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AIMS: Hepatocellular adenoma (HCA) is an uncommon liver neoplasm, and studies of HCA subtypes have been primarily limited to France, the USA, and Japan. The aim of this study was to describe the clinicopathological features of HCA subtypes in Turkey. METHODS AND RESULTS: The resection specimens of 59 cases diagnosed as 'hepatocellular adenoma' collected from 15 institutions were reviewed to confirm the diagnosis and to classify them according to the current World Health Organization 2019 classification. Immunostaining for glutamine synthetase, liver fatty acid-binding protein, C-reactive protein, ß-catenin and reticulin was performed. Of the 59 cases, 48 (81%) were diagnosed as HCA. We identified 24 (50%) hepatocyte nuclear factor 1α (HNF1α)-inactivated HCAs, five (10%) inflammatory HCAs, 15 (32%) ß-catenin-activated HCAs, three (6%) ß-catenin-activated inflammatory HCAs, and one (2%) unclassified HCA. HCA patients were predominantly female (female/male ratio of 5:1); they had a median age of 34 years and a median tumour diameter of 60 mm. In the ß-catenin-activated HCA group, nine cases (19%) showed cytoarchitectural atypia, and were also referred to as atypical hepatocellular neoplasms. In the ß-catenin-activated HCA group, three cases (6%) showed focal areas supportive of transition to HCA. The original diagnosis of HCA was changed to well-differentiated hepatocellular carcinoma in nine cases and to focal nodular hyperplasia in two cases. CONCLUSION: In our series, the major HCA subtype was HNF1α-inactivated HCA. We found a low incidence of inflammatory-type HCA. Our data also showed that ß-catenin-activated hepatocellular neoplasms, including cases with atypical histology, constituted a relatively high proportion of the cases. These findings are in contrast to those of most other studies of HCA subtypes.
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Adenoma de Células Hepáticas/clasificación , Adenoma de Células Hepáticas/patología , Neoplasias Hepáticas/clasificación , Neoplasias Hepáticas/patología , Adolescente , Adulto , Anciano , Biomarcadores de Tumor/análisis , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Turquía , Organización Mundial de la Salud , Adulto JovenRESUMEN
The hepatocellular carcinoma (HCC) tumor marker alpha-fetoprotein (AFP) is only elevated in about half of the HCC patients, limiting its usefulness in following the effects of therapy or screening. New markers are needed. It has been previously noted that the inflammation markers C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR) are prognostically important and may reflect HCC aggressiveness. We therefore examined these 2 markers in a low-AFP HCC cohort and found that for HCCs > 2 cm, both markers significantly rise with an increasing maximum tumor diameter (MTD). We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden index value for each marker, and their area-under-the-curve values for each MTD group. Patients were dichotomized into 2 groups based on the CRP and PLR from the receiver-operating characteristic curve analysis. In the logistic regression models of the 4 different MTD patient groups, CRP and PLR levels were statistically significant to estimate MTD in univariate logistic regression models of MTD groups > 2 cm. CRP and PLR were then combined, and the combination was statistically significant to estimate MTD groups of 3-, 4-, and 5-cm cutoffs. CRP and PLR thus have potential as tumor markers for low-AFP HCC patients, and possibly for screening.
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Biomarcadores de Tumor , Proteína C-Reactiva , Carcinoma Hepatocelular/sangre , Neoplasias Hepáticas/sangre , Recuento de Linfocitos , Recuento de Plaquetas , alfa-Fetoproteínas , Área Bajo la Curva , Proteína C-Reactiva/metabolismo , Carcinoma Hepatocelular/diagnóstico , Humanos , Neoplasias Hepáticas/diagnóstico , Pronóstico , Curva ROC , Análisis de Regresión , Carga Tumoral , alfa-Fetoproteínas/metabolismoRESUMEN
A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and α-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large ≥5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar ≥5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels ≤100 IU/mL (and 42.1% had values ≤20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower hepatitis B virus, hepatitis D virus, cirrhosis, and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups.
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Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/patología , Bilirrubina/sangre , Biomarcadores de Tumor/sangre , Plaquetas/patología , Proteína C-Reactiva/metabolismo , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/metabolismo , Femenino , Humanos , Cirrosis Hepática/sangre , Cirrosis Hepática/metabolismo , Cirrosis Hepática/patología , Pruebas de Función Hepática/métodos , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/metabolismo , Masculino , Persona de Mediana Edad , Vena Porta/patología , Pronóstico , Estudios Prospectivos , Trombocitopenia/sangre , Trombocitopenia/metabolismo , Trombocitopenia/patología , Turquía , Trombosis de la Vena/sangre , Trombosis de la Vena/metabolismo , Trombosis de la Vena/patología , alfa-Fetoproteínas/metabolismoRESUMEN
AIM: The aim of the present study is to investigate the frequency of celiac disease in children with peptic ulcers and to compare it with that of non-celiac peptic ulcers in terms of clinical and laboratory values. METHODS: Upper gastrointestinal endoscopy was performed in 1769 patients at the Department of Pediatric Gastroenterology, The Faculty of Medicine, Cukurova University, Turkey, between January 2012 and January 2017. These cases consisted of subjects presenting with various GIS symptoms and indicated for endoscopy (with chronic diarrhea, delayed growth and development, abdominal pains, GIS bleeding, etc.). The levels of immunoglobulin A (IgA) serum anti-tissue transglutaminase antibodies, IgA anti-endomysial antibodies (EMA), and IgA serum were estimated in the patients with peptic ulcers. RESULTS: Celiac disease was diagnosed with serology, endoscopy, and histopathology in 250 (14%) of all cases undergoing endoscopy. Peptic ulcers were diagnosed in 74 patients (4.2%) of all cases undergoing endoscopy. tTGA and EMA (+) levels were determined in 22 (29%) of the 74 patients with peptic ulcers, and then the presence of peptic ulcers was investigated in the upper gastrointestinal system using gastrointestinal endoscopy, followed by histopathological confirmation of celiac disease. HP infection was present in 14 (63%) of the patients with celiac disease and in 23 (44%) of non-celiac peptic ulcers; the difference was not statistically significant (p = 0.12). In the total ulcer group, 10.8% (8/74) of patients with celiac peptic ulcers were negative for HP infection, whereas 21% (8/37) of HP-negative patients with ulcers had celiac disease. CONCLUSION: There exists a high risk of celiac disease in children with peptic ulcers. We thus recommend celiac disease to be investigated, particularly in HP-negative patients with peptic ulcers but with no history of NSAID use.
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Antiinflamatorios no Esteroideos/efectos adversos , Enfermedad Celíaca , Helicobacter pylori/aislamiento & purificación , Úlcera Péptica , Antiinflamatorios no Esteroideos/uso terapéutico , Autoanticuerpos/sangre , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Enfermedad Celíaca/inmunología , Enfermedad Celíaca/fisiopatología , Niño , Preescolar , Endoscopía Gastrointestinal/métodos , Femenino , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Humanos , Masculino , Úlcera Péptica/diagnóstico , Úlcera Péptica/epidemiología , Úlcera Péptica/inmunología , Úlcera Péptica/fisiopatología , Estudios Retrospectivos , Factores de Riesgo , Turquía/epidemiologíaRESUMEN
We aimed to research whether lycopene (L) could prevent radiation-induced acute esophageal toxicity in Wistar albino rats. 60 rats were placed in five groups as follows: control, L, radiotherapy (RT), L before RT (L + RT), and L before and after RT (L + RT + L). 6 mg/kg bw/day L was administered 7 days in the L group, 7 days before RT in the L + RT group, and 7 days before and after in the L + RT + L group. 35 Gy thoracic RT was performed. Serum L levels were measured, and the esophagi were evaluated histopathologically for intraepithelial degenerative changes-necrosis, vacuole formation, inflammation, regeneration-mitosis, and subepithelial bulla formation. L levels were significantly higher in the L receiving groups. All histopathologic results were significantly worse in the RT group than in the none-RT groups. The L + RT and the L + RT + L groups had better results than the RT group. Grade 2-3 degenerative changes-necrosis and vacuole formation were significantly lesser in the L + RT and the L + RT + L groups than those in the RT group. There was a trend toward decreased subepithelial bulla formation and inflammation in the L + RT and the L + RT + L groups compared to the RT group. Regeneration-mitosis was insignificantly lesser in the L + RT and significantly fewer in the L + RT + L groups than that in the RT group.
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Carotenoides/farmacología , Esofagitis/prevención & control , Traumatismos por Radiación/prevención & control , Animales , Esofagitis/etiología , Esofagitis/patología , Licopeno , Traumatismos por Radiación/patología , Radioterapia/efectos adversos , Ratas WistarRESUMEN
Alpha-linolenic acid is one of the fatty acids known as omega 3. Previous studies have shown the antioxidant and anti-inflammatory effects of alpha-linolenic acid, which prevented cell damage by inhibiting apoptotic pathway. Also, it is known that gentamicin activates apoptotic mediators and causes necrosis in the kidney. Due to this reason, we planned a study to evaluate the protective effects of alpha-linolenic acid on gentamicin induced ototoxicity by evaluating inflammation and apoptotic mediators. For this purpose, 100 mg/kg gentamicin (i.p; intraperitoneally) and 200 mg/kg alpha-linolenic acid (gavage) are administered to mice for 9 days. On 9th and 10th days, rotarod performance was assessed to test the effect of gentamicin and alpha-linolenic acid treatment on the motor coordination of mice. Gentamicin treatment decreased fall latency of mice and gentamicin treatment together with alpha-linolenic acid increased fall latency of mice. Gentamicin treatment also increased expression of phospholipase A2(plA2), cyclooxygenase-2(COX-2) and inducible nitric oxide syntheses (iNOS). Furthermore, it increased Bax and caspase-3, which are proapoptotic proteins and decreased bcl-2 that is an antiapoptotic protein. Gentamicin treatment together alpha-linolenic acid recovered the change of expression of these enzymes. In conclusion, this study showed that alpha-linolenic acid will be useful to prevent gentamicin-induced ototoxicity by inhibiting apoptosis and inflammation.
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Antibacterianos/toxicidad , Antiinflamatorios/uso terapéutico , Apoptosis/efectos de los fármacos , Gentamicinas/toxicidad , Ácido alfa-Linolénico/uso terapéutico , Accidentes por Caídas/prevención & control , Animales , Caspasa 3/metabolismo , Ciclooxigenasa 2/metabolismo , Modelos Animales de Enfermedad , Hipoestesia/inducido químicamente , Hipoestesia/tratamiento farmacológico , Inflamación/inducido químicamente , Inflamación/tratamiento farmacológico , Ratones , Óxido Nítrico Sintasa de Tipo II/metabolismo , Fosfolipasas A2/metabolismo , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Tiempo de Reacción/efectos de los fármacos , Prueba de Desempeño de Rotación con Aceleración Constante , Factores de Tiempo , Proteína X Asociada a bcl-2/metabolismoRESUMEN
OBJECTIVE: The purpose of this experimental study was to evaluate the efficacy of hesperidin (HES) in protecting against methotrexate (MTX)-induced intestinal damage using histopathological and immunohistochemical techniques. MATERIALS AND METHODS: Seventy-eight male Wistar albino rats were divided into 4 groups that received (a) saline only (control group), n = 19; (b) HES only, n = 19; (c) MTX only, n = 19, and (d) MTX plus HES, n = 21. On the first day of the study, a single dose of MTX (20 mg/kg) was administered intraperitoneally to group 3 and 4 rats. The HES (200 mg/kg) was administered by gavage for 5 days. For the MTX plus HES group, HES (200 mg/kg) was administered by gavage for 5 days after MTX treatment. Rats were sacrificed on the 2nd, 4th and 6th day of the study. Tissue samples from the jejunum were taken for histopathological and immunohistochemical analysis. RESULTS: On the 4th day, crypt injury in the MTX plus HES group (1.00 ± 0.00) was less than that in the MTX group (2.00 ± 0.89; p < 0.05). The small intestinal damage score was lower in the MTX plus HES group (6.33 ± 0.82) as compared to the MTX group (8.00 ± 2.37). Inducible nitric oxide synthase and interleukin-8 levels were lower in the MTX plus HES group (65 and 25%, respectively) as compared to the corresponding values of the MTX group (80 and 52.5%, respectively). On the 6th day, the Ki-67 proliferation index in the MTX group (45%) was lower than that in the MTX plus HES group (76.67%) and the control group (p < 0.05). The small intestinal damage score was high in the HES group on the 4th day due to increased cellular infiltration. On the 6th day, the Ki-67 proliferation index rose in parallel with the decrease in cellular infiltration and therefore histopathological scoring. The proliferation-enhancing effect of HES also appeared in healthy rats. CONCLUSION: HES seemed to have a protective effect against MTX-induced intestinal injury.
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Antineoplásicos/efectos adversos , Fármacos Gastrointestinales/farmacología , Hesperidina/farmacología , Mucosa Intestinal/efectos de los fármacos , Metotrexato/efectos adversos , Animales , Hesperidina/administración & dosificación , Interleucina-8/metabolismo , Mucosa Intestinal/patología , Intestino Delgado/efectos de los fármacos , Intestino Delgado/patología , Antígeno Ki-67/metabolismo , Masculino , Óxido Nítrico Sintasa de Tipo II/metabolismo , Peroxidasa/metabolismo , Ratas , Ratas WistarRESUMEN
AIM: Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the gastrointestinal tract. Significant advances have been made in its pathogenesis, diagnosis, and treatment over the past few decades. However, little is known about the occurrence of synchronous or methacronous tumors with other histogenesis in addition to GISTs. The aim of this study was to present a series of 15 patients diagnosed with a second primary neoplasm in addition to GIST. MATERIAL AND METHODS: Patients who were diagnosed with both GIST and other primary neoplasm between January 2010 and December 2019 were included in the study. Demographic, clinicopathologic and immunohistochemical parameters of the patients were analyzed along with the follow-up results RESULTS: This study included 12 men and 3 women with a median age of 68 years (range: 57-83 years). Of the GISTs, 93.3% were localized in the stomach and 73.3% were at very low / low risk category. Of the second primary tumors, 66.6% were in the gastrointestinal tract. Detection of the GIST was synchronous in 9 cases, metachronous in 2 cases and preceded the GIST diagnosis in 4 cases. GIST was incidentally found intra-operatively in 3 of the cases. The mean size of the synchronous GISTs was 20 mm while the most common GIST-associated malignancy was gastric adenocarcinoma. The median follow-up times was 62 months (range: 13-129 months). CONCLUSIONS: The prevalence of secondary malignancies in GIST patients is significantly higher than the healthy population. The high occurrence rate of additional primary tumors in GIST patients has focused the attention of surgeons on this problem. While it is not yet clear if there is a causal association or a common genetic mechanism for the concomitant occurrence of GIST with other malignancies, a closer surveillance of GIST patients is needed due to their proved increased prevalence of a second primary tumor especially during the first year after diagnosis. KEY WORDS: Gastrointestinal stromal tumor, Coexistence, Synchronous malignancy, Second neoplasm, Gastric adenocarcinoma.
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Adenocarcinoma , Neoplasias Gastrointestinales , Tumores del Estroma Gastrointestinal , Neoplasias Primarias Múltiples , Neoplasias Primarias Secundarias , Neoplasias Gástricas , Masculino , Humanos , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Tumores del Estroma Gastrointestinal/epidemiología , Tumores del Estroma Gastrointestinal/cirugía , Tumores del Estroma Gastrointestinal/diagnóstico , Neoplasias Primarias Secundarias/patología , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/epidemiología , Adenocarcinoma/cirugía , Adenocarcinoma/complicaciones , Factores de Riesgo , Neoplasias Gastrointestinales/epidemiología , Neoplasias Gastrointestinales/cirugía , Neoplasias Primarias Múltiples/epidemiología , Neoplasias Primarias Múltiples/cirugíaRESUMEN
BACKGROUND: In colorectal cancer, the investigation of cancer pathogenesis and the determination of the relevant gene and gene pathways is particularly important to provide a basis for treatment-oriented studies. miRNAs which affect gene regulation in the molecular pathogenesis of cancer, have an active role in carcinogenesis. In the literature, miRNA expression levels have been associated with metastasis and prognosis in different cancers. OBJECTIVE: In our study, expression profiling of miRNAs involved in oncogenic and apoptotic pathways in patients with locally advanced colorectal cancer receiving neoadjuvant therapy was performed. METHODS: miRNAs were isolated from three different FFPE tissue samples taken at different times of the same patient (tumor tissue taken at the time of diagnosis, normal tissue samples, and after neoadjuvant therapy). The expression analysis of 84 miRNAs determined by PCR array (Fluidigm, USA) and mediated meta-analysis was performed comparatively to each study and non-cancerous control group. Evaluations were performed with ΔΔCT calculations. RESULTS: As a result of the miRNA PCR array study, in addition to differences were observed in miRNA expression between control and study groups. The potential biomarkers which were hsamiR- 215-5p, hsa-miR-9-59, hsa-miR-193a-5p, hsa-miR-206, hsa-miR-1, hsa-miR-96-5p have been detected for possible treatment resistance, prognosis and predispositions to cancers. CONCLUSION: In patients with colorectal cancer, miRNA expression in the tumoral regions before and after neoadjuvant therapy has represented a variable pattern. It has been shown that miRNA studies can be used to predict the clinical course and response to treatment with differences in expression levels. It has been concluded that specific miRNAs may be candidate biomarkers for colorectal cancer.
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OBJECTIVE: Intraabdominal schwannomas are rare benign tumors. In this study, we aimed to present our clinical experience in patients with intrabdominally located Schwannoma. MATERIAL-METHOD: Patients who received the diagnosis of intrabdominal schwannoma between 2011-2019 were retrospectively examined. Demographic and clinical characteristics, treatment methods, short- and long-term results and immunohistochemical characteristics of the patients were analyzed. RESULTS: A total of 7 patients were included in the study. Four patients were female and three were male. The mean age was 51.5 (31-63) years. The most common clinical presentation was abdominal pain (57.1%). Tumor location was stomach (n=2), pelvic region (n=2), rectum (n=1), retropancreas (n=1), and left juxtadrenal space (n=1). Postoperative wound infection developed in one patient and pancreatic fistula complication was seen in one patient. Re-admissions to the hospital were due to anemia and pleural effusion in two patients. The mean tumor diameter was 6 cm (0.3-13 cm). All patients were S 100 strongly positive Mitoses / 50 HPFs (high power field), <2 Ki67 <3%. The mean follow- up period was 60 months. Currently, 5 patients are being followed without disease, 1 patient survives despite recurrence and 1 patient has died due to non-cancer reasons. CONCLUSION: Intrabdominal schwannomas are rare tumors which most commonly exhibit gastrointestinal involvement. Since these tumors are mostly benign, the long-term prognosis of patients is good. Schwannoma should be kept in mind in the differential diagnosis of intrabdominal masses. Radical resections with high morbidity and mortality should be avoided if preoperative diagnosis is made. KEY WORDS: Abdominal tumor, Mesenchymal tumor, Nerve sheath tumor, Schwannoma.
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Neoplasias Abdominales , Neurilemoma , Neoplasias Pélvicas , Neoplasias Abdominales/diagnóstico , Neoplasias Abdominales/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neurilemoma/diagnóstico , Neurilemoma/cirugía , Neoplasias Pélvicas/diagnóstico , Neoplasias Pélvicas/cirugía , Estudios Retrospectivos , TurquíaRESUMEN
PURPOSE: There are no studies showing PRAME expression in stage II and III colon adenocarcinoma. In this study, we aimed to determine the frequency of PRAME expression and the relationship with survival and clinicopathological data in stage II and III colon adenocarcinoma that need adjuvant therapy. METHODS: Included were 81 patients with stage II and III colon cancer with adjuvant therapy without a second malignancy and systemic inflammatory diseases. RESULTS: A statistically significant relationship was detected between PRAME expression and disease progression and survival (p=0.01 and p=0.003, respectively). Shorter disease-free survival (DFS) and overall survival (OS) were detected in right colon tumors in patients with lymph node metastasis, metastatic lymph node >3, N1 or N2 according to the TNM staging system, with lymphovascular invasion, perineural invasion and PRAME expression (p=0.004, p=0.023, p=0.002, p=0.004, p=0.001, p=0.006, p=0.01, respectively and p=0.009, p=0.037, p=0.001, p=0.004, p=0.003, p=0.004, p=0.006, respectively). In multivariate analysis, it was determined that right colon tumor (HR: 0.488, 95% CI, 0.201-0.998, p=0.049) and PRAME expression (HR: 0.423, 95% CI, 0.170-1.052, p=0.046) were independent risk factors for short DFS. For the OS, only the presence of PRAME expression was determined as an independent risk factor. (HR:0.332, 95%CI, 0.129-0.856, p=0.022). CONCLUSION: PRAME can be a potential target in immunotherapy in colon cancer treatment.
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Antígenos de Neoplasias/metabolismo , Neoplasias del Colon/genética , Melanoma/genética , Estadificación de Neoplasias/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios RetrospectivosRESUMEN
AIM: Primary mesenteric fibromatosis is a rare, locally invasive, non-metastasizing type of intra-abdominal fibromatoses with a very high rate of recurrence. In this study, we aimed to present our surgical approach, tumor characteristics, clinical presentation and long-term follow-up results in cases of primary mesenteric fibromatosis. MATERIAL AND METODS: The data collected from 11 patients who underwent surgery due to primary mesenteric fibromatosis in our clinic between 2010 and 2019 were analyzed retrospectively. RESULTS: Abdominal ipain, abdominal distention, and two patients (18.2%) were operated on with a diagnosis of acute abdomen in the emergency setting due to mechanical bowel obstruction in one patient There were 11 patients in our study. Six patients were female and 5 were male. The mean age was 44.2±15.8 years. Abdominal mass was detected in 5 patients (45.5%) who had complaints of mechanical bowel obstruction such as nausea and vomitingand gastrointestinal perforation in other patient. Mesenteric mass was detected in 3 patients (27.3%) with vague abdominal pain. One patient (9.1%) presented with abdominal pain and swelling of the right leg. After a mean follow-up period of 43.4±28.4 months, only 1 patient (9.1%) had recurrence and required reoperation approximately 80 months after the first operation. One patient (9.1%) died of anastomotic leakage and sepsis in the first 30 days postoperatively, and other patient (9.1%) idied of other reasons 1 year later postoperatively. CONCLUSIONS: Although mesenteric fibromatosis is a benign tumor pathologically, the main principle in the treatment of this tumor which is clinically aggressive and has high recurrence rate is wide surgical resection. Mesenteric fibromatoses have a varied clinical presentation. Radiological imaging methods helps diagnosis and planning the surgical treatment. Immunohistochemical characteristics confirms the diagnosis and differentiates from other similar tumors. KEY WORDS: Desmoid tumor, Fibromatosis, Mesentery, Mesenteric tumor,Mesenteric fibromatosis.
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Fibroma , Fibromatosis Abdominal , Fibromatosis Agresiva , Adulto , Femenino , Fibroma/diagnóstico por imagen , Fibroma/cirugía , Fibromatosis Abdominal/diagnóstico , Fibromatosis Abdominal/cirugía , Humanos , Masculino , Mesenterio/cirugía , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Estudios RetrospectivosRESUMEN
Tularemia is a zoonotic infection caused by Francisella tularensis. Tularemia has several clinical form in humans, including ulceroglandular, pneumonic, oropharyngeal, oculoglandular, and systemic (typhoidal). Tularemia may develop granulomatous and suppurative lesions, especially in the affected regional lymph nodes and various organs. Patients with hepatic involvement typically have elevated transaminase levels, hepatomegaly and rarely jaundice. Histologically, there are typically suppurative microabscesses with occasional surrounding macrophages. Rarely, hepatic granuloma can develop due to tularemia. We present a case of an 8 year-old male residing in a rural village in Turkey, who came to our hospital after having intermittent fever for four months and right upper abdominal pain for two months. Liver had a nodular appearance in liver imaging and liver biopsy were consistent with granulomatous hepatitis. The microagglutination test was positive for tularemia in the patient who was investigated for granulomatous hepatitis etiology. Symptoms and signs improved with tularemia treatment. We present a rare case of hepatic involvement of tularemia in a child. Clinicians should be suspicious of and evaluate for typhoidal tularemia in patients who present with prolonged fever and non-specific systemic symptoms, potentially with associated abdominal pain.
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Granuloma/etiología , Hepatitis/etiología , Tularemia/complicaciones , Animales , Antibacterianos/uso terapéutico , Niño , Francisella tularensis/aislamiento & purificación , Granuloma/diagnóstico , Granuloma/microbiología , Hepatitis/diagnóstico , Hepatitis/microbiología , Humanos , Ganglios Linfáticos/patología , Masculino , Supuración/etiología , Resultado del Tratamiento , Tularemia/diagnóstico , Tularemia/tratamiento farmacológico , Turquía , Ultrasonografía , Zoonosis/complicaciones , Zoonosis/diagnósticoRESUMEN
OBJECTIVE: Cajal cells have been defined as pacemakers in the gastrointestinal tract, and have recently been reported in the urogenital tract. In this study, the effects of experimental obstruction of the vas deferens on Cajal-like cells in rats were investigated. MATERIAL AND METHODS: Ninety rats were divided into study (S), sham-operated (SH) and control (C) groups. The vasa deferentia were removed at the beginning of the study in the C group and in the 1st, 2nd and 3rd months after distal vas deferens ligation in the SH and S groups (S1, S2 and S3 consecutively). The sections stained with c-kit antibody were studied under a light microscope to determine the number and morphology of Cajal-like cells in the submucosal and muscular layers. RESULTS: There were no statistically significant differences between the C, S1 and S2 groups despite a higher mean in S1. The decrease in the mean values for the submucosal and muscular layers in S3 was statistically significant compared to the C group. No morphologically significant difference was detected under a light microscope after obstruction. CONCLUSIONS: The increase in Cajal-like cells in the early phase, although insignificant, might be associated with increased motility to overcome the obstruction, whereas the significant decrease in the late phase might be a sign of disordered motility.
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Conducto Deferente/citología , Conducto Deferente/fisiología , Animales , Ligadura , Masculino , Proteínas Proto-Oncogénicas c-kit/metabolismo , Ratas , Ratas WistarRESUMEN
INTRODUCTION: The aim of the study was to assess the prevalence of Helicobacter pylori (HP) in children with celiac disease (CD) and its relationship with clinical, histopathological, and laboratory parameters. MATERIAL AND METHODS: Two hundred and fifty-six patients with serologically and histopathologically diagnosed CD at the Pediatric Gastroenterology Department, Turkey, from January 2012 to March 2017, were included in the study, as well as 1012 patients with dyspeptic complaints. Biopsies of the duodenum and antrum were taken; the existence of HP and the histological level of damage were studied. HP (+) and HP (-) cases were compared according to age, sex, noted complaints, and clinical and laboratory features. RESULTS: Seventy (27.4%) CD patients and 270 (26.7%) patients with dyspeptic complaints were HP (+). The diagnostic age was higher in HP (+) cases, and diarrhea and abdominal distension were significantly higher. Although hemoglobin, ferritin, vitamin B12, and transferrin saturation were lower in HP (+) cases, the differences were not statistically significant. The serum folate level in the HP (+) group was significantly lower compared to the HP (-) group. CONCLUSIONS: The prevalence of HP was not increased in cases of CD. The CD was diagnosed later in HP (+) cases, distension and diarrhea complaints were more frequent, and folate deficiency was significant.
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Cisplatin is an antineoplastic agent used in the treatment of various types of solid tumors. Despite the dose-dependency of its antineoplastic effect, the high risk for nephrotoxicity frequently precludes the use of higher doses. α-Linolenic acid (ALA), a carboxylic acid having three cis double bonds, is an essential fatty acid required for health and can be acquired via foods that contain ALA or supplementation of foods high in ALA. Previous studies have shown that ALA demonstrates anti-cancer, anti-inflammatory, and anti-oxidative effects. In this study, we show the protective effect of ALA on cisplatin-induced renal toxicity associated with oxidative stress in mice using biochemical parameters. The mice were randomly assigned into four experimental groups. Group 1 (control group) were administered physiological saline solution for 9 days; group 2 (ALA group) received 200 mg/kg alpha-linolenic acid via gavage for 9 days; group 3 (CIS group) received 100 mg/kg intraperitoneal (i.p.) CIS for 9 days; and group 4 (ALA + CIS group) received 100 mg/kg i.p. CIS and followed by ALA 200 mg/kg via gavage for 9 days. Alpha-linolenic acid significantly reduced the expression of myeloperoxidase (MPO), phospholipase A2 (PLA2), cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) in the ALA + CIS group compared to the CIS group. Furthermore, catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) quantities were significantly elevated in the ALA + CIS group when compared to the CIS group. ALA significantly decreased the levels of Bax and cleaved caspase-3, while significantly increasing the level of bcl-2, an anti-apoptotic protein, in the ALA + CIS group than in the CIS group. Finally, histopathological examination in renal tissue showed that the significant edematous damage induced by CIS administration alone was reduced in ALA + CIS group. In conclusion, our findings show that ALA is beneficial to CIS-induced nephrotoxicity in mice via its anti-inflammatory and anti-oxidative effects.
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Gastrointestinal angiodysplasia can be encountered in cases with aortic stenosis, inflammatory gastrointestinal conditions, von Willebrand disease or vascular damage, and degenerative changes. Predisposing factors have been described in four adults with vascular ectasia located in the stomach, duodenum, and the distal esophagus. Here, we report a 2-month-old infant with vascular ectasia in the proximal esophagus and diagnosed by molecular karyotyping. This is the first case of vascular ectasia in the proximal esophagus in a pediatric patient.
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INTRODUCTION: Several markers of systemic inflammation, including blood C-reactive protein, platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) have been identified as independent prognosticators for hepatocellular carcinoma (HCC). METHODS: To attempt to understand the significance of these markers, they were examined in relation to 4 tumour parameters, namely maximum tumour diameter (MTD), tumour multifocality, portal vein thrombosis (PVT) and blood alpha-fetoprotein (AFP) levels. RESULTS: Using linear and logistic regression models, we found that C-reactive protein and PLR on single variables, were statistically significantly related to the tumour parameters. In a logistic regression final model, CRP was significantly related to MTD, AFP and PVT, and the Glasgow Index significantly related to MTD and AFP. Results of the area under the receiver operating characteristic curves (ROC), showed that the areas for PLR and CRP were statistically significant for high versus low MTD and for presence versus absence of PVT. CRP alone was significant for high versus low AFP. CONCLUSIONS: These analyses suggest that the prognostic usefulness of the inflammatory markers PLR and CRP (but not NLR) may be due to their reflection of parameter values for tumour growth and invasiveness.
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BACKGROUND: Chronic liver disorders represent a serious health problem. Nitric oxide (NO) synthesized by inducible nitric oxide synthase (iNOS) can function as an antimicrobial agent able to kill or reduce replication of microorganisms, and plays an important role in immune regulation. This study was undertaken to evaluate the expression of iNOS in chronic viral hepatitis and its relation to histopathology. METHODS: This study included 56 patients with chronic viral hepatitis (38 hepatitis B, 18 hepatitis C). There were 35 men and 21 women with a mean age of 38.6+/-21.731 years. A modified form of the histology activity index (HAI) designed by Ishak and colleagues was used to assess grading and staging of chronic viral hepatitis. The needle biopsy specimens were fixed in 10% formalin and routinely processed. Routine hematoxylin-eosin, periodic acid-Schiff, and reticulin staining, and iNOS immunoperoxidase technique were performed on paraffin-embedded tissues. RESULTS: We demonstrated that all liver samples had a marked iNOS expression, with a diffuse distribution pattern. iNOS consistently labeled mononuclear cells infiltrating portal tracts in all samples. Statistical evaluation of data showed that the iNOS expression correlated with the HAI and fibrosis. Furthermore a correlation between iNOS and severity of disease was detected (r=0.772, p=0.000). CONCLUSIONS: Further investigations are required to determine whether iNOS-related treatment protocols could be useful in reducing disease severity.
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Hepatitis B Crónica/enzimología , Hepatitis C Crónica/enzimología , Hepatocitos/enzimología , Monocitos/enzimología , Óxido Nítrico Sintasa de Tipo II/metabolismo , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Hepatitis B Crónica/patología , Hepatitis C Crónica/patología , Hepatocitos/virología , Humanos , Masculino , Persona de Mediana Edad , Monocitos/virologíaRESUMEN
Although medical education in the Republic of Turkey appears to be relatively new, there is almost 500 years of background development within the Anatolian region. Turkey has faced many difficulties in its past and present times, related to its vast and diverse geography, its crowded population, and the many ethnic groups that constitute its population. As in many other countries throughout the world, medical education in Turkey has recently been debated, reviewed and renewed. This article gives a general overview of the history of medical education and the present situation in Turkish medical schools; the quality and professionalism of medical education within the medical system, from the perspectives of undergraduate, postgraduate and continuing medical education; and an overview of the challenges and opportunities that presently exist.