjects with non-functioning adrenal adenomas. SUBJECTS AND METHODS: The adenoma group included 40 subjects without clinical and subclinical findings of hypercortisolism or other adrenal gland disorders. Twenty-two body mass index-matched controls were also enroled. The patients and control subjects underwent hormonal evaluation and assessment of anthropometric and metabolic parameters. Endothelial function was assessed with flowmediated dilatation (FMD) of the brachial artery and intima media thickness (IMT) of common carotid arteries. Visceral adipose tissue area was measured by computed tomography. Plasma OPG and serum IL-18 levels were also measured. RESULTS: When compared with healthy controls, the adenoma group had elevated systolic blood pressure, post-dexamethasone suppression test cortisol and reduced DHEAS. Visceral adipose tissue area and IMT of common carotid arteries were comparable. In the adenoma group, FMD of the brachial artery was significantly impaired and IL-18 level was significantly elevated. Visceral adipose tissue area was independently related with FMD. Homeostasis model assessment (HOMA) was the independent factor associated with visceral adipose tissue area. Cortisol, DHEAS and visceral adipose tissue area were independently associated with HOMA. CONCLUSIONS: We achieved evidence that could be attributable to endothelial alterations in subjects with non-functioning adrenal adenomas. Impaired FMD appeared to be a consequence of subtle changes in HPA axis in terms of elevated cortisol and reduced DHEAS as these conditions were known to disturb endothelial-dependent vasodilatation.

Soluble CD44 is a potential marker for the early detection of head and neck cancer.

INTRODUCTION: Head and neck squamous cell carcinoma (HNSCC) is a devastating and deadly disease, largely because it is diagnosed in late stage. Cure rates, currently at 50%, could increase to >80% with early detection. In this study, we evaluate soluble CD44 (solCD44) as an early detection tool for HNSCC by determining whether it reliably distinguishes HNSCC from benign disease of the upper aerodigestive tract. METHODS: We carried out the solCD44 ELISA on oral rinses from 102 patients with HNSCC and 69 control patients with benign diseases of upper aerodigestive tract to determine the sensitivity and specificity of the test for differentiating HNSCC from benign disease. Furthermore, we did a pilot study using methylation-specific PCR primers on oral rinses from 11 HNSCC patients with low solCD44 levels and 10 benign disease controls. RESULTS: Mean salivary solCD44 levels were 24.4 +/- 32.0 ng/mL for HNSCC patients (range, 0.99-201 ng/mL) and 9.9 +/- 16.1 ng/mL (range, 0.73-124 ng/mL) for the patients with benign disease (P < 0.0001). Depending on cutoff point and HNSCC site, sensitivity ranged from 62% to 70% and specificity ranged from 75% to 88%. Nine of 11 HNSCC and 0 of 10 controls with low solCD44 levels showed hypermethylation of the CD44 promoter. CONCLUSIONS: SolCD44 is elevated in the majority of HNSCC and distinguishes cancer from benign disease with high specificity. Whereas the solCD44 test lacks sensitivity by itself, methylation status of the CD44 gene seems to complement the solCD44 test. Our pilot data indicate that, together, these markers will detect HNSCC with very high sensitivity and specificity.

The prognostic significance of vascular endothelial growth factor levels in sera of non-small cell lung cancer patients.

BACKGROUND: Angiogenesis, the formation of new blood vessels from the existing vascular bed, is essential step for the growth and invasion of the primary tumor. Vascular endothelial growth factor (VEGF) is known to play crucial role in tumor angiogenesis. Increased serum VEGF levels may be associated with poor prognosis in patients with non-small cell lung cancer (NSCLC). METHODOLOGY: In the present study, we measured plasma VEGF levels in 20 normal subjects and 75 patients with untreated NSCLC; 23 operable (stages I, II, IIIA) and 52 inoperable (stages IIIB, IV) (Histology: squamous cell carcinoma, 40; adenocarcinoma, 27; undetermined, 8). VEGF was measured by enzyme-linked immunosorbent assay. RESULTS: The median VEGF level in patient group was 119 pg/ml (29-1235), which was significantly higher than the control group (P = 0.044). Median survival of patients was 210 days (30-220). The patients were divided into high VEGF (> 119 pg/ml) and low VEGF (< 119 pg/ml) groups using the median value as a cut-off. It was investigated if there were significant associations between serum VEGF level and clinico-pathological parameters like age, sex, histopathological diagnosis and TNM staging. Also high VEGF and low VEGF patient groups were compared according to the median survival. CONCLUSIONS: Serum VEGF level is significantly associated with the clinical staging of the patients (operable and inoperable) (P = 0.031) and it also correlates with the prognosis of the patients (P = 0.0006).