Impact of Radiation Therapy on Serum Humanin and MOTS-c Levels in Patients with Lung or Breast Cancer.

BACKGROUND: Lung and breast cancer are the most frequent causes of death from cancer globally. The objectives of this research were to evaluate the serum mitochondrial open reading frame of the 12S rRNA-c (MOTS-c) and humanin levels in lung or breast cancer patients, and investigate the impacts of radiation therapy on the circulating levels of these peptides. METHODS: 35 lung cancer patients, 34 breast cancer patients, and healthy volunteers as a control group were recruited in this prospective observatory research. Lung cancer patients with stage IIIA/IIIB were treated with paclitaxel-based chemotherapy plus radiotherapy (2 Gy per day, 30 times, 60 Gy total dose). Breast cancer stage IIA/IIB patients were treated with postoperative locoregional radiation therapy (2 Gy per day, 25 times, 50 Gy total dose). The ELISA method was used to detect serum humanin and MOTS-c levels during, before, and after radiotherapy. RESULTS: We observed marked elevations in circulating MOTS-c, but not humanin levels in patients with lung cancer (P < 0.001). Radiation therapy led to a marked augmentation in MOTS-c levels in these patients (P < 0.001). On the other hand, there was a marked decline in humanin, but not MOTS-c, levels in breast cancer patients (P < 0.001). CONCLUSION: Our research has shown, for the first time, that increased MOTS-c and decreased humanin levels play a role in lung cancer and breast cancer, respectively. Additionally, radiotherapy modifies MOTS-c levels in patients with lung, but not breast cancer.

Impact of respiratory motion on lung dose during total marrow irradiation.

We evaluated the impact of respiratory motion on the lung dose during linac-based intensity-modulated total marrow irradiation (IMTMI) using two different approaches: (1) measurement of doses within the lungs of an anthropomorphic phantom using thermoluminescent detectors (TLDs) and (2) treatment delivery measurements using ArcCHECK where gamma passing rates (GPRs) and the mean lung doses were calculated and compared with and without motion. In the first approach, respiratory motions were simulated using a programmable motion platform by using typical published peak-to-peak motion amplitudes of 5, 8, and 12 mm in the craniocaudal (CC) direction, denoted here as M1, M2, and M3, respectively, with 2 mm in both anteroposterior (AP) and lateral (LAT) directions. TLDs were placed in five selected locations in the lungs of a RANDO phantom. Average TLD measurements obtained with motion were normalized to those obtained with static phantom delivery. The mean dose ratios were 1.01 (0.98-1.03), 1.04 (1.01-1.09), and 1.08 (1.04-1.12) for respiratory motions M1, M2, and M3, respectively. To determine the impact of directional respiratory motion, we repeated the experiment with 5-, 8-, and 12-mm motion in the CC direction only. The differences in average TLD doses were less than 1% when compared with the M1, M2, and M3 motions indicating a minimal impact from CC motion on lung dose during IMTMI. In the second experimental approach, we evaluated extreme respiratory motion 15 mm excursion in only the CC direction. We placed an ArcCHECK device on a commercial motion platform and delivered the clinical IMTMI plans of five patients. We compared, with and without motion, the dose volume histograms (DVHs) and mean lung dose calculated with the ArcCHECK-3DVH tool as well as GPR with 3%, 5%, and 10% dose agreements and a 3-mm constant distance to agreement (DTA). GPR differed by 11.1 ± 2.1%, 3.8 ± 1.5%, and 0.1 ± 0.2% with dose agreement criteria of 3%, 5%, and 10%, respectively. This indicates that respiratory motion impacts dose distribution in small and isolated parts of the lungs. More importantly, the impact of respiratory motion on the mean lung dose, a critical indicator for toxicity in IMTMI, was not statistically significant (p > 0.05) based on the Student's t-test. We conclude that most patients treated with IMTMI will have negligible dose uncertainty due to respiratory motion. This is particularly reassuring as lung toxicity is the main concern for future IMTMI dose escalation studies.

A cutaneous metastasis of bronchogenic carcinoma: Milia-like lesions with dermatomal pattern.

Clinical presentation of cutaneous metastases is often variable. Presented case had an intriguing cutaneous metastasis of bronchogenic squamous cell carcinoma. Lesions were characterized by dermatomal pattern with milia-like papules, plaques, and nodules.

Cutaneous metastasis in prostate cancer: Two cases with similar clinical findings.

Cutaneous metastasis of prostate cancer is rare. Lesions in this type of skin metastasis are usually seen as suprapubic nodules. Here, we presented two cases with skin metastases of prostate cancer characterized by grouped cutaneous and subcutaneous nodules.

Vulvar syringomas as a part of nonfamilial generalized eruptive form: Unusual lesions leading to pseudohyper-trophy of the labia majora.

We present a case of eruptive generalized syringoma with vulvar involvement. This case is unique in terms of being a nonfamilial, linear variant, leading to pseudohypertrophy of the labia majora.

Scrotal Kaposi's Sarcoma in HIV-negative patient: A case report and review of the literature.

Kaposi's Sarcoma (KS) is a malignancy that generally effects the skin, and can be systemic with internal organ involvement. It originates from the vascular endothelium. KS's relationship with human immunodeficiency virus (HIV) infection is well known. Isolated scrotal KS in the urogenital system is quite rare and scrotal KS in an HIV-negative patient is limited to a few cases. In this case report, the biopsy result from the violescent nodular lesions on the scrotum of the HIV-negative 81-year-old patient was found compatible with KS and a pathology was not detected in the systemic screening. With a diagnosis of isolated scrotal KS, the patient underwent surgical excision aimed at the lesions on the scrotum. KS is rare in HIV-negative patients and it is associated with human herpes virus-8 infection.

Skin diseases of the nose.

OBJECTIVES: The goal of this study was to review the main lesion types of the nasal skin and appropriate treatment strategies rather than to present a comprehensive list of all diseases that affect the skin that can involve the nose. METHODS: We reviewed the main nasal skin lesion types and available treatment strategies. Nasal skin lesions were classified as benign, premalignant, or malignant. RESULTS: Benign lesions of the nose include nonmalignant tumoral lesions (i.e., freckles, comedo, adenoma sebaceum [Pringle disease], hydrocystoma, fibrous papules, sebaceous hyperplasia, and rhinophyma), autoimmune and inflammatory conditions (i.e., pemphigus, sarcoidosis, systemic lupus erythematosus, facial eosinophilic granuloma, rosacea, herpes zoster infection, leishmaniasis, and leprosy), and vascular lesions (i.e., telangiectasis, hemangioma, and spider nevus). Premalignant lesions are actinic keratosis and keratoacanthoma; and malignant tumors are melanoma, basal cell carcinoma, and squamous cell carcinoma. Regardless of whether or not they are malignant, all facial lesions can yield significant cosmetic discomfort that should be evaluated carefully before commencing any curative or corrective intervention. In general, benign lesions are treated with dermabrasive modalities, such as trichloroacetic acid, phenol, salicylate, and laser ablation. Electrocautery, cryosurgery, and surgical excision are also used, although these methods may result in scar formation, which can sometimes be more problematic than the original lesion itself. CONCLUSION: Any disease that affects the skin, especially those diseases that are triggered by ultraviolet exposure, can involve the face and nose. Cosmetic defects due both to the lesion itself and the intervention must be discussed with the patient, preferably in the presence of a first-degree relative, before commencement of treatment. As a result of heterogeneity of skin lesions of the nose, appropriate education of general practitioners as well as otorhinolaryngologists is mandatory.

Bilateral and symmetrical tinea mammae.

Tinea corporis has rarely been reported in some locations such as on the breast skin as unilaterally. Herein, we present a case of bilateral tinea mammae, which has not been reported before in English language literature to our knowledge.

Melkersson Rosenthal syndrome associated with ipsilateral facial, hand, and foot swelling.

Melkersson-Rosenthal syndrome is a complex neuromucocutaneous disorder. A 60-year-old woman presented with granulomatous cheilitis of the lower lip, unilateral facial paralysis, and ipsilateral facial and acral swelling. The result of histopathological evaluation in extremities and inferior lip was compatible with Melkersson-Rosenthal syndrome.

Preliminary study among truck drivers in Turkey: effects of ultraviolet light on some skin entities.

In this study, we aimed to compare driver (left) and opposite (right) sides for some skin entities in drivers. We also evaluated the effect of occupational duration, age and skin type among this population. One hundred and forty-eight truck drivers were included in this study. Sun exposed areas were classified. Dermatological entities such as actinic keratosis, solar lentigo, seborrheic keratosis, melanocytic nevus, spider angioma, ephelid, basal cell carcinoma (BCC), squamous cell carcinoma, and melanoma were compared to driver and right sides. In addition, drivers were divided into two subgroups according to: (i) age (subgroups A1, 20-40 years, and A2, >40 years); (ii) occupational duration (subgroups O1, 1-10 years, and 02, >10 years); and (iii) skin type (subgroups S1, skin types I and II, and S2, skin types III and IV. Each of the two subgroups were compared with respect to the total prevalence (left and right sides) of lesions excluding the location. Seborrheic keratosis and lentigo solaris were found to be increased on the driver side of the face (P = 0.00) and ear (P = 0.013), respectively. Statistically significant increases of lesions on the driver side were determined according to the subgroups: melanocytic nevi were found to be increased on the driver side in A1 (P = 0.00), A2 (P = 0.00), O2 (P = 0.00), S1 (P = 0.00) and S2 (P = 0.006) groups; actinic keratoses were found to be significantly increased on the driver side in A2 and O2 groups (P = 0.03 for both).

Subungual osteochondroma: a diagnostic dilemma.

Osteochondroma is the most common skeletal neoplasm of all benign bone tumors. However, it rarely occurs subungually. In this location, the lesion may penetrate the skin, causing nail deformity, and can easily be misdiagnosed. We report two cases of subungual osteochondroma of the distal phalanges of the first toes with cutaneous penetration and discuss the clinical, histologic, and radiographic features and the treatment options.

Ofloxacin induced Sweet's syndrome in a patient with Crohn's disease.

Sweet's syndrome is an acute febrile neutrophilic dermatosis. This syndrome can be idiopathic, para-inflammatory, paraneoplastic, drug-induced, or pregnancy-related. In this paper, a case of Sweet's syndrome associated with ofloxacin therapy in a patient with Crohn's disease is reported.

A neglected case of macrodystrophia lipomatosa of the foot in an elderly man.

Macrodystrophia lipomatosa is a rare disorder characterized by three-dimensional enlargement of one or more fingers or toes with predominantly fibroadipose tissue. Radiographically, it appears as hypertrophy of soft tissues and bones. The pathologic findings are infiltration and hypertrophy of adipose tissue in subcutaneous tissue, nerve sheaths, and periosteum. Macrodystrophia lipomatosa is usually diagnosed during childhood. The case presented here involves the most elderly patient with the condition ever reported, to our knowledge. As such, it may advance current knowledge of macrodystrophia lipomatosa. Special emphasis is given to the unique "bridge" formation seen radiographically in this case.

Unilateral nevoid telangiectasia and hyperthyroidism: a new association or coincidence?

Telangiectasia and spider angioma were distributed in a unilateral, dermatomal pattern in a female patient. Physical examination and laboratory studies revealed hyperthyroidism. The possible effects of thyroid hormones on formation of vascular nevi were considered to be noteworthy.

[A painful subungual nodule: subungual exostosis]. / Agrili subungual bir nodül: Subungual ekzostoz.

Subungual exostosis is an acquired, benign, often painful, and nearly always solitary bone tumor usually occurring in the dorsal medial aspect of the phalanges. An eighteen-year-old male patient presented with a progressively enlarging mass and pain that developed over two years in the distal medial aspect of the right first toe. Conventional radiographs, computed tomography, and histopathologic findings showed subungual exostosis. Complete removal of the tumor was performed including its base in the cortex of the phalanx. No recurrence was observed during a follow-up of 11 months. It was emphasized that clinical presentation of subungual exostosis may resemble other benign or malignant bone tumors.

Extensive cutaneous metastasis of transitional cell carcinoma of the bladder.

Cutaneous metastasis of bladder carcinoma is extremely rare. Iatrogenic implantations have been the main cause in the majority of cases of transitional cell carcinoma with cutaneous metastasis. Otherwise, primary cutaneous metastasis is accepted as the late manifestation of systemic spread. The present paper describes a case of relatively early and extensive skin metastasis of transitional cell carcinoma in a 78-year-old man. The patient had a histopathological diagnosis of poorly differentiated (grade III) muscle invasive transitional cell carcinoma with a staging of T2NOMO 6 months prior to presenting. He presented to our outpatient clinic with a 3-month history of skin lesions as multiple, rubbery subcutaneous nodules. Radiological reinvestigation revealed no other metastatic site (including bone and lung), except for a metastatic nodule in the liver. The present paper reports an interesting and rare case of extensive skin metastasis of transitional cell carcinoma as the primary complaint.

Nevoid hyperkeratosis of the nipple and areola: a distinct entity.

Although nevoid hyperkeratosis of the nipple and areola was initially described in 1923, there are only case reports or reviews about it; no large series have been documented to date. The clinical features of the reported cases in the literature are not uniform, and it is questioned whether nevoid hyperkeratosis of the nipple and areola is a distinct clinicopathologic entity or a clinical presentation of various dermatoses. We describe 7 cases with hyperkeratotic nevoid lesions localized on the nipple and areola with different clinical features. None of them had any other associated dermatologic or systemic disease. Histopathologic examination was performed in 6 patients. Four of them had common histopathologic features suggesting a distinct entity, namely, nevoid hyperkeratosis of the nipple and areola; 2 of them had histopathologic features consistent with seborrheic keratosis. Seborrheic keratosis presents as sharply demarcated papules or plaques, whereas nevoid hyperkeratosis of the nipple or areola presents as a plaque diffusely involving the nipple or the areola.