An experimental rat model of electric shock injury with isolated electric shock and water conduction: the histopathological changes on the skin and internal organs and the effect on biochemical parameters.

It is difficult to determine the cause of death in electric shock injuries when no trace can be determined on the skin, and this is accepted as a reason for negative autopsy. We aimed to determine useful parameters in the definition of the cause of deaths associated with electric shock and particularly those formed with water conduction. This study used a total of 42 rats, applied with fatal electric shock formed of isolated electric shock at 220 V and with water conduction. The serum NT-ProBNP and H-FABP levels were examined together with histopathological changes in the brain, cerebellum, brainstem, heart, liver and skin and the Bax, caspase-3 and HSP-60 antibody status in these tissues. A statistically significant difference was determined between the groups in respect of the serum H-FABP values and the immunohistochemical staining of the samples taken from the organs. In conclusion, this study is the first in literature with an experimental model of electric shock with water conduction. Using immunohistochemical and biochemical markers in deaths associated with isolated electric shock and electric shock with water conduction, the results of this study can contribute to the clarification of one of the reasons for negative autopsy in forensic medicine.

Incidental cancer in colectomy specimens from patients with familial adenomatous polyposis: single centre experience and literature review.

BACKGROUND: Since cancer development is inevitable in patients with familial adenomatous polyposis (FAP), we aimed to determine the incidence of incidental malignancy in prophylactic colectomy specimens. METHODS: The files of patients who underwent prophylactic surgery for FAP between 2010 and 2020 were retrospectively reviewed. The incidence of incidental malignancy in histopathological specimens was examined and a comprehensive literature review was made. RESULTS: Fifty-five patients were included in the study, of whom 30 patients had a diagnosis of primary malignancy. Prophylactic colectomy was performed on 25 patients. The pathology results indicated that the specimens were benign in 12 patients (48%) and revealed carcinoma in situ in 11 patients (44%). Incidental malignancy was detected in 2 patients (8%). In the literature review, there were 243 patients who underwent prophylactic colectomy and incidental cancer was detected in 25 patients (10.3%) with the stages of 1 (7.4%), 2 (2.1%), and 3 (0.8%), respectively. CONCLUSIONS: Incidental cancer is not rare in patients who have undergone prophylactic colectomy for FAP. Hopefully. they are usually at early stages and unexpected advanced cancers are seen rarely.

A 9-year retrospective review of lightning deaths from the Eastern Anatolian Region of Turkey.

In this study, deaths from lightning strikes in Eastern Turkey revealed distinct patterns in lifestyle and physical injury. Farmers, sailors, and those engaged in outdoor sports are all at risk of being struck by lightning. Death from a lightning strike is associated with cardiovascular and central nervous system damage. This study examines cases of autopsies that were performed on bodies that had suffered a lightning strike, including sociodemographic data, burns on the body, injured regions, histopathological findings, and causes of death. This retrospective evaluation included 17 cases. The cases comprised 88.2% males and 11.8% females, with a mean age of 41.5 years. The person's occupation was farmer in 29.4% of the cases and shepherd in 70.6%. Their deaths occurred most frequently in the summer months. Deaths associated with lightning strikes are more frequent in east of Turkey than in other regions, as agriculture and livestock are common sources of income. The majority of the victims among the cases were males working outside because of their occupations. Histopathologically, subarachnoid fresh bleeding was seen in five cases, subpleural fresh bleeding in the lungs in five cases, and interlobular rupture in the lungs in three cases. Deaths associated with lightning strikes have been correlated with a low level of education in this subject. This study is the largest case study of deaths associated with lightning strikes in Turkey.

Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital.

Background: Bronchiectasis is still a challenging chronic lung disease in developing countries. Patients with bronchiectasis can also have pulmonary hypertension. There are sparse data on the prevalence of pulmonary hypertension in patients with bronchiectasis. Materials and methods. Archived H&E-stained slides of 141 patients histopathologically diagnosed with bronchiectasis were reevaluated. Cases were categorized into 4 subgroups based on histology: tubular, varicose, follicular, and cystic. In addition, concomitant histopathological changes were also reevaluated. For patients with available CT sections, main, right, and left pulmonary artery (PA) diameters and PA/aorta ratio were measured with regard to pulmonary hypertension. Results: Of the cases, 70% (n = 89) were female and 30% (n = 52) were male, with a mean age of 36.58 in females and 33.84 in males. Histopathologically, 43% (n = 68) of the cases showed follicular, 37% (n = 59) showed varicose, 35% (n = 56) showed tubular, and 28% (n = 45) showed cystic bronchiectasis morphology. All cases showed chronic inflammation, fibrosis, muscle destruction, and cartilage destruction. Aspergillus were present in 11% of the cases showing cystic morphology. Approximately 17% of the cases (n = 24) were found to have neuroendocrine cell proliferations. In cases with medial hypertrophy, a statistically significant increase in the left pulmonary artery diameter was radiologically determined. Conclusions: Medial hypertrophy was found to be significant with regard to indicating a radiological increase in left pulmonary artery diameter. Vascular changes observed in bronchiectasis cases and the presence of neuroendocrine cell proliferations should be specified in pathology reports, and aspergilloma should be carefully investigated in cases with predominant cystic morphology.

The therapeutic efficacy of dexpanthenol on sciatic nerve injury in a rat model.

Objective: The aim of this study was to evaluate histopathological, functional and bone densitometry examinations of the beneficial effects of dexpanthenol (DEX) on nerve regeneration in a rat model of peripheral nerve crush injury.Methods: Thirty adult Sprague-Dawley rats were divided equally into three groups. A crush injury was simulated in all rats by clamping the right sciatic nerve for one minute. In group 1, one day before the surgical procedure, 500 mg/kg DEX administered via intraperitoneally (ip) was initiated and continued three times in a week during the experiment period as 28 days. In group 2, rats received a dose of 10 mg/kg DEX to investigate possible effects of DEX alone. Group 3 served as the control (sciatic nerve injury) and was not given any drugs.Results: Performance was significantly lower in group 3 compared to the drug treatment groups during the rotarod test (30 rpm and 40 rpm) (p < 0.05). After a while, the rats which were able to remain on the rod was significantly lower in group 3 during the acceleration test (p < 0.05). Hot plate latency test results in group 3 were significantly lower when compared to the other groups (p < 0.05).Conclusion: DEX appears to be useful as a supportive clinical agent for the treatment of pain and nerve damage.

Endoscopic Transoral Resection of Tongue Base Ancient Schwannoma.

Schwannoma is a benign slow growing nerve sheath tumor that is typically encapsulated and composed of well-differentiated schwann cells. Schwannomas may take origin from different nerves such as cranial, spinal nerves, and the sympathetic chain. Approximately 25% to 45% of all occur in the head and neck only 1% of them are located in the oral cavity. However, it is quite rare to for schwannomas to form on the tongue base. Ancient schwannoma is the rarest, and also extremely rare in oropharynx. A 32-year-old female patient was admitted to our clinic with complaints of hoarseness, difficulty in swallowing, throat pain, snoring, and dyspnea. In examination, a smooth surfaced circumscribed mass, which originated from the tongue base was observed. In the magnetic resonance imaging, a 4.5 × 3 cm sized tongue base mass which narrowed the upper airway was detected. An endoscopic transoral excisional biopsy was performed. The histopathological diagnosis was determined as ancient schwannoma. The use of the endoscopic transoral approach can be suitable to protect the important anatomical structures, functions, and reduce the complications and esthetic concerns for the resection of tongue base schwannomas.

Protective effects of molsidomine against doxorubicin-induced renal damage in rats.

PURPOSE: The purpose of this study was to investigate the therapeutic and protective effects of molsidomine (MLS) against doxorubicin (DOX)-induced renal damage in rats. METHODS: Forty rats were randomly divided into five groups (control, MLS, DOX, DOX+MLS and MLS+DOX groups). Thiobarbituric acid reactive substance (TBARS), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), nitric oxide (NO) and glutathione peroxidase (GPx) levels were determined from kidney tissues and blood urea nitrogen (BUN), creatinine (Cr) and albumin (Alb) levels also determined. RESULTS: DOX treatment caused a significant increase in TBARS levels and a significant decrease in the GSH and CAT levels compared with the control group. In comparison, MLS administration before DOX injection caused a significant decrease in TBARS levels and also increases in GSH and CAT levels, whereas treatment of MLS after DOX injection did not show any beneficial effect on these parameters. All groups showed a significant increase in NO levels compared to the control group. There were no significant differences among the all groups for BUN and Cr levels. Serum level of Alb decreased in the DOX-treated groups when compared with control and MLS groups. The histopathological findings were in accordance with the biochemical results. MLS treatment reversed the DOX-induced kidney damage in group 4. MLS treatment before DOX injection exerted a protective effect against DOX-induced kidney damage. CONCLUSIONS: MLS shows promise as a possible therapeutic intervention for the prevention of kidney injury associated with DOX treatment. Additional studies are warranted.

Protective effect of sitagliptin against renal ischemia reperfusion injury in rats.

This study was designed to investigate the protective effects of sitagliptin on renal damage induced by renal ischemia reperfusion (I/R) in rats. For this, rats were randomly divided into four groups (n = 8): (1) sham group, in which the rats only underwent right nephrectomy; (2) right nephrectomy and left kidney ischemia (1 h) and reperfusion (24 h) group (I/R); (3) 5 mg/kg sitagliptin administrated group, per-oral once a day for two weeks; (4) 5 mg/kg sitagliptin administrated group, per-oral once a day for two weeks before left kidney I/R (n = 8). Sitagliptin-treated rats that underwent renal I/R demonstrated significant decrease in the serum urea nitrogen and creatinine and also, lipid peroxidation, total oxidant status and malondialdehyde level in the renal tissue when compared to the renal I/R group. Additionally, reduced glutathione, glutathione peroxidase, superoxide dismutase, catalase and total antioxidative capacity were significantly increased after renal I/R in sitagliptin-treated rats. Our histopathological findings were in accordance with these biochemical results. In sum, in the current study all of our results indicated that sitagliptin treatment ameliorated renal damage induced by renal I/R in rats.

Protective effect of leflunomide against oxidative intestinal injury in a rodent model of sepsis.

BACKGROUND: Sepsis is defined as an uncontrolled inflammatory response in a host. The process may lead to severe sepsis, multisystem organ failure and even death. Leflunomide has important immunomodulatory and anti-inflammatory effects, which may mitigate host response to bacterial translocation. The goal of our study was to measure the effects leflunomide administration had on a variety of biochemical markers upregulated in systemic inflammatory response syndrome, sepsis, and multiple organ failure syndrome. MATERIALS AND METHODS: Wistar albino type rats were randomly divided into five groups: control, sham, leflunomide, sepsis, and sepsis + leflunomide. Sepsis was achieved by means of the cecal ligation and puncture method. Leflunomide 2 × 10 mg/kg/d was administered before the experiment. At the end of 24 h, the tissue levels of superoxide dismutase, catalase activity, malondialdehyde, nitric oxide, and protein carbonyl were measured. RESULTS: The level of the bowel superoxide dismutase and catalase levels of the sepsis group is significantly lower than those of the control, sham, and leflunomide groups (P < 0.05). Malondialdehyde, nitric oxide, and protein carbonyl levels are significantly higher in sepsis compared with other groups (P < 0.05). CONCLUSIONS: Leflunomide's prevention of protein and lipid peroxidation was observed in septic bowel tissue. Use of leflunomide could have protective effects against both the onset and the progressive stages of sepsis.

Surgical management of immature teratoma involving the oral cavity and orbit in a neonate.

Teratomas are congenital germ cell tumors composed of elements from 1 or more of the embryonic germ layers and contain tissues usually foreign to the anatomic site of origin. In the head and neck region, these lesions are rare, and 90% of head and neck teratomas present during the neonatal and infantile periods. Besides, in neonates, it carries serious risk for respiratory distress as well as feeding problems due to oral cavity and airway obstruction.Here, an unusual case of intraoral teratoma involving the orbit in a newborn who underwent immediate surgical excision successfully is described.

Rare Cause of Hematochezia in Children: Solitary Rectal Ulcer, Single Center Experience.

Background/Aims: Solitary rectal ulcer syndrome (SRUS) can be overlooked, diagnosed late, or misdiagnosed, particularly in childhood. This study reviewed the 13-year experience of the authors' institution to increase clinicians' awareness of SRUS in the presence of symptoms. This paper reports the endoscopic and histopathological findings in children presenting with hematochezia. Methods: The clinical and laboratory findings of 22 patients diagnosed with biopsy-proven SRUS in the authors' clinic between 2007 and 2020 were evaluated retrospectively. Results: The mean age at diagnosis was 12.5±2.6 years, and 59.1% of the patients were male. The median time of diagnosis was 24 months. A single ulcer lesion was found by colonoscopy in 18 patients (81.8%), two ulcers in two patients (9%), and more than two ulcers in two patients (9%). The pathology reports of all biopsies taken from the lesions were consistent with a solitary rectal ulcer. In the first stage, the treatment was started with toilet training, a high-fiber diet, and laxatives. In 11 patients (50%) who did not respond to the initial treatment, a 5-ASA enema was added. A glucocorticoid enema was added to treatment in five patients (22%) whose complaints did not regress despite this treatment. Clinical remission was achieved in five of the patients (18.1%). The time to diagnosis was significantly shorter in those in remission than those not in remission (p=0.04). Conclusions: This study is the first large series on Turkish children. An increased awareness of SRUS in children will increase the rate of early diagnosis and treatment, allowing remission in more patients.

Follicular dendritic cell sarcoma associated with hyaline-vascular Castleman's disease.

Follicular dendritic cell sarcoma (FDCS) of the head and neck region, associated with Castleman's disease (CD), is an extremely rare entity. To the best of our knowledge, we report the first case demonstrating the transformation of the former into the latter as documented in the same lymph node disection material. A 45-year-old female presented to our hospital with right sided neck swelling. Radiologic imaging showed a well defined 3.5 x 3.5 cm mass of soft tissue at the right side of the neck with multiple bilateral cervical lymph nodes. Excision of the right neck mass with lymph node disection was performed. Microscopic examination and immunohistochemical findings showed features of follicular dendritic cell sarcoma. The associated lymph nodes exhibited changes consistent with hyaline-vascular type CD, follicular dendritic cell hyperplasia and foci of overgrowth in which FDCS possibly evolved. This report confirms the evolving of FDCS in the setting of follicular dendritic cell hyperplasia occurring in Castleman's disease.

Fingolimod induced fulminant liver failure requiring liver transplantation: A case report.

Fingolimod has been used for about ten years to treat multiple recurrent sclerosis. It has been reported that Fingolimod causes an elevation in liver enzymes. In this case report, the clinical and laboratory parameters improved after discontinuation of the drug. However, there is no publication in the literature regarding acute liver failure and liver transplantation following Fingolimod treatment. In this article, we presented a 33 - year - old female patient who developed acute liver failure and underwent liver transplantation after Fingolimod treatment for recurrent multiple sclerosis.

Parameters Predicting Microvascular Invasion and Poor Differentiation in Hepatocellular Carcinoma Patients with Normal Alpha-fetoprotein Level Before Liver Transplantation.

BACKGROUND/AIMS: The aim of this study is to evaluate the parameters that might be associated with pathologically diagnosed microvascular invasion and poor differentiation, using complete blood count and routine clinical biochemistry test results, in hepatocellular carcinoma patients before liver transplantation. MATERIALS AND METHODS: The data of patients who underwent liver transplantation for hepatocellular carcinoma at our institute, between March 2006 and November 2021, was researched retrospectively. RESULTS: The incidence of microvascular invasion was 28.6%, poor differentiation rate was 9.3%, hepatocellular carcinoma recurrence rate after liver transplantation was 12.1%, and median time to recurrence was 13 months, in the patients with normal alpha-fetoprotein levels. After univariate and multivariate analysis, maximum tumor diameter >4.5 cm and the number of nodules (n > 5) were found to be independent risk factors for microvascular invasion, and number of nodules >4 and mean platelet volume ≤8.6 fL were found to be independent risk factors for poor differentiation. Serum alpha-fetoprotein levels were still within the normal range at the recurrence time, in 53% of the patients who had recurrence after liver transplantation, but surprisingly were elevated in 47% of the patients at time of hepatocellular carcinoma recurrence. CONCLUSIONS: In hepatocellular carcinoma patients with normal alpha-fetoprotein levels before liver transplantation, independent risk factors of the presence of microvascular invasion were maximum tumor diameter and number of nodules, and independent risk factors of poor differentiation were mean platelet volume and number of nodules. Furthermore, serum alpha-fetoprotein levels were still normal at time of recurrence in 53% of hepatocellular carcinoma patients whose alpha-fetoprotein levels were normal before liver transplantation but were elevated in 47% of the patients at recurrence time, despite having normal levels before liver transplantation.

Metastatic renal cell carcinoma to the condyle of the mandible.

A 59-year-old woman who had left nephrectomy because of renal cell carcinoma (RCC) 3 years ago referred with trismus and a mass on her left temporomandibular joint. Computed tomography scan revealed an expanding lytic lesion on the left condyle of the mandible. Incisional biopsy was carried out. Histopathologic diagnosis was metastatic clear cell variant of RCC. Metastasis of RCC to the condyle of the mandible has not been reported yet. In this study, we presented a case of RCC metastasis to the condyle of the mandible.

Synovial chondromatosis of the temporomandibular joint: radiologic and histopathologic findings.

Synovial chondromatosis is a formation of multiple intrasynovial nodules resembling osteochondromas, resulting from proliferative changes in the synovial linings of joints; as the disorder progresses, nodules increasingly withdraw from the intrasynovial areas for the joint cavities. This is a relatively unusual case that can arise at unilateral large joints, such as knee, hip, and elbow, with the temporomandibular joint being the rarest one of them. Early recognition of the signs and symptoms with resultant accurate diagnosis, as well as proper surgical treatment, offers patients the best hope of recovery and improved quality of life. We report a conventional radiologic film, computed tomography, magnetic resonance imaging, and histopathologic findings of the synovial chondromatosis presenting as a large right preauricular mass arising from the temporomandibular joint without bone destruction.

Cystic adrenal lymphangioma--report of two cases and review of the literature.

Cystic adrenal lymphangiomas are very rare, benign vascular lesions. They are usually found during a work up for abdominal pain or incidentally during imaging studies for an unrelated cause. We report two cases of cystic adrenal lymphangiomas. They presented with flank discomfort, hypertension and flushing. Their laboratory findings were in normal limits. Radiologic imagings showed adrenal cystic neoplasm and the patients underwent adrenelectomy. Histopathologic examination and immunohistochemical findings were consistent with lymphangioma. Cystic lymphangiomas may imitate other adrenal neoplasms and must be kept in mind in the clinical and radiologic differential diagnosis of cystic adrenal lesions.

Hemangiopericytoma like tumor of the nasal cavity: a case report.

Sinonasal hemangiopericytoma originates from vascular pericytes. It may arise in any part of the body but it is an uncommon vascular tumor in the nose. It can show benign or malignant histologic features. Sinonasal hemangiopericytoma like tumor is important as it is recognized as a special variant of hemangiopericytoma. In this article, we present a 65-year-old male patient with hemangiopericytoma like tumor of the nasal cavity.

Management and Survival Analysis of Gastrointestinal Neuroendocrine Tumors by Different Tumor Characteristics: Tertiary Center Experience.

BACKGROUND: Gastrointestinal neuroendocrine tumor (GI-NET) is a group of neoplasia consisting of amine and acid producing cells with different hormonal profiles. Although the entire GIS accounts for about 2% of tumors, recent research reveals that the incidence rate has increased. Given the increasing incidence in GI-NETs, more and more extensive research is needed on this subject. In this regard, the demographic and clinicopathological features of the patients diagnosed with GI-NET and their relationship with survival were investigated in the present study. METHODS: Thirty-four patients diagnosed with GI-NETs between January 2009 and December 2019 at the Department of Gastroenterology, Inonu University Faculty of Medicine were analyzed retrospectively. Gender, age, tumor localization, metastasis status, tumor number, tumor diameter, tumor grade, Ki-67 index, and the relationships of these factors with overall survival were examined. RESULTS: Of the patients, 61.8% included in the study were male and 38.2% were female. The average age of the patients was 60.74 years. The most common tumor location was in the stomach (26.5%) and liver (26.5%). Apart from this, 17.6% of NETs were seen in the pancreas, 11.8% in the colon, 8.8% in the rectum, 5.9% in the small intestine, and 2.9% in the appendix. No significant relationship was observed between tumor location and gender (p = .326) and age (p = .641). The tumor diameter ranged from 0.2 cm to 13.91 cm, but the average tumor diameter was 3.84 cm. Solitary tumor was found in 51.5% of cases and multiple tumors in 48.5% of cases. The most common grade was Grade 1 with 41.2% of occurrence. The average of Ki-67 index was 18.36%. There was metastasis in 52.9% of cases. The rate of medical treatment was 48.5%. The median overall survival time of the patients was 23.1 months. In addition, 1-year overall survival was 74.9%, 2-year overall survival was 44.6%, and 5-year overall survival was 35.7%. A statistically significant difference was found between tumor grade and the presence of metastasis, and the overall survival (p = .003 and p = .005). CONCLUSIONS: The tumor grade and the presence of metastasis in gastrointestinal neuroendocrine tumors were found to be the most important prognostic factors affecting overall survival.

Thymic Seminoma with Regressive Changes Obscured by Granulomatous Reaction.

Primary thymic seminoma is an exceedingly rare tumour. There are few case reports about mediastinal thymic seminoma accompanied by secondary changes. We report a case of a 29-year male admitted to our hospital because of chest pain and dyspnea for 8 months. Computed tomography of the thorax revealed hypodense, solid masses showing calcification and cystic degeneration in the anterior mediastinum. Histopathological examination of the resected specimen revealed a diagnosis of thymic seminoma with regressive and reactive changes. The present case was unique in its presentation as a primary seminoma showing combination of cystic degeneration, follicular hyperplasia, fibrosis, calcification and granulomatous reaction in one case. High level of suspicion is necessary to identify seminomas in a thymic lesion accompanied by secondary changes. Excluding the possibility of metastasis from testicular seminoma is very important before making this diagnosis. Key Words: Thymus, Seminoma, Granuloma, Calcification, Cyst.