Towards Development of a Standard Terminology of the World Health Organization Classification of Tumors of the Central Nervous System in the Turkish Language, and a Perspective on the Practical Implications of the WHO Classification for Low and Middle Income Countries.

In our manuscript, we propose a common terminology in the Turkish language for the newly adopted WHO classification of the CNS tumors, also known as the WHO CNS 5th edition. We also comment on the applicability of this new scheme in low and middle income countries, and warn about further deepening disparities between the global north and the global south. This division, augmented by the recent COVID-19 pandemic, threatens our ability to coordinate efforts worldwide and may create significant disparities in the diagnosis and treatment of cancers between the "haves" and the "have nots".

Combination of infra-red light with nanogold targeting macrophages in the treatment of Leishmania major infected BALB/C mice.

PURPOSE: In the treatment of cutaneous leishmaniasis (CL), developing drug resistance, existing toxic effects of drugs and failure respond to treatment cause the need to try different treatment methods. We investigated the effect of gold-conjugated macrophage-specific antibody on amastigotes under infra-red light for the treatment of CL. METHODS: Female BALB/c (4-8 weeks old, 20 ± 5 g weight) mice were used in the study. The L. major strain was inoculated on the soles of mice in amastigote form and subpassed. Nanogold (Au), Au + macrophage-specific antibody (MSA) modification and near infra-red (NIR) (5 seconds) were applied to mice groups that developed cutaneous leishmaniasis on their soles. On the 5th and 10th days of the treatment, the lesions were examined clinically and pathologically. RESULTS: When the erythema values were examined, the highest decrease was calculated in the Au + MSA + NIR group in the measurements made on the 10th day (p < 0.014). The best improvement in 10th day measurements is in the NIR and Au + MSA + NIR groups when area values were examined (p = 0.011, p = 0.001). There was a statistically significant difference between the groups in terms of parasite load (PL) (p < 0.005) in pathological evaluation. According to PL grouping, the best result is NIR (p = 0.002). When both main titles (clinical and pathological) are examined, the Au + MSA + NIR group is thought to have an optimal therapeutical feature. CONCLUSIONS: Au + MSA + NIR combination could be a new treatment approach for CL treatment.

Antifibrotic Effect of Boric Acid in Rats with Epidural Fibrosis.

BACKGROUND: Epidural fibrosis is a major problem after spine surgery, with some patients having recurrent symptoms secondary to excessive formation of scar tissue resulting in neurologic compression. We used a rat laminectomy model to determine if topical application of boric acid could be helpful in the prevention of epidural fibrosis. METHODS: Rats were randomly assigned to 2 control and 2 experimental groups (n = 8 for each group). The negative control group received no surgery, and the positive control group underwent laminectomy only. Experimental groups were classified according to the study agents applied onto the dura mater after laminectomy at the L3 level: 2.5% boric acid solution and 5% boric acid solution. The extent of epidural fibrosis was assessed 4 weeks later macroscopically and histopathologically. RESULTS: Boric acid reduced epidural fibrosis in rats after laminectomy. The effect of 5% boric acid solution was more pronounced (P < 0.05) compared with the 2.5% solution. CONCLUSIONS: The antifibrotic effect of boric acid solution for the prevention of epidural fibrosis suggests that boric acid should be further evaluated in future studies for the prevention of epidural fibrosis.

Comparison of the Effects of Contractubex Gel and Benzothiazole After Topical Application in an Experimental Model of Epidural Fibrosis in Rats.

BACKGROUND: Postoperative epidural adhesion is a frequent cause of failed back surgery syndrome, manifesting with back and leg pain or neurologic deficits. Development of preventive measures for epidural adhesion after laminectomy is critical to improve outcomes of lumbar surgery. We hypothesized that positive effects of topical application of Contractubex (CTX) gel and benzothiazole (BT) individually and in combination could aid in preventing epidural fibrosis in a rat laminectomy model. METHODS: Rats were randomly assigned to 2 control and 5 experimental groups (n = 8 for each group). The control(-) group received no surgery, whereas the control(+) group underwent laminectomy without any drug administration. In experimental groups, study agents applied to dura mater after laminectomy were 100mgCTX, 2.5%BT, 5%BT; 100mgCTXplus2.5%BT, and 100mgCTXplus5%BT. Laminectomy was performed at the L3 level for all rats. The extent of epidural fibrosis was assessed 4 weeks later macroscopically and histopathologically. Hepatic and renal toxicity of study drugs was assessed histopathologically. RESULTS: Topical CTX and BT individually and in combination reduced epidural fibrosis after laminectomy in rats. Although a meaningful decrease of epidural fibrosis with individual application of CTX and BT (2.5% or 5%) was obtained (P < 0.05), the effect of their combination was more pronounced without meaningful hepatic and renal toxicity (P < 0.05). CONCLUSIONS: Combined use of topical CTX and BT could be a potential therapy for epidural fibrosis. Further research with this agents for the prevention of epidural fibrosis is warranted.

Chordoid Meningioma - A Case Report: Clinicopathological Features and Differential Diagnosis of an Uncommon Tumor.

Meningiomas are tumors that originate from the arachnoid cell and the majority are benign and grade I tumors according to World Health Organization. Chordoid meningioma is an uncommon variant of meningioma and corresponds to grade II tumor in the World Health Organization Classification of Tumors of the Nervous System 2007 because of its more aggressive behavior and increased likelihood of recurrence. A 75-year-old female was referred to the neurosurgery department complaining of headache, syncope, and seizure. Radiological examination revealed a mass lesion in the neighbourhood of the frontal lobe that destructed bone and was associated with peritumoral edema. The patient underwent surgery. The tumor was totally excised with the dura beneath. Histopathological examination showed that the tumor was composed of clusters and cords of small polygonal cells with fine chromatin and eosinophilic vacuolated cytoplasm embedded in a myxoid matrix, and also focal whorls of spindle-shaped cells. Two mitoses were seen in 10 high power fields. Vascular proliferation was observed in some tumoral areas. Bone invasion was present. Immunohistochemical analysis of the tumor cells revealed widespread strong membranous and cytoplasmic expression of epithelial membrane antigen. The Ki67 labeling index was 6-8%. All of these findings were consistent with a diagnosis of chordoid meningioma, the neoplasm was identified as grade II based on the World Health Organization Classification, 2007. In this report we present a case of chordoid meningioma without classical radiological findings of meningioma with areas of vascular proliferation that mimicked glial tumors at histopathologic examination.

Well-differentiated abdominal liposarcoma: experience of a tertiary care center.

BACKGROUND: We presented abdominal liposarcoma cases diagnosed and managed in a tertiary care center and also conducted a literature review on main features of this tumor. METHODS: Chart reviews of eight cases were conducted, and clinical, surgical, histopathological, and follow-up data were recorded. RESULTS: Overall, complete surgical resection was performed with adjacent organ resection in 25% of cases, and radiotherapy was not administered. Recurrence was developed in only one case and died after 2 years and 3 months, and other cases are under follow-up without recurrence. Histopatological examinations revealed findings of well-differentiated liposarcoma. CONCLUSIONS: According to our surgical experience, the surgical margin positivity may not be a determining factor for the survival of patients with well-differentiated liposarcoma, and in the absence of macroscopic invasion, adjacent organ resection may not be required. Radiotherapy may not be preferred when complete resection of abdominal mass was achieved.

Β-catenin expression in in situ and infiltrative ductal carcinomas of the breast.

OBJECTIVE: Cascades that include ß-catenin that has a function in adhesion and interaction with tumor suppressor genes such as APC have important roles in many neoplasms. The aim of the current study was to confirm the effect of the ß-catenin pathway in breast tumor carcinogenesis and invasion. MATERIAL AND METHOD: Polyclonal rabbit ß-catenin antibody was applied to 52 cases of infiltrative ductal carcinoma and 28 cases of ductal carcinoma in situ using the Avidin Biotin complex immune peroxidase method. The intensity and cellular localization of immunostaining were evaluated and compared. RESULTS: ß-catenin immunoreactivity similar to that of normal epithelium was observed in 7 (8.75%) cases and weak or absent ß-catenin expression was noted in 45 (56.25%) infiltrative ductal carcinoma cases. ß-catenin expression was strong in 5 (6.25%) cases of ductal carcinoma in situ but weak or absent immunostaining was observed in 23 (28.75%) cases. Membranous ß-catenin immunoreactivity was observed in 18 (22.5%) cases of infiltrative and 14 (%17.5) cases of ductal carcinoma in situ. Cytoplasmic immunostaining or complete absence of staining was noted in 34 (42.5%) cases of infiltrative and 14 (17.5%) cases of ductal carcinoma in situ. CONCLUSION: Similar quantitative and qualitative changes in ß-catenin expression were detected in a considerable proportion of in situ and infiltrative ductal carcinomas in the current study. These findings suggest that ß-catenin plays a role in the carcinogenesis of infiltrative ductal carcinoma but similar expression patterns of ß-catenin in infiltrative and in situ ductal carcinomas indicates that changes in ß-catenin expression occur early in carcinogenesis.

Evaluation of urinary bladder function after acute spinal cord injury: an experimental study.

OBJECTIVES: The aim of this study was to evaluate the efficacy of early surgical decompression of acute spinal cord injury through the evaluation of urinary bladder function in rabbits. MATERIALS AND METHODS: The study was done with 21 New Zealand male rabbits which were 9 to 12 months in age, and weighed an average of 2438 grams (range 2150 to 3550 g). The animals were assigned into four groups as follows: a control group (n=5), a laminectomy group (n=6), a 15-second compression group (n=5) and a 60-second compression group (n=5). A 60 gram compression force was applied on both compression groups with aneurysm clips. All rabbits were sacrificed seven days postoperatively. Urinary bladder tissues were dissected and in vitro relaxation and contraction tests were performed in organ baths. RESULTS: At the beginning of each experiment, 80 mM KCl was added to the isolated organ bath with no significant difference among all four groups (p>0.05). Carbachol was then added to the organ bath and contraction responses were obtained. Carbachol contraction responses were calculated as the percentage of the 80 mM KCl contraction responses, with compression groups showing significant difference from control and sham-operated groups (p<0.05). Electrical field stimulation responses were obtained for all group preparations at 4, 8, 16, 32 Hz frequencies, and showed significant difference in the 15 and 60-second compression groups (p<0.05). The contractility was assessed using E-max and pD2 values. All groups exhibited same pD2 values. CONCLUSION: The study demonstrated a slightly better outcome for bladder contractility with early decompression. However, there was no significant difference between early and delayed decompression groups.

The intratumoral microvessel density and expression of bFGF and nm23-H1 in colorectal cancer.

It has previously been reported that intratumoral microvessel density (IMD), and the expression of bFGF and nm23-H1 are useful prognostic markers in colorectal cancer (CRC). In this study, a total of 100 CRCs were evaluated histopathologically, and IMD, bFGF and nm23-H1 expression were assessed by immunohistochemistry. IMD of patients increased with grade and stage, and this increase was statistically significant (p<0.05). A significantly higher incidence of high bFGF expression scores was also associated with increasing grade and stage (p<0.05). However, there was no significant difference between the grades in nm23-H1 expression (p=0.234). nm23-H1 expression occurred with lower incidence in stages C1, C2 and D than in stages B1 and B2 (p<0.05). Thus, a negative correlation was found between nm23-H1 expression and stage or lymph node metastasis (LNM) (p<0.05). IMD and bFGF expression were positively correlated with grade, stage, LNM, and lymphovascular invasion. Although positive correlation was found between IMD and bFGF, nm23-H1 expression negatively correlated with both of them. As a result, in clinical practice, increased IMD and bFGF expression and decreased nm23-H1 expression may provide valuable information in characterizing the malignant phenotype.

Interobserver variation in histopathological assessment of Helicobacter pylori gastritis.

AIM: Because the presence or absence of H pylori infection has important implications for therapeutic decisions based on histological assessment, the reproducibility of Sydney system is important. The study was designed to test the reproducibility of features of Helicobacter pylori gastritis, using the updated Sydney classification. METHODS: Gastric biopsies of 40 randomly selected cases of H pylori gastritis were scored semiquantitatively by three pathologists. Variables analysed included chronic inflammation, inflammatory activity, atrophy, intestinal metaplasia, H pylori, surface epithelial damage. Kappa values below 0.5 represented poor, those between 0.5 and 0.75 good and values over 0.75 excellent interobserver agreement. RESULTS: The best interobserver agreement (kappa=0.62) was present for intestinal metaplasia. The agreement was the poorest for evaluating atrophy (kappa=0.31). CONCLUSION: Although the results of this study were in accordance with some previous studies, an excellent agreement could not be reached for any features of H pylori gastritis. This low degree of concordance is assumed to be due to the personal evaluation differences in grading the features, the lack of standardized diagnostic criteria, and the ignorance to reach a consensus about the methods to be used in grading the features of H pylori gastritis before initiating the study.

Subcutaneous undifferentiated sarcoma induced by N'-ethyl-N'-nitrosourea in rat: radiology, histopathology and mutagenesis.

The aim of the present study was to investigate high dose and long-term effects of a common industrial agent, N'-ethyl-N'-nitrosourea (ENU), on soft tissues in a rat model. ENU, which was dissolved in polyethyleneglycol (PEG) was injected intra-peritoneally once a week (300 mg/kg) in the first experimental group. The second group received only PEG. The control group was free of any agent administration. Only rats treated with ENU for a period of 45 weeks developed large subcutaneous tumours (approximately 5-9 cm in size). Tumoral tissues were examined radiologically, histopathologically and immunohistochemically. There was no bone destruction beneath the soft tumoral tissues in direct X radiograms. Computed tomographic (CT) images showed heterogeneous soft tissue masses with a density ranging from 50 to 65 HU. Macroscopically, all tumors were circumscribed with a gray-white surface in the cross-sections. The histopathological and immunohistochemical examination of the subcutaneous tumoral tissues showed a spindle cell type of sarcoma. Lymphatic and skeletal muscle invasion, atypical mitoses and necroses were determined in all tumoral tissues in the experimental group. A somatic point mutation was detected in exon 2 of KRAS oncogene in sarcoma tissues using the single strand conformational polymorphism (SSCP) analysis. In conclusion, the activated KRAS oncogene might contribute to the progression of subcutaneous sarcoma in experimentally ENU induced rats due to point mutation.

Bcl-2, iNOS, p53 and PCNA expression in normal, disordered proliferative, hyperplastic and malignant endometrium.

We attempted to determine Bcl-2, inducible nitric oxide synthase (iNOS), p53 and proliferating cell nuclear antigen (PCNA) expression, and the relationships between them, in endometrioid adenocarcinomas and precursor lesions. Expression of Bcl-2, iNOS, p53 and PCNA were investigated immunohistochemically in 91 samples from benign (proliferative (pEM), secretory (sEM), disordered proliferative (dEM), inactive/atrophic (aEM), hyperplastic endometrium) and malignant endometrial tissue. Staining scores for Bcl-2 in the dEM, endometrial hyperplasia (EMH) and endometrioid cancer (ECA) groups were higher than in the pEM group (P = 0.004; P = 0.036 and P = 0.020, respectively). A significant difference in proliferating cell nuclear antigen staining was found between simple and complex EMH samples (P = 0.000). An inverse relationship was found between iNOS and p53 in the hyperplasia group (r = -0.533, P = 0.019). While a significant difference was found in p53 staining in ECA between the pEM, dEM and EMH groups, no such difference was found in iNOS staining. In addition, there was no direct relationship between iNOS and p53 in the ECA group. It was concluded that the interaction between iNOS, p53 and Bcl-2 in proliferative processes in the development of type 1 endometrioid adenocarcinomas is different from that in tumors originating in other organs.