Intranodal palisaded myofibroblastoma; a case report and review of the literature.

Intranodal palisaded myofibroblastoma (IPM) also called as intranodal hemorrhagic spindle cell tumor with amianthoid fibers is a distinctive and rare mesenchymal neoplasm of lymph nodes. This entity generally misdiagnosed as intranodal Kaposi's sarcoma or schwannoma in past. In contrast to Kaposi's sarcoma, it behaves in a benign fashion and does not need any further therapy except total surgical resection of the mass. This neoplasm has a great predilection for the inguinal region. The lesion presents typically as a unilateral, painless, solitary mass. To our knowledge, approximately 53 cases of IPM have been reported in the English-language literature. We present a 43-year-old-male patient with IPM and discuss histological, immunohistochemical features and pathogenesis of this rare benign neoplasm.

Experimentally induced acute sinusitis and efficacy of vitamin A.

CONCLUSIONS: Although antibiotics are the mainstays for treatment of sinusitis, they do not specifically treat tissue damage due to free radicals. We propose that antioxidant, anti-infective, immunomodulator vitamin A may be a useful addition in the management of sinusitis. OBJECTIVES: Acute sinusitis is one of the most common diseases in humans. Vitamin A is a fat-soluble vitamin and essential for immunity, cellular differentiation, and maintenance of respiratory and gastrointestinal epithelial surfaces, growth, reproduction, and vision. The objective of this study was to investigate the therapeutic role of vitamin A on healing of acute sinusitis. MATERIALS AND METHODS: This was a prospective controlled animal trial. Experimental sinusitis was induced by blocking the right nose and inoculating Streptococcus pneumoniae into the right maxillary sinuses. Left maxillary sinuses were used as controls. Rabbits were divided in to two groups. At 48 h after inoculation, group I received only parenteral ampicillin-sulbactam (50 mg/kg), group II was treated with parenteral ampicillin-sulbactam (50 mg/kg) and parenteral a dose of 100,000 IU vitamin A in palmitate form. All animals were sacrificed on the 10th day. Mucosal samples were excised from the infected and control sinuses for histopathologic examination, for measurement of activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT), and for evaluation of levels of malondialdehyde (MDA) and nitric oxide (NO). RESULTS: All the infected sinuses displayed signs of inflammation, but there was no statistically significant difference between the study and control groups. In our study, epithelial integrity as well as NO and MDA levels were better in the group receiving both antibiotic and vitamin A than the group receiving antibiotic alone. Nevertheless, SOD activity was significantly increased in the group receiving only antibiotics, compared with the control mucosal SOD activity. There was no difference between the groups as regards CAT and GSH activity.

Adenocarcinoma originating from a mature teratoma of the testis.

Malignant transformation in testicular teratomas has been reported very rarely in the literature. Although testicular teratomas in childhood are regarded as benign neoplasms, these tumors, if left untreated until advanced ages, may present the risk of malignant transformation. We report a case of differentiated adenocarcinoma originating from colonic glands in primary testicular teratoma.

Effect of chronic prostatitis on angiogenic activity and serum prostate specific antigen level in benign prostatic hyperplasia.

The aim of this study was to evaluate the effect of chronic inflammatory pathology on the angiogenic activity in benign prostatic hyperplasia (BPH). Besides the presence of a relationship between serum prostate specific antigen (PSA) values and microvessel density (mvd), the intensity and extent (widespread or focal) of tissue PSA expression was also examined. The distribution of 30 cases according to the diagnosis groups was as follows: group 1, nine cases with prostatic adenocarcinoma; group 2, 10 cases with BPH and chronic prostatitis; group 3, 11 cases with BPH. The biopsy materials obtained by tru-cut biopsy (five cases) and transurethral resection (25 cases) were evaluated retrospectively. The evaluation of angiogenesis was made by CD34 immune marker, while the analysis of immunohistochemical tissue PSA expression was verified by PSA immune marker. Serum PSA levels and other clinical parameters were obtained from the clinical files of the patients. The mean age of the patients was 68 +/- 3 years (range, 48-83 years). The difference between the mean mvd values of the groups was statistically significant (chi2 = 10.492, p = 0.005). Group 1 showed higher mean mvd value than the other two groups. Although group 2 showed higher mean mvd value than group 3, the difference was not statistically significant (p = 0.863). There was no correlation between the mean mvd and serum PSA levels in any group. The intensity of PSA expression in prostate specimens was different in all groups. Maximum cases in group 3 showed high tissue PSA expression (chi2 = 12.442, p = 0.014). In group 1, there was a significant relationship between the intensity of PSA expression and the mean mvd (U = 1, p = 0.032). In group 2, a statistically significant correlation was noted between the mean serum PSA levels and the widespread occurrence of PSA expression (U = 0, p = 0.017). In the present study, we determined that chronic prostatitis had no effect on mvd in BPH cases. The correlation between tissue PSA expression and mvd was contradictory to the reports in the literature. Analyses in larger series are needed to prove the presence of a probable effect of chronic prostatitis on angiogenesis.

[Combination of microfracture and periosteal transplantation techniques for the treatment of full-thickness cartilage defects]. / Tam kalinlikta kikirdak defektlerinin tedavisinde mikrokirik ve periost transplantasyon tekniklerinin birlikte kullanimi.

OBJECTIVES: Microfracture and periosteal transplantation techniques were combined in order to enhance the quality of repair for the treatment of full-thickness cartilage defects. METHODS: In 40 mature New Zealand white rabbits, a full-thickness cartilage defect of 4 mm was induced on the weight-bearing surfaces of the medial condyles of the right femur. The rabbits were randomly divided into four groups equal in size. Control animals remained untreated following defect induction. Two groups were either treated with periosteal transplantation or the microfracture technique, while the fourth group underwent combination of the two techniques. All the animals were immobilized for two weeks postoperatively. At the end of 12 weeks, the animals were sacrificed and the specimens were removed for evaluation according to the criteria of the ICRS scale (International Cartilage Repair Society), and with respect to newly regenerated cartilage areas and the number of viable chondrocytes. RESULTS: Specimens treated with the combination of the two techniques exhibited significant differences from the other groups in all criteria of the ICRS scale (surface, matrix, cellular distribution, cell viability, and cartilage mineralization) except for subchondral bone criteria. In addition, the mean number of viable chondrocytes and newly regenerated cartilage areas were the highest in this group (p=0.0001). CONCLUSION: Due to markedly improved quality of repair, the combination of the microfracture and periosteal flap techniques seems to be more effective than either of the techniques used alone in the treatment of cartilage defects.

Effect of n-butyl-2-cyanoacrylate on high-risk colonic anastomoses.

We investigated the effect of n-butyl-2-cyanoacrylate (BCA) on colonic anastomosis under clean contaminated procedure (CCP) and bacterial peritonitis (BP) conditions in rats. Male Wistar albino rats (n = 80) were divided into two groups: CCP and BP. In the CCP group, colonic resection and anastomosis were performed. BP was induced by cecal ligation and puncture. BCA was administered to the anastomosis in half of the rats in both groups. Anastomotic assessment was done on postoperative days 3 and 7 by evaluating the burst pressure, and gross anastomotic and histopathologic healing indices. The presence and severity of adhesion formation was also investigated. There were no differences in terms of gross healing parameters on days 3 and 7. Burst pressures were also similar on both days (p = 0.244 and p = 0.101, respectively). In the early phase (day 3), adhesion development (p < 0.001), granulocytic cell infiltration (p = 0.02), inflammation (p = 0.019) and necrosis (p = 0.019) were higher in the BCA groups. Mononuclear cell infiltration (p = 0.659), fibroblastic cell infiltration (p = 0.538) and capillary formation (p = 0.316) were similar. In the late phase (day 7), adhesion development (p < 0.001), necrosis (p = 0.001) and granulocytic cell infiltration (p = 0.034) were higher in the treatment groups. Fibroblastic cell infiltration (p = 0.017) and capillary formation (p = 0.016) were lower in BCA treated rats, particularly in the BP condition. Mononuclear cell infiltration did not differ (p = 0.176). The application of BCA did not provide any benefit under either CCP or BP conditions. Moreover, BCA caused increased inflammatory reactions, necrosis and adhesion formation. During the late phase of healing, the ongoing enhanced inflammation caused a reduction in capillary formation and fibroblastic infiltration, particularly under BP conditions.

Effects of calcitonin and alendronate on distraction osteogenesis.

In this experimental animal study the effects of calcitonin and alendronate on distraction osteogenesis are investigated. Forty-five mature female New Zealand type rabbits were used. Rabbits were randomized into three groups, each consisting of 15 animals. Under optimal operating conditions a pre-reconstructed circular external fixator was applied to the right tibia of rabbits, and osteotomy was performed with a Gigli saw just below the tibial tuberosity. During the ten days of distraction, a placebo was administered for group I (control group), group II received 10 U of calcitonin, and group III was treated with alendronate (0.5 mg/kg/day) gavages. Rabbits were examined histologically (at the third and eighth weeks, according to Huddlestone et al.), radiologically (at the third, sixth, and eighth weeks, according to Lane and Sandhu), and mechanically (at the eighth week, as torsional loading). During the first three weeks, the groups did not differ much with regard to radiological parameters. However, in the calcitonin and alendronate groups improved histological scores were detected compared with the control group. Radiological images obtained at the end of six weeks demonstrated improved consolidation in the calcitonin and alendronate groups compared with the control group. At the end of eight weeks postoperatively, radiological and histological parameters did not differ among the groups, while torsional failure load was found to be much improved in the calcitonin group (p=0.006). During the distraction osteogenesis period, calcitonin and alendronate affected the quality of regenerate favourably. This effect is sustained until the end of the consolidation period. However, this finding needs to be supported by experimental and human studies.