Cabazitaxel's ototoxicity: An animal study and histopathologic research.

Introduction: Chemotherapeutic agents can have both serious side effects and ototoxicity, which can be caused by direct toxic effects or by metabolic derangement by the agents. Cabazitaxel (CBZ) is a next-generation semi-synthetic taxane derivative that is effective in both preclinical models of human tumors that are sensitive or resistant to chemotherapy and in patients suffering from progressive prostate cancer despite docetaxel treatment. The primary aim of this study is to investigate the ototoxicity of CBZ in a rat model. Materials and Methods: : A total of 24 adult male Wistar-Albino rats were equally and randomly divided into four groups. CBZ (Jevtana, Sanofi-Aventis USA) was intraperitoneally administered to Groups 2, 3, and 4 at doses of 0.5, 1.0, and 1.5 mg/kg/week, respectively, for 4 consecutive weeks; Group 1 received only i.p. saline at the same time. At the end of the study, the animals were sacrificed and their cochlea removed for histopathological examination. Results: : Intraperitoneal administration of CBZ exerted an ototoxic effect on rats, and the histopathological results became worse in a dose-dependent manner (P < 0.05). Conclusion: : Our findings suggest that CBZ may be an ototoxic agent and can damage the cochlea. More clinical studies should be conducted to understand its ototoxicity.

Relationship between molecular markers and lymphadenectomy and lymphovascular space invasion in endometrial cancer.

PURPOSE: Relationship between pathologic parameters, surgical parameters, or lymph node status with oncologic outcomes is not fully elucidated in endometrial cancer (EC). We want to investigate the molecular classification of uterine cancer in the Turkish population and its relationship between lymphadenectomy and lymph node metastasis. METHODS: In this study, 100 patients' clinical and pathologic data diagnosed with EC were analyzed. Pathologic and molecular parameters were investigated and compared them with clinical parameters. RESULTS: According to the molecular analysis, 16 patients (16%) had p53 mutation, 3 patients (3%) were classified as POLE mutant group, 38 (38%) patients in the MSI group, and the remaining 43 patients (43%) into the no specific mutation profile (NSMP) group. Lymph node metastasis rate was significantly higher in copy number high (CNH) group compared to the others. In the CNH group, 29 of 437 (6.6%) dissected lymph nodes had metastasis. The median OS was the highest in the POLE group (72 months) and lowest in the CNH group (36 months). CONCLUSION: Endometrial cancer patients showed significantly different overall and disease-free survival according to the molecular subtypes and it was consistent with the literature, Lymph node metastasis risk was the highest in CNH group. MSI status is important for the lymph node metastasis risk but not all abnormalities, especially PMS2 and MLH1 expression changes showed the highest risk.

The relationship between immunohistochemical parameters, bone marrow fibrosis and bone marrow 18F-FDG uptake in multiple myeloma patients undergoing PET/CT examination.

PURPOSE: The aim of this study was to determine the power of the SUVmax value obtained from 18F-FDG PET/CT in multiple myeloma (MM) patients to be able to predict immunophenotype characteristics (CD20, CD44, CD56, CD117, CD138 antigen expressions), bone marrow fibrosis, cyclin D1 oncogene, and M-protein subtypes which play a role in diagnosis-treatment and prognosis of the disease. MATERIAL AND METHOD: The study included 54 patients with multiple myeloma who underwent PET/CT for initial staging and bone marrow biopsy. The relationship was examined in these patients between the SUVmax value measured from the iliac bone region and the immunohistochemical and bone marrow fibrosis data of the biopsy taken from the iliac bone. The Mann Whitney U test was used in the comparisons of dependent paired groups, and the Kruskal Wallis H test in the comparisons of three or more groups. RESULTS: The median SUVmax value was 4.5 (1.9-15.6) in patients with CD117 antigen positivity, which was statistically significantly higher than the value in the patients with CD117 negativity (p = 0.031). When patient grouping was made according to the reticulin level; we found that the median SUVmax value was 4.9 (3.0-14.8) in the group with increased fibrosis and 3.6 (1.6-15.6) in the group with low fibrosis. The median SUVmax was statistically significantly higher in the group with increased fibrosis compared to the group with low fibrosis (p = 0.004). No statistically significant difference was determined in the comparisons of the SUVmax values when the patients were grouped according to the immunoglobulin heavy chain and light chain, CD20, CD44, CD56, and cyclin D1 characteristics (p > 0.05). CONCLUSION: In MM patients who underwent PET/CT for initial staging, significant relationships were determined between FDG uptake in the bone marrow (SUVmax) and CD117 antigen and bone marrow fibrosis, which is an important prognostic factor. Higher SUVmax values were determined in the bone marrow of patients with increased fibrosis and CD117 positivity.

A Role for Mast Cell-Mediated Antibodies in the Formation of Cholesteatoma and Cholesteatoma-Induced Bone Erosion.

The study aimed to evaluate the effects and relationships between mast cells in the matrix, mast cell enzymes tryptase and chymase, epithelial proliferation, microvascular density, and bone destruction in cholesteatoma. Thirty-five biopsies diagnosed with cholesteatoma and seven healthy skin tissues taken from the retro-auricular region for control were evaluated. Immunohistochemical studies were performed with CD117, CD34, Ki-67, chymase, and tryptase antibodies, in a single session for all cases and the control group. The relationship between erosion size and antibody load was determined. The mean cholesteatoma epithelium Ki-67 was higher than the control group (p < 0.001). CD117-positive mast cells, chymase-positive mast cells, tryptase-positive mast cells, and microvessel density were significantly higher in the cholesteatoma matrix compared to the control group (p < 0.002, p < 0.001, p < 0.005). In the group with bone erosion scores of two and above, immunohistochemical markers tended to be higher. A positive correlation was found between CD117 and chymase, tryptase, and microvessel density; between tryptase, chymase, and microvessel density; and between chymase and microvessel density. CD117-positive mast cells and chymase-positive mast cells stimulate angiogenesis, increase the epithelium's proliferative capacity in the cholesteatoma matrix, and form cholesteatoma. The increased proliferation of cholesteatoma epithelium and increased vascular density in the matrix exacerbate bone erosion.

A rare cause of dyspnea: Primary large B cell lymphoma causes giant cardiac mass.

Cardiac lymphoma (CL) is a rare and life-threatening clinical condition. Most cases are diagnosed late period. Although the definitive diagnosis is made by biopsy, a biopsy could not be performed in most cardiac masses due to the high mortality rate and therefore the exact incidence is not known. In this case report, we present a case of giant CL filling both the pericardial area and right heart cavities and treated with surgical resection in a previously healthy male patient who presented with symptoms of heart failure.

The relationship of tumour-associated macrophages (CD68, CD163, CD11c) and cancer stem cell (CD44) markers with prognostic parameters in breast carcinomas.

INTRODUCTION: In invasive breast cancer (IBC), tumour-associated macrophages and cancer stem cells in the tumour microenvironment are thought to be associated with poor prognosis, tumour growth, and metastasis. MATERIAL AND METHODS: In this study, we evaluated the relationship of CD68, CD163, CD11c, and CD44 expressions in the tumour microenvironment of IBC with prognostic parameters by immunohistochemical method. RESULTS: A correlation was found between high histological grade, oestrogen receptor/ progesterone receptor negativity, and high Ki-67 index in IBC, and the number of CD68-, CD163-, and CD11c-positive macrophages in the tumour microenvironment. In addition, in the tumour microenvironment, a correlation was found between IBC-specific subtypes and CD68, luminal A subtype relative to luminal B and CD163, HER2 score 3 cases, and CD11c-positive macrophage count. It was observed that CD44 expression in the tumour in IBC was not associated with the parameters examined. In addition, a high-level linear correlation was found between CD68- and CD163- and CD11c-positive macrophage counts. Tumour-associated macrophages in the tumour microenvironment in IBC may be a novel prognostic factor and an alternative avenue for targeted therapies. CONCLUSIONS: The fact that CD44 positivity in the tumour is not associated with prognostic parameters will contribute to the literature in this direction.

Effect of Regular Aerobic Training on Serum C-Reactive Protein and IL-6 Levels in Obese Women.

OBJECTIVE: This study's objective was to evaluate interleukin-6 (IL-6) and C-reactive protein (CRP) responses and performance changes in obese women after 8 weeks of aerobic training with an intensity of 50 to 60% of their individual maximum oxygen uptake (VO2). METHODS: A total of 18 sedentary women with an average age of 44.3 (± 1.9) years volunteered for this study. Over a period of 8 weeks, in 4 40-minute sessions per week, the participants walked at an exercise intensity that caused their heart rates to increase to levels corresponding to 50 to 60% of their VO2 peaks. Blood samples were collected from the participants, both when they were at rest and a couple of minutes after the end of the 1st exercise session. Sampling was repeated in the 4th and 8th weeks, before and after the last training sessions. RESULTS: The participants' body mass indices and weights decreased significantly by the end of the 8th week, while their maximum running speeds and VO2 peaks increased significantly. There were no differences in CRP or IL- 6 concentrations between the pre- and post-training sessions, but most of the participants' IL-6 levels dropped below 10 pg/ml after 8 weeks of training. CONCLUSION: Although no significant changes were observed in CRP or IL-6 concentrations, it is important to note that in response to aerobic training, the IL-6 levels of most of the participants fell to what is generally considered acceptable.

A case of pediatric psoriasis achieving remission after allogenic bone marrow transplantation.

BACKGROUND: Psoriasis is an inflammatory skin disease in which the cells and molecules of innate and adaptive immunity are involved in the pathogenesis. Aplastic anemia is a bone marrow deficiency syndrome that is characterized by an extreme reduction in the number of blood cells as a result of failure in hematopoiesis. Allogenic hematopoietic stem cell transplantation is a promising treatment for Aplastic Anemia and it is important to note that other comorbid diseases like psoriasis- since both have some common pathogenetic mechanisims- might achieve remission after treatment. CASE: We present a 12-years-old male patient who underwent bone marrow transplantation for aplastic anemia and his psoriasis vulgaris lesions completely regressed. The final follow-up visit on day 150 also revealed no sign of the pre-transplantation skin and scalp lesions. CONCLUSIONS: This is the first case of pediatric psoriasis together with aplastic anemia that achieved complete remission of psoriasis after bone marrow transplantation. Our case report needs to be supported by prospective studies involving larger patient populations.

A Determination of Hopelessness and the Perception of Illness in Cancer.

This study was performed with the objective of determining hopelessness and perception of illness in cancer patients. This was a descriptive and regressional study. The study was performed between January and June 2014 on 105 outpatients at the oncology clinic of Manisa Government Hospital in Turkey's western. A patient information form, the Beck Hopelessness Scale, and the illness perception questionnaire were used to collect data, and data analysis was performed using the program Statistical Package for Social Sciences 15.0. Percentages, t test, Kruskal-Wallis, one-way analysis of variance, and Pearson correlation were used in the evaluation of research data. The hopelessness levels of cancer patients participating in the study were at a medium level. As patients' scores on the hopelessness scale and its subscales increase, so their illness perception scores also increase. The hopelessness levels of patients whose illness perception was good were lower; that is, as patients' hopelessness levels fell, their illness perceptions and view of their illness were affected in a positive way.

Are radio-contrast agents commonly used in discography toxic to the intact intervertebral disc tissue cells?

In the literature, there have been no studies showing clear results on how radio-contrast pharmaceuticals would affect intact disc tissue cells. In this context, it was aimed to evaluate the effects of iopromide and gadoxetic acid, frequently used in the discography, on intact lumbar disc tissue in pharmaco-molecular and histopathological level. Primary cell cultures were prepared from the healthy disc tissue of the patients operated in the neurosurgery clinic. Except for the control group, the cultures were incubated with the indicated radio-contrast agents. Cell viability, toxicity and proliferation indices were tested at specific time intervals. The cell viability was quantitatively analysed. It was also visually rechecked under a fluorescence microscope with acridine orange/propidium iodide staining. Simultaneously, cell surface morphology was analysed with an inverted light microscope, while haematoxylin and eosin (H&E) staining methodology was used in the histopathological evaluations. The obtained data were evaluated statistically. Unlike the literature, iopromide or gadoxetic acid did not have any adverse effects on the cell viability, proliferation and toxicity (P < 0.05). Although this study reveals that radio-contrast pharmaceuticals used in the discography, often used in neurosurgical practice, can be safely used, it should be remembered that this study was performed in an in vitro environment.

Analysis of musculoskeletal dysmorphic abnormalities of 20 fetuses.

OBJECTIVES: This study aims to report rates of skeletal abnormalities and their risk factors in light of information obtained in a fetal autopsy series. PATIENTS AND METHODS: The study included 20 fetuses (11 males, 8 females and 1 ambiguous genitalia; mean age 19.3±4.0 weeks; range 16 to 32 week) who underwent autopsy in our hospital between January 2013 and March 2015. Fetuses were systematically classified according to age, gender, family history, abortus week, abortus type, and extremity and organ abnormalities. Skin biopsies were performed for genetic evaluation. Radiographic, pathologic and genetic findings were classified. RESULTS: Except one spontaneous abortus, all cases were applied medical abortus (94.1%). Genetic diagnosis could not be established in seven cases, whereas genetic disorders were identified in 13 cases: two trisomy 13, two trisomy 18, one (triploidi) 69,XXY, two arthrogryposis multiplex congenita, one osteogenesis imperfecta, one lethal multiple pterygium, one Saldino-Noonan syndrome, one teratogenic drug effect, one perinatal lethal hypophosphatasia, and one Beckwith-Wiedemann syndrome. Decreased fetal movement was one of the most frequently observed findings. Consanguineous marriage, oligohydramnios, drug addiction of the mother, teratogenic exposure, and other systemic abnormalities were risk factors. CONCLUSION: Skeletal dysplasias are rare diseases. Clinicians should be careful for skeletal abnormalities in perinatal period follow-ups.

Effects of thymoquinone against cisplatin-induced cardiac injury in rats.

PURPOSE: T o investigate the possible protective effect of thymoquinone (TQ) in cisplatin (CP) induced myocardial injury. METHODS: A total of 28 adult male Wistar-Albino rats were randomly and equally divided into four groups as follows: Group 1 (control), Group 2 (CP at 15 mg/kg dose), Group 3 (TQ 40 mg/kg/day for two days prior to CP injection and on third day, CP at 15 mg/kg dose was intraperitoneally administered and TQ treatment continued until fifth day) and Group 4 (TQ at 40mg/kg/day dose for five days). RESULTS: There was a significant increment in CP group in terms of congestion, edema and pycnotic nuclei in myocardial fibers, comparing with other groups. TQ group exhibited significant increase in expression of antiapoptotic protein Bcl-2, comparing with CP group (p<0.05). In only CP administered group, expression of antiapoptotic protein Bcl-2 was lowest comparing with other groups. CONCLUSION: Established data indicate that cisplatin is cardiotoxic and thymoquinone may be useful in treating CP-induced cardiac injury.

Effects of thymoquinone against cisplatin-induced cardiac injury in rats

PURPOSE: T o investigate the possible protective effect of thymoquinone (TQ) in cisplatin (CP) induced myocardial injury. METHODS: A total of 28 adult male Wistar-Albino rats were randomly and equally divided into four groups as follows: Group 1 (control), Group 2 (CP at 15 mg/kg dose), Group 3 (TQ 40 mg/kg/day for two days prior to CP injection and on third day, CP at 15 mg/kg dose was intraperitoneally administered and TQ treatment continued until fifth day) and Group 4 (TQ at 40mg/kg/day dose for five days). RESULTS: There was a significant increment in CP group in terms of congestion, edema and pycnotic nuclei in myocardial fibers, comparing with other groups. TQ group exhibited significant increase in expression of antiapoptotic protein Bcl-2, comparing with CP group (p<0.05). In only CP administered group, expression of antiapoptotic protein Bcl-2 was lowest comparing with other groups. CONCLUSION: Established data indicate that cisplatin is cardiotoxic and thymoquinone may be useful in treating CP-induced cardiac injury.

A rare condition: Ectopic liver tissue with its unique blood supply encountered during laparoscopic cholecystectomy.

INTRODUCTION: Developmental abnormalities of liver including ectopic liver tissue (ELT) are rare conditions. Few cases presenting ELT have been reported in literature till now. Even though the most common area seen is gallbladder, it is detected both abdominal and thoracic sites. There is a relationship between HCC and ectopic liver that necessitates the removal. PRESENTATION OF CASE: A 51-year-old female was hospitalized because of abdominal pain. Gallstone and bile duct dilatation were determined during ultrasonographic (USG) evaluation. The patient was operated for cholecystectomy following a successful endoscopic retrograde cholangiopancreatography (ERCP). During operation, a mass located on gallbladder with its unique vascular support was identified and resected together with gallbladder. The mass had a separate vascular stalk arising from liver parenchyma substance and it was clipped with laparoscopic staples. The histopathological examination revealed that the mass adherent to gallbladder was ectopic liver confirming the intraoperative observation. The postoperative course of patient was uneventfull and she was discharged at the second day after the operation. DISCUSSION: Ectopic liver tissue is incidentally found both in abdominal and thoracic cavity. ELT can rarely be diagnosed before surgical procedures or autopsies. It can be overlooked easily by radiological techniques. Although it does not usually produce any symptom clinically, it can rarely result in serious complications such as bleeding, pyloric and portal vein obstruction. ELT also has the capacity of malignant transformation to hepatocellular carcinoma that makes it essential to be removed. CONCLUSION: Although ELT is rarely seen, it should be removed when recognized in order to prevent the complications and malignant transformation.

A study on distribution of cancer cases diagnosed in Çorum.

OBJECTIVE: In order to help obtain accurate knowledge and to contribute to the establishment of data for regional tumor statistics, we aimed to determine the frequency distribution of cancer cases that was diagnosed in Çorum province. MATERIAL AND METHOD: In this descriptive study, we retrospectively reviewed the archive records of the pathology departments' of one university hospital and two private hospitals serving in the province of Çorum. A total of 138,973 recorded pathology reports were reviewed. Metastatic cancers with a known primary source were excluded. A total of 2184 cases with a diagnosis of cancer were recorded by gender, age, and system/organ and classified to 10 most frequent types of cancer both in general and in terms of gender distribution. RESULTS: The male to female ratio was 1.44 and the mean age was 64.26 years. The cancer is most commonly encountered between 70 and 79 years of age (35.27%) in males whereas the second most common interval was 60 to 69 years of age (23.88%). In females, the cancer is most commonly encountered between 70 and 79 years of age (24.16%) whereas the second most common interval was 60 to 69 years of age (22.60%). The top five cancers were skin (33.60%), prostate (13.87%), stomach (9.07%), urinary bladder (8.61%) and breast (7.88%). CONCLUSION: Distribution of organ/system involvement of cancer cases that were diagnosed in Çorum is quite different from the data regarding Turkey in general. Development of cancer registry centers, upgrading to an active registry system and having all cancer data from health institutions unified in a single organization are mandatory to achieve reliable data.

Congenital Pulmonary Airway Malformation Type 2: A Case Report with Review of the Literature.

A congenital pulmonary airway malformation is a rare disorder of the pulmonary airway and a hamartomatous mass of disorganized lung tissues with various degrees of cystic change. A 20-year-old pregnant woman who did not have previous clinical follow-up during her pregnancy visited the gynecology department for her first check on the 19th week of gestation. The sonogram, showed severe hydrops fetalis. Laboratory findings were consistent with non-immune hydrops fetalis. Medical abortion was performed and the fetus was sent to our department for a complete fetal autopsy. Macroscopically, whole parts of the fetus had striking oedema. Massive pleural and peritoneal effusions were seen on dissection. The left lung filled the whole thoracic cavity. The heart was displaced to the right and the right lung was compressed. Microscopically, the left lung mass showed dilated bronchiole-like structures (1-20 mm) that were lined with ciliated columnar cells without any intervening mucinous cells. The subepithelial stroma contained thin, interrupted smooth muscle fibers and elastic connective tissue without cartilage plates. Our case is a very good example of non-immune hydrops fetalis associated with congenital pulmonary airway malformation type 2. Prenatal clinical and ultrasonographic follow-ups during pregnancy are very important for early diagnosis of congenital malformations.

Laryngeal chondroma: a rare diagnosis in this localization.

Primary chondroid tumors of the larynx represent less than 1% of all laryngeal tumors. Most of them are chondromas and they often involve to the cricoid cartilage. A 31-year-old male patient applied to the oto-laryngology service with a history of dysphonia and dyspnea. Microlaryngoscopy revealed 2 cm sized, ill-defined, covered with regular mucosa, porous, and hard mass on posterior surface of crycoid cartilage in subglottic area. Following the excision of the lesion, histopathologic examination revealed as chondroma. Two years later, local recurrence was detected and the diagnosis was again chondroma. There was no complaint of the patient in last 3 and half years of follow-up. Chondroma should carefully be differentiated from chondrosarcoma and the patients should be followed for possible recurrences.

Cardiac rhabdomyoma in an adult patient presenting with right ventricular outflow tract obstruction.

We present a 24 year old woman with cardiac rhabdomyoma. Cardiac rhabdomyoma is the most common benign cardiac tumor in infants, but in adults, cardiac rhabdomyoma is very rare. These tumors are often spontaneously reversible because they are associated to the right or left ventricular outflow tract obstruction, tachyarrhythmias and heart failure where surgery is necessary.

Expression of Bcl-2 and Ki-67 in tamoxifen-associated endometrial polyps: comparison with postmenopausal polyps.

BACKGROUND: The aim of this study was to evaluate the expression of Bcl-2 and Ki-67 in tamoxifen (TAM)-associated endometrial polyps and postmenopausal polyps. MATERIAL AND METHODS: For this purpose, a retrospective analysis of paraffin-embedded specimens was carried out. Polyps of 20 postmenopausal and 14 TAM-treated patients, 11 simple endometrial hyperplasia, 10 atypical complex endometrial hyperplasia and 8 endometrial adenocarcinoma specimens were included in the study. Hematoxylin/eosin-stained sections were evaluated. Immunohistochemical staining was performed to investigate the expression of Bcl-2 protein and the Ki-67 proliferation index. RESULTS: There was no statistically significant difference between the 5 groups with regard to Bcl- 2 staining (p > 0.05). However, Bcl-2 expression in TAM-associated polyps was higher (86%) than in the postmenopausal control group (80%). Positive Ki-67 was highest in the endometrial adenocarcinoma specimens, followed by the atypical complex endometrial hyperplasia group (p < 0.0001). Compared to these 2 groups, Ki- 67 expression was lower in TAM-associated polyps, but Ki-67 indexes were significantly higher in the TAM-associated group than in the control group (p < 0.0001). CONCLUSION: Since TAM-associated polyps tend to have higher proliferation indexes and Ki-67 ratios than control groups, we suggest that they are likely to have a higher malignant potential.