Laminin receptor 1 expression in premalignant and malignant squamous lesions of the cervix.

Laminin receptor 1 (LAMR) may have a role in the progression of premalignant squamous epithelial lesions to cervical cancer. Therefore, we aimed to investigate the expression of laminin receptor 1 (LAMR) in normal, premalignant, and malignant tissues of the uterine cervix. Paraffin blocks of 129 specimens with the diagnoses of normal cervical tissue (n = 33), cervical intraepithelial neoplasia (CIN) 1 (n = 30), CIN 2 (n = 14), CIN 3 (n = 28), and squamous cell carcinoma (n = 24) were immunohistochemically stained with LAMR antibody and its expression percentage, pattern, and intensity in these tissues were assessed. Compared to the other groups, the nonstaining with LAMR was highest in low grade squamous intraepithelial lesion (LSIL) (p < 0.0001). LAMR expression, which was positive in less than 50% of cells with weak staining, increased significantly between normal cervical epithelium and high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma, as well as between LSIL and HSIL (p < 0.0001). Between LSIL and invasive carcinoma, a significant increment was also observed for weak staining in less than 50% of cells (p < 0.001). LAMR expression, which was positive in more than 50% of cells with strong staining, was significantly higher in normal cervical tissue compared to the other groups (p < 0.0001). Disease progression related gradual increment of LAMR expression from normal cervical epithelium or LSIL towards HSIL or cervical cancer reveals that LAMR may play an important role in the transition from premalignant to malignant state in cervical lesions.

Total Sialic Acid, Antioxidant Enzyme Activities, Trace Elements, and Vitamin Status Before and After Surgery in Women with Uterine Myoma and Endometrial Cancer.

The objective of present study was to examine endometrial tissue Be, As, Cr, Mo, Sr, Ti, Tl, Cu, Co, Se, Zn, Mn, Fe, Cd, Pb, Mg, P, erythrocytes CAT, SOD, GSH-Px, GSH, MDA, serum retinol, cholecalciferol, phylloquinone, TSA, LSA, TOS, and TAS status and to evaluate the relationships between the variables. The study had 110 participants; of these, 50 were women with uterine myoma (UM), 10 were women with endometrial cancer (EC), and 50 were healthy female subjects. In the study, vitamin analyses by HPLC and element analyses were determined using ICP-OES method. It was observed that EC group was significantly lower than healthy group in terms of levels of cholecalciferol (p < 0.05), phylloquinone (p < 0.01), GSH (p < 0.05), Fe (p < 0.05), and had a significant rise in Mg/Fe (p < 0.01) and Zn/Fe (p < 0.05) in preoperative period. UM group had significantly lower retinol (p < 0.05), phylloquinone (p < 0.001), GSH-Px (p < 0.01), GSH (p < 0.01), Cr (p < 0.01), Cu (p < 0.05), Mg (p < 0.01), and Zn (p < 0.01) levels than control group in preoperative period and significantly higher levels of MDA (p < 0.01), TSA (p < 0.01), and LSA (p < 0.01) than control group. It was found that significant associations were observed between Cu-CA 15-3 (r = 0.558, p = 0.016), Mn-CA 15-3 (r = 0.511, p = 0.030), P-CA 15-3(r = - 0.502, p = 0.034) and with UM, also between GSH-CA-125 (r = - 0.825, p = 0.022) and with EC group. The results of correlation analysis observed that concentrations of Cu, Mn, P, and GSH together with CA 15-3 and CA-125 levels might be important for monitoring patients with UM and EC before surgery.

Relationship Between Proliferative Breast Lesions and Breast Cancer Risk Factors.

OBJECTIVE: The prognosis of breast cancer (BC) is determined directly based on the stage of disease at the time of diagnosis. Proliferative breast lesions (PBLs) are an important risk factor for BC development. The risk of developing BC varies according to the presence of extent of proliferation in the breast lesions. We aimed to investigate the effect of BC risk factors on the PBLs in this study. MATERIALS AND METHODS: Patients who visited the surgical clinic of the university during the past 6 years who presented with PBLs with or without atypia by fine/core needle aspiration biopsy were included in this study. The relationship between PBLs and BC risk factors such as the age, mass size, Body Mass index (BMI), smoking, sports activity, BC family history, the use of hormone replacement therapy, number of pregnancies, and the duration of breastfeeding were compared. RESULTS: A total of 74 (96.1%) of all patients were women and three were men. The median age of the patients was 38 (range: 19-74) years; the cut-off value of age was 35.5 years. The mean age of patients with PBL-with atypia (PBL-WA) was higher (p=0.005) in the malignant group based on the final pathology and radiological imaging features (for both, p<0.001). The mean size of the mass was large at 2.53±1.33 (1-6) cm; and the cut-off value of the tumor size was 2.5 cm. The mean size was greater in the PBL-WA patients (p=0.171) in the malignant group based on the final pathology and radiological characteristic (respectively, p=0.004 and p=0.016). The mean BMI was 26.8±4.4 kg/m2 (18.8-35.1) and the cut-off value was 25.4 kg/m2. BMI was greater in the PBL-WA group and in the malignant group based on the final pathology (respectively, p=0.002 and p=0.001). Smoking was positive in 66.2% (n=51) of the patients, and it was high in the PBL-WA patients (p=0.001). The percentage of patients with no sports activity was 63.6% (n=49), while it was 20.8% (n=16) for those with once a week sports activity and 15.6% (n=12) for those with twice a week activity. There was family history of BC in 16.9% (n=13) of all patients. The number of positive cases of family history of BC was greater in the malignant group (p=0.001). Hormone replacement therapy was recorded in 11.7% (n=9) of the patients. The mean numbers of pregnancies (2.1±2.4) and breastfeeding duration (32.5±37.4 months) were low in the benign groups due to the relatively lower average age of the patients. CONCLUSION: Based on our analysis, age is an extremely important aspect for assessing PBLs. The age of the patient was statistically significantly greater in the patients with malignant lesions in all groups. The factors lesion size, BMI, smoking habit, and BC family history were also more frequent in the malignant groups. The rate of sports activity was lower in the malignant groups. Thus, it is necessary to evaluate patients individually when evaluating PBLs. It is recommended to evaluate PBLs together with BC risk factors for the better understanding.

A Rare Case of Secondary Hydatid Cyst: Uterus and Colon Locations in the Same Patient

The aim of the present study was to present a case with secondary hydatid cysts in both uterus and colon. The patient was a 71-year-old female living in Hakkari, Turkey. She was admitted to the Van Yuzuncu Yil University Faculty of Medicine Medical Center with complaints of chronic abdominal and pelvic pain, and swelling in the abdomen. First, the sagittal T2 weighted magnetic rezonance imaging (MR) showed a type-3 cyst hydatid with daughter vesicles located at the posterior of uterus. Later, MR revealed a type-2 cystic lesion with detached membrane adhered to the anterior wall of colon and it was reported to be associated with abdomen. When the previous liver surgery history of the patient was kept in mind, the new finding was suggestive of a secondary cystic hydatid . In conclusion, it is possible to diagnose secondary cystic echinococcosis in patients with a history of primary cyst surgery in liver or any other organ by combining the symptoms and imaging findings.

Ewing's sarcoma of the lung: A rare case.

The Ewing's sarcoma family of tumors (ESFT) incorporates both the wellrecognized primary bone and the extraskeletal soft tissue sarcomas. Primitive neuroectodermal tumors (PNET) and ESFT have a similar neural phenotype and can be considered in the same entity. Here, we will present 28 years old patient with Ewing Sarcoma. Patient was admited chest pain. Chest radiograph showed a suspicious lesion in the left paracardiac area. Computed tomography (CT) scan and positron emission tomography (PET)/CT result were compatible with malignant tumor. The patient was underwent surgical resection as the bronchoscopic result couldn't a malignant finding and pathological finding was detected as Ewing's sarcoma. Ewing's sarcoma should be considered in patients who are very fast growing in the lungs, are properly confined and suspected of malignancy in FDG-PET/CT.

Immunohistochemical evaluation of the effect of acitretin and systemic steroid treatments on Ki-67, Bcl-2, and COX-2 levels in cutaneous lichen planus patients.

BACKGROUND: Lichen planus (LP) is an inflammatory disease that affects skin, hair follicles, mucous membranes, and nails. Ki-67 is an antigen associated with the proliferation of cells in all stages of cell cycle except G0. Bcl-2 is a protooncogene that protects cells from apoptosis. COX-2 is an antiapoptotic protein that increases in inflammation. The infiltration of T cells in LP seems to be responsible in the apoptosis of the basal keratinocytes. OBJECTIVE: The purpose of this study was to investigate the effects of prednisolone and acitretin treatments on Ki-67, Bcl-2, and COX-2 expression and apoptosis in patients with LP and the role of Ki-67, Bcl-2, and COX-2 proteins in LP. METHODS: Fifty-eight patients with clinically and histopathologically diagnosed LP who had not been treated with systemic treatment before and 15 healthy volunteers were evaluated prospectively. Pretreatment and posttreatment biopsies were immunohistochemically stained with Ki-67, Bcl-2, and COX-2. The percentage of the stained cells were calculated and recorded. RESULTS: Although the percentage of staining with Ki-67 and Bcl-2 after treatment with prednisolone and acitretin decreased significantly (P < 0.05) in both groups, there was no significant difference between groups (P > 0.05). COX-2 decreased but was not statistically significant. CONCLUSIONS: With this study in cutaneous lichen planus, prednisolone and acitretin treatments reduced Bcl-2 and Ki-67 levels and did not effect COX-2 levels. It should be clarified whether these results can be obtained with any treatment effective in cutaneous lichen planus.

A comparison of the effects of thymoquinone, silymarin and N-acetylcysteine in an experimental hepatotoxicity.

This study investigated the effects of thymoquinone, silymarin, and N-acetylcysteine in a rat model with carbon tetrachloride (CCl4)-induced hepatotoxicity. Although numerous similar studies are available, we aimed to compare the efficacy of these agents by considering N-acetylcysteine as a reference compound. A total of 50 male Wistar albino rats were randomly designated as 5 groups: Group I, CCl4; group II, thymoquinone and CCl4; group III, silymarin and CCl4; group IV, N-acetylcysteine and CCl4; group V, control group. CCl4 was administered intraperitoneally at a dose of 1.5 mL/kg (a mixture of CCl4: olive oil, 1:2) twice a week. Thymoquinone was administered at a dose of 10 mg/kg, silymarin was administered at a dose of 100 mg/kg, and N-acetylcysteine was administered at a dose of 100 mg/kg by daily intraperitoneal injection. At the end of four weeks, blood and liver tests were analyzed. The results were evaluated statistically via the one-way ANOVA test. A p-value <0.05 was considered statistically significant. Thymoquinone, silymarin, and N-acetylcysteine improved the levels of alanine aminotransferase, tumor necrosis factor-α, platelet-derived growth factor-BB, and interleukin-6, which were increased by CCl4. Thymoquinone and silymarin showed the positive increase in liver glutathione levels. Thymoquinone, silymarin, and N-acetylcysteine improved blood total oxidant status. In the histological examinations of liver tissue, thymoquinone decreased necrosis, and inflammation. The most positive decrease in the α-smooth muscle actin-stained hepatic stellate cell count was only observed with thymoquinone. These findings suggest that thymoquinone, silymarin, and N-acetylcysteine have potential for the treatment of diseases causing liver injury. Among these agents, thymoquinone showed the best results on most of the parameters. Since TQ appears to be at least as effective as SM and NAC in our in-vitro study, we propose that it is time for clinical studies with thymoquinone on hepatotoxicity.

Clinical and histological evaluation of the efficacy of antimicrobial photodynamic therapy used in addition to antibiotic therapy in pericoronitis treatment.

BACKGROUND: Although antimicrobial efficacy of photodynamic therapy has been studied several times, there is no study investigating its efficacy on pericoronitis. This study aimed to determine whether antimicrobial photodynamic therapy combined with antibiotic therapy is clinically and histologically superior to antibiotic therapy alone in pericoronitis treatment. METHODS: Patients (n = 40) with pericoronitis were divided into two groups (20 patients for each) to receive either antibiotic + indocyanine green + 810 nm wavelength diode laser (antimicrobial photodynamic therapy group) or antibiotic alone. Initial biopsy samples were obtained from the affected tissue of the patients at their first presentation to the clinic before any intervention. The second biopsy samples were obtained on the 3rd day of treatment in both groups from the tissue part not biopsied before; tooth extraction was then performed. All tissue samples were histologically examined to assess inflammatory cell response. Patients' pain (using Visual Analogue Scale) and lymphadenopathy (presence or absence) were clinically evaluated in the first 3 days and on the 7th day of treatment. RESULTS: In the antimicrobial photodynamic therapy group, 100% improvement was achieved regarding pain and lymphadenopathy at the end of the 7th day. Comparison of the inflammatory cell scores of the 2nd biopsy samples between the antibiotic alone and antimicrobial photodynamic therapy groups revealed a significant difference in favor of antimicrobial photodynamic therapy group. CONCLUSIONS: Antimicrobial photodynamic therapy combined with antibiotic therapy for pericoronitis treatment was found to be more successful as compared with the antibiotic therapy alone regarding clinical and histological outcomes.

Comparison of Enalapril, Candesartan and Intralesional Triamcinolone in Reducing Hypertrophic Scar Development: An Experimental Study.

BACKGROUND: The purpose of this study was to compare the effects of oral enalapril, an angiotensin-converting enzyme inhibitor (ACE-I), oral candesartan, an angiotensin receptor blocker (ARB), and intralesional corticosteroid treatments in reducing scar formation. METHODS: Twenty male rabbits were divided into five study groups: A (sham), B (control), C (ACE-I), D (ARB) and E (intralesional corticosteroid). The rabbit ear hypertrophic scar model was used. The hypertrophic scars were photographed and analyzed with the program ImageJ quantitatively to determine the degree of collagen fibers. The scar elevation index (SEI) was calculated at the end of the 40th day. Tissue samples were stained with hematoxylin and eosin and Masson's trichrome and examined under light microscopy for the determination of fibroblast number, epithelization, vascularization, inflammation and fibrosis. RESULTS: The SEI was the highest in the control group with the highest number of fibroblasts under the epithelium. In the steroid group, the SEI was significantly lower than both the ACE-I (p: 0.02) and ARB (p: 0.001) groups. The density of type 1 collagen fibers was the lowest in the control group, whereas type 3 collagen fibers were highest in that group. The ACE-I and ARB groups were similar regarding densities of type 1 and type 3 collagen fibers. The density of type 1 collagen fibers was the highest in the steroid group, whereas the density of type 3 collagen fibers was the lowest in that group. CONCLUSIONS: Enalapril, candesartan and intralesional steroid therapies were all effective in reducing scar tissue development; however, enalapril and steroid groups revealed better results. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Tonsillar solitary fibrous tumour: A interesting rare case.

A solitary fibrous tumour (SFT) is a rare mesenchymal tumour that frequently originates in the mesothelium-covered surfaces, such as the pleura and peritoneum. It may develop in various body parts, including the head and neck. These tumours may arise in several different patterns, which results in difficulties in diagnosing them. This case is a solitary tumour developing from the palatine tonsil in a 17-year-old male patient; it is the second case in the literature. The tumour has the histopathological characteristics of a patternless pattern, a slight pleomorphism, and a composition of hypercellular and hypocellular sites. Immunohistochemically, the tumour cells showed a strong positive staining with CD34, Bcl-2, and vimentin. No recurrence developed in the patient's approximately 18-month-long follow-up period.

Lip cancer: A 16-year retrospective epidemiological study in Eastern part of Turkey.

OBJECTIVE: To review lip cancer patients with respect to age, gender, location and histological type of tumour, and risk factors. METHODS: This retrospective study was conducted at the Yuzuncu Yil University, Van, Turkey, and comprised medical records of the histologically confirmed lip cancer patients who presented between 1994 and 2010. No patient had neck nodes or evidence of distant metastasis. RESULTS: Of the 91 patients 73(80.22%) were men and 18(19.78%) were women. The overall mean age was 62.32±13.88 years (range: 25 to 97 years). Histologically, the tumour was a squamous cell carcinoma in 81(89.01%) cases and a basal cell carcinomas in 10(10.99%) cases. Upon admission, the mean diameter of the tumour in squamous cell carcinoma patients was 2.03±1.23 cm and 1.87±1.29 cm in basal cell carcinoma patients. As for the tumour differentiation, 67(84.72%) of the squamous cell carcinoma cases were well differentiated, while 14(17.28%) were moderately differentiated. CONCLUSIONS: The incidence of lip cancer was found to be higher among men, while the histopathological type was mostly squamous cell carcinoma and well differentiated.

Endobronchial aspergilloma: A case report.

A 28-year-old male with B-cell acute lymphoblastic leukemia presented to our pulmonary clinic with progressive dyspnea, cough, hemoptysis, and fever. Diagnostic bronchoscopy revealed white masses at the entrance of the right middle lobe bronchus and distal to the right main bronchus. Histopathological examination of the biopsy specimen showed those masses to be hyphae of Aspergillus.

Paricalcitol may improve oxidative DNA damage on experimental amikacin-induced nephrotoxicity model.

This study aimed to investigate the possible protective effect of paricalcitol on experimental amikacin-induced nephrotoxicity model in rats. Wistar albino rats (n = 32) were allocated into four equal groups of eight each, the control (Group C), paricalcitol (Group P), amikacin-induced nephrotoxicity (Group A), and paricalcitol-treated amikacin-induced nephrotoxicity (Group A + P) groups. Paricalcitol was given intra-peritoneally at a dose of 0.4 µg/kg/d for 5 consecutive days prior to induction of amikacin-induced nephrotoxicity. Intra-peritoneal amikacin (1.2 g/kg) was used to induce nephrotoxicity at day 4. Renal function parameters, oxidative stress biomarkers, oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio), kidney histology, and vascular endothelial growth factor (VEGF) immunoexpression were determined. Group A + P had lower mean fractional sodium excretion (p < 0.001) as well as higher creatinine clearance (p = 0.026) than the amikacin group (Group A). Renal tissue malondialdehyde levels (p = 0.035) and serum 8-hydroxy-2'-deoxyguanosine/deoxyguanosine ratio (8-OHdG/dG ratio) (p < 0.001) were significantly lower; superoxide dismutase (p = 0.024) and glutathione peroxidase (p = 0.007) activities of renal tissue were significantly higher in group A + P than in group A. The mean scores of tubular necrosis (p = 0.024), proteinaceous casts (p = 0.038), medullary congestion (p = 0.035), and VEGF immunoexpression (p = 0.018) were also lower in group A + P when compared with group A. This study demonstrates the protective effect of paricalcitol in the prevention of amikacin-induced nephrotoxicity in an experimental model. Furthermore, it is the first study to demonstrate that paricalcitol improves oxidative DNA damage in an experimental acute kidney injury model.

The Prevalence of Gastric Intestinal Metaplasia and Distribution of Helicobacter pylori Infection, Atrophy, Dysplasia, and Cancer in Its Subtypes.

Objectives. Gastric intestinal metaplasia (IM) is frequently encountered and is considered a precursor of gastric adenocarcinoma. In the Van region of Turkey, gastric adenocarcinoma incidence is high but the prevalence of gastric IM is not known. Helicobacter pylori (H. pylori) infection is a main factor leading to atrophy, IM, and cancer development in the stomach. The aim of the current study was to investigate the prevalence of IM and its subtypes and the prevalence of H. pylori infection, atrophy, dysplasia, and cancer in gastric IM subtypes. Materials and Methods. This retrospective study was conducted on 560 IM among the 4050 consecutive patients who were undergoing esophagogastroduodenoscopy (EGD) with biopsy between June 2010 and October 2014. Clinical records and endoscopic and histopathologic reports of patients with IM were analyzed. Results. The prevalence of gastric IM was 13.8%. The prevalence of incomplete IM was statistically significantly higher than complete IM. Type III IM was the most frequent subtype. Conclusions. Gastric IM is a common finding in patients undergoing EGD with biopsy in this region. High prevalence of incomplete type IM, especially type III, can be associated with the high prevalence of gastric cancer in our region.

Effects of jnk inhibitor on inflammation and fibrosis in the ovary tissue of a rat model of polycystic ovary syndrome.

OBJECTIVE: In our study, we aimed to investigate the effects of Jun N-terminal kinase inhibitor (SP600125) on fibrosis and inflammation in rats with polycystic ovary syndrome (PCOS). METHOD: 50 Wistar-albino rats were divided into five groups (n=10 each): control group, sham group, PCOS group, SP600125+ PCOS group and SP600125 group. In the estradiol valerate (EV)-treated group in which PCOS was injected with a single 4 mg/kg i.p. of EV in 0.2 ml sesame oil and the rats were sacrificed on day 60. The estradiol valerate (EV)-treated + SP600125-treated group was injected with a single 4 mg/kg i.p. of EV in 0.2 ml sesame oil. As of day 60, the treatment group was additionally given 15 mg/kg i.p. of SP600125 once daily for 4 consecutive days and the rats were sacrificed on day 65. Histopathological findings (ovarian morphology, edema, inflammatory cell infiltration, vascular congestion and hyperemia) and collagen type IV immunoexpression were assessed. RESULTS: The SP600125+ PCOS group showed a significant level of improvement in ovarian follicle morphology, edema, inflammatory infiltrate, vascular congestion and hyperemia as compared with the PCOS group. Furthermore, collagen type IV immunoexpression showed a significant reduction in staining intensity on the theca cell layer and ovary stroma as compared to the PCOS group. CONCLUSION: This study demonstrates the therapeutic effect of SP600125 in the prevention of PCOS in an experimental model.

A Dilemma in Staging of Esophageal Cancer: How Should We Stage ypT0 N2 M0 Esophageal Cancer after Neoadjuvant Therapy?

Background. Since neoadjuvant treatment in esophageal cancer began to become popular, a complete pathological response at the primary tumour site has been commonly reported. An issue of conflict is whether complete response in the esophageal lumen means that the esophagus is completely tumour-free. Another important issue is whether lymph nodes that are retrieved from pathologically complete response cases are also tumour-free or not. There is a gap in the esophageal cancer staging system for ypT0 N2 M0 tumours that have received neoadjuvant therapy. Here, we will discuss the problem about staging of esophageal cancer associated with neoadjuvant therapy. Case. A female aged 40 years complaining of dysphagia was diagnosed as having locally advanced thoracic esophageal cancer. Neoadjuvant therapy decision was taken by oncology committee. Six weeks after neoadjuvant therapy, with a curative intention, minimal invasive surgery was performed. The pathology report was as follows. "There were no neoplastic cells in the suspected area of the esophageal mucosa upon examination with all staining. There was no cancer at resection margins. Four metastatic lymph nodes were infiltrated with squamous cell cancer." Conclusion. Despite the growing use of neoadjuvant treatment in locally advanced esophageal cancer in world, we do not have a protocol for the evaluation of these patients' pathology reports. We believe that new studies and new ideas are needed to resolve this dilemma associated with neoadjuvant therapy.

Is Immunohistochemical Sex Hormone Binding Globulin Expression Important in the Differential Diagnosis of Adenocarcinomas?

Adenocarcinomas (AC) are the most frequently encountered carcinomas. It may be quite challenging to detect the primary origin when those carcinomas metastasize and the first finding is a metastatic tumor. This study evaluated the role of sex hormone binding globulin (SHBG) positivity in tumor cells in the subclassification and detection of the original organ of adenocarcinomas. Between 1994 and 2008, 64 sections of normal tissue belonging to ten organs, and 116 cases diagnosed as adenoid cystic carcinoma and mucoepidermoid carcinoma of the salivary gland, lung adenocarcinoma, invasive ductal carcinoma of the breast, adenocarcinoma of stomach, colon, gallbladder, pancreas and prostate, endometrial adenocarcinoma and serous adenocarcinoma and mucinous adenocarcinoma of the ovary, were sent to the laboratory at the Department of Pathology at the Yuzuncu Yil University School of Medicine, where they were stained immunohistochemically, using antibodies against SHBG. The SHBG immunoreactivity in both the tumor cells and normal cells, together with the type, diffuseness and intensity of the staining were then evaluated. In the differential diagnosis of the adenocarcinomas of the organs, including the glandular structures, impressively valuable results are encountered in the tumor cells, whether the SHBG immunopositivity is evaluated alone or together with other IHC markers. Further extensive research with a larger number of cases, including instances of cholangiocarcinoma and cervix uteri AC [which we could not include in the study for technical reasons] should be performed, in order to appropriately evaluate the role of SHBG in the differential diagnosis of AC.