Dedifferentiated Liposarcoma of the Left Thigh: a Rare Case.

INTRODUCTION: Liposarcoma is generally classified into four subtypes: a) well-differentiated liposarcoma/atypical lipomatous tumor, b) dedifferentiated liposarcoma, c) myxoid/round cell liposarcoma, and d) pleomorphic liposarcoma. Dedifferentiated liposarcoma is mostly seen in the region of retroperitoneum. AIM: To present a case of dedifferentiated liposarcoma in a rare site of location: the lower extremity. CASE REPORT: A 24-year-old woman presented with a firm painful mass, 3x2 cm in diameter on the medial side of left thigh. MRI demonstrated a lesion on that location showing low signal intensity on T1-wieghted and high signal intensity on T2A-wieghted sequences. After an excisional biopsy the histopathological examination via Haematoxylin and Eosin firstly revealed the diagnosis of malign undifferentiated tumor. The results of immunohistochemical evaluations were as follows: SMA (-), HMB45 (-), S100 (+, focally), Desmin (-), Vimentin (+, focally), CD68 (+, focally), CD34 (-), LCA (-), and Inhibin (-). The final histopathological diagnosis was dedifferentiated liposarcoma. CONCLUSIONS: In English-language literature data for dedifferentiated liposarcoma of the lower extremities are very restricted. Although imaging with CT and MRI, the final and distinct diagnosis is made immunohistochemically. A clinician should be aware of the presence of a dedifferentiated liposarcoma within a mass on the lower extremities.

The Effects of Colchicine-Impregnated Oxidized Regenerated Cellulose on Capsular Contracture.

Capsular contracture is the most common complication of breast augmentation. Oxidized regenerated cellulose can be used as a matrix for drug transport. Colchicine is an antimitotic drug that interferes with various steps of wound healing. The aim of this study was to evaluate the effects of oxidized regenerated cellulose alone or in combination with colchicine on capsular contracture. Twenty-one adult female Wistar-Albino rats were divided into 3 groups. In group 1 silicone blocks only, in group 2 oxidized regenerated cellulose-wrapped silicone blocks, and in group 3 colchicine-impregnated oxidized regenerated cellulose-wrapped silicone blocks were inserted in the dorsal region. Four weeks later, implants were removed and histopathological examination was performed. Capsular thickness, inflammatory infiltrate degree, collagen fiber organization, and myofibroblast density were evaluated. Macroscopic examination revealed a distinct capsule formation only in group 1 animals, with average measurement being 134.65 µm on histopathological examination. In groups 2 and 3 animals, no distinct capsule formation was seen. Inflammatory infiltrate degree was found to be less in groups 2 and 3 animals than in group 1 animals. Collagen fiber organization around the implants was found to be parallel and organized in group 1 animals, whereas it was random and disorganized in animals in both groups 2 and 3. High myofibroblast density was observed in animals in groups 1 and 2, while no myofibroblast was found in animals in group 3. The results of our study suggest that coating silicone implants with oxidized regenerated cellulose or with colchicine-impregnated oxidized regenerated cellulose may be effective in preventing capsular contracture.

Eccrine Syringofibroadenomatosis of the Soles.

Eccrine syringofibroadenoma is a rare adnexal tumor with acrosyringeal differentiation. It was first described by Mascaro in 1963. Its clinical presentation varies from a solitary nodule, keratotic papule, verrucous plaque, or palmoplantar keratoderma to multiple lesions with linear or diffuse distributions. Age at onset ranges from 16 to 80 years. Lesion distribution is wide and includes the face, back, abdomen, buttocks, extremities, and, rarely, nails. There are five subtypes of eccrine syringofibroadenoma. Histologically, eccrine syringofibroadenoma, independent of the subtype, is characterized by anastomosing cords of acrosyringeal cells forming ductal structures in a fibrovascular stroma and attached to the undersurface of the epidermis in multiple foci. In this article, we describe a 51-year-old woman diagnosed as having eccrine syringofibroadenomatosis.

Evaluation of Invasive and Noninvasive Methods for the Diagnosis of Helicobacter Pylori Infection

Objective: The present study was conducted to evaluate invasive and noninvasive diagnostic methods for detection of Helicobacter pylori (H. pylori) in patients admitted with dyspeptic complaints and to compare sensitivities and specificities. Method: Sets of four gastric biopsy specimens were obtained from a total of 126 patients included in the study. The presence of H. pylori was determined by invasive tests including culture, rapid urease test, polymerase chain reaction (PCR) and histopathology. Among noninvasive tests, urea breath test, serological tests and enzyme-linked immunosorbent assay (ELISA) were performed. Results: H. pylori was isolated in 79 (62.7%) gastric biopsy cultures, whereas positivity was concluded for 105 (83.3%) patients by rapid urease test, for 106 (84.1%) by PCR, for 110 (87.3%) by histopathology, for 119 (94.4%) by urea breath test, and for 107 (84.9%) by ELISA. In the present study, the culture findings and histopathological examination findings were accepted as gold standard. According to the gold standard, urea breath test had the highest sensitivity (96.5%) and the lowest specificity (30%), whereas culture and histopathology had the highest specificities (100%). Conclusion: The use of PCR invasively with gastric biopsy samples yielded parallel results with the gold standard. PCR can be recommended for routine use in the diagnosis of H. pylori.

Ocular surface changes in patients treated with oral antidiabetic drugs or insulin.

PURPOSE: To describe and compare ocular surface changes in patients with type 2 diabetes treated with either oral antidiabetic drugs (OAD) or insulin. METHODS: Forty eyes of 20 patients treated with OAD, 40 eyes of 20 patients treated with insulin, and 10 nondiabetic controls seen at Ministry of Health Ankara Educational and Research Hospital, 1st Eye Clinic, were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis, and conjunctival impression cytologic analysis. Patients treated with OAD or insulin and a control group were compared for tear function parameters, goblet cell density, and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorder and serum HbA1c levels of diabetic patients were also noted. RESULTS: The tear film break-up time values were significantly lower in patients treated with OAD (p<0.05). There was no statistically significant difference in Schirmer test results of the 3 groups. Goblet cell density and squamous metaplasia grade were similar in all groups. The median grade was grade 1, in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm, and goblet cells are decreased in number. Status of retinopathy did not seem to relate to ocular surface disorder. The serum HbA1c level of diabetic patients treated with insulin or OAD was similar (p>0.05). CONCLUSIONS: Precorneal tear film stability was worse in patients treated with OAD; however, impression cytology analysis and Schirmer test results were similar in all groups.

Comparison of Conjunctival Cytological Alterations following Conventional and Sutureless Sclerotomies.

PURPOSE: To assess the alterations in conjunctival impression cytology following 23-gauge transconjunctival sutureless versus conventional pars plana vitrectomy. PATIENTS AND METHODS: Sixty consecutive patients were enrolled in the study. Conjunctival impression cytology was performed on 30 eyes (of 30 subjects) with 23-gauge transconjunctival sutureless vitrectomy and on 30 eyes (of 30 subjects) with conventional vitrectomy. Conjunctival impression cytology was performed preoperatively on the 1st day and in the 3rd month after the surgery. Impression cytology specimens of each group were graded and scored using a range of 0-3 according to Nelson's method. RESULTS: In the conventional pars plana vitrectomy group, statistically significant alterations in the conjunctival impression cytology were detected on the 1st postoperative day (p = 0.001) and in the 3rd postoperative month (p = 0.001), whereas in the 23-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were observed on the 1st postoperative day. However, no significant changes were observed in the following 3 postoperative months (p = 0.08). CONCLUSION: The properties of impression cytology were altered in the early postoperative period after sutureless and conventional vitrectomy. These changes were improved in the sutureless vitrectomy group only. Sutureless vitrectomy also had an advantageous effect on the conjunctival cytological changes and conjunctival structure.

Alpha-lipoic acid inhibits peridural fibrosis following laminectomy through the inactivation of TGF-ß1, PDGF, PAI-1 and IL-6 expressions.

AIM: The objective of this study was to investigate the antifibrotic effect of parenteral administration of alpha-lipoic acid (ALA), which has been reported to reduce fibrosis in the liver, oral mucosa, and peritoneum, in laminectomized rabbits as a potential candidate for the prevention of peridural fibrosis. MATERIAL AND METHODS: Twelve adult New Zealand white male rabbits were divided into control (n=6) and ALA treatment groups (n=6). Laminectomy of the lumbar spine was performed in all animals, and ALA was administered intramuscularly in six rabbits composing the treatment group. Total RNA obtained from the paraffin-embedded tissues was analyzed for transforming growth factor-ß1 (TGF-ß1), plateletderived growth factor (PDGF), plasminogen activator inhibitor-1 (PAI-1) and interleukin-6 (IL-6). RESULTS: mRNA investigations showed that TGF-ß1, PDGF, PAI-1 and IL-6 gene expressions, which constitute strong evidence for the development of fibrosis, were significantly lower in the treatment group compared with the results obtained from the control group. According to the histological peridural grading, the ALA-treated group showed significantly less peridural fibrosis than the control group. CONCLUSION: Intramuscular administration of ALA is a promising treatment for the prevention of peridural fibrosis in the postoperative period.

Significance of androgen receptor and CD10 expression in cutaneous basal cell carcinoma and trichoepithelioma.

Differential diagnosis of trichoepithelioma (TE) and basal cell carcinoma (BCC) on the basis of clinical symptoms and laboratory investigations may be difficult in certain patients. The aim of the present study was to compare cluster of differentiation 10 (CD10) and androgen receptor (AR) expression patterns in BCC and TE, to investigate the predictive power of these proteins as markers of the two conditions. A total of 39 cases of BCC and 15 cases of TE were retrieved from the pathology department archives. AR and CD10 immunohistochemistry was performed on all of the specimens; 23 BCC cases displayed focal nuclear AR staining, however, none of the cases demonstrated diffuse nuclear staining and 16 BCC cases were negative for AR staining. Stromal CD10 staining was more common in TE cases than in BCC cases, and peripheral CD10 staining was more common in BCC cases than in TE cases. AR immunostaining of the BCC samples typically appeared as scattered clusters and individual cells. In addition, AR and CD10 staining exhibited varying staining intensities within each samples. Incisional punch biopsy specimens have the potential to present false-negative results. Therefore, AR and CD10 staining of total excision biopsies provides a more accurate differential diagnosis of BCC and TE for cases with difficulties in the histopathological analysis.

The Effectiveness of Porcine Dermal Collagen (Permacol(®)) on Wound Healing in the Rat Model.

Porcine acellular dermal collagen (PDC), which is a biological material derived from processing porcine dermis, has already been used for urologic, gynecologic, plastic, and general surgery procedures up to now. The aim of this study is to investigate the effectiveness of PDC on wound healing as a dermal substitute in the rat model. Twenty Wistar albino rats were divided into two groups. Standard full-thickness skin defects were created on the back of the rats. In the control group (Group 1), the dressings moisturized with saline were changed daily. In the study group (Group 2), porcine dermal collagen was implanted onto each wound and fixed with 4-0 polypropylene sutures. Contraction percentages of wound areas were calculated on the third, seventh, tenth, and fourteenth days by using the planimetric program. On fourteenth day, the wound areas were excised for histopathological examination, inflammatory scoring, and evaluation of collagen deposition. The study group was superior to the control group in terms of inflammatory scoring, type I/type III collagen ratio, and wound contraction rates. Porcine dermal collagen may be used effectively and safely on full-thickness wounds as a current dermal substitute.

Effects of the Oral Nutritional Supplement Containing Arginine, Glutamine, and Hydroxymethylbutyrate (Abound®) on Healing of Colonic Anastomoses in Rats.

We evaluated the effects of the oral nutritional supplement containing arginine, glutamine, and hydroxymethylbutyrate (Abound®) on healing of colonic anastomoses in experimental rat model. Seventy Wistar-Albino male rats were divided into seven groups. Colon transection and anastomosis were performed in all groups except for the sham group. In groups 2 and 5, rats were fed with standard rat chow after the operation. Oral nutritional supplement was added to standard nutrition for 3 days postoperatively in group 3 and 7 days in group 6 and preoperative 7 days plus postoperative 3 days in group 4 and preoperative 7 days plus postoperative 7 days in group 7. Bursting pressures were measured, adhesions were evaluated, and tissue samples were taken for measurement of tissue hydroxyproline levels and for histopathological examination. The usage of oral nutritional supplement had positive effects on bursting pressures, tissue hydroxyproline levels, and histopathological findings of anastomoses, but feeding with oral nutritional supplement both preoperatively and postoperatively had no additive effect on these parameters when compared with the groups that were fed only postoperatively. The mixture of arginine, glutamine, and hydroxymethylbutyrate may be safely used for achieving better healing results after colonic anastomoses.

Intravascular papillary endothelial hyperplasia: histomorphological and immunohistochemical features.

BACKGROUND: Intravascular papillary endothelial hyperplasia (IPEH) is a benign intravascular process with features mimicking other benign and malignant vascular proliferations. IPEH lesions predominate in the head-neck region and the extremities. The characteristic histomorphological feature of IPEH is a papillary structure covered with hyperplastic endothelial cells within the vascular lumen. It is critical that this clinically benign lesion should not be mistaken for well-differentiated vascular tumors. In addition to the characteristic histological features, other useful diagnostic features included the intra-luminal location of the lesion, an intimate association with the organizing thrombus, the absence of necrosis, cellular pleomorphism, and mitotic activity. In addition, immunohistochemistry may indicate the vascular origin and proliferative index. In this study, we evaluated histomorphological and immunohistochemical findings (CD31, CD34, FVIII, type IV collagen, SMA, MSA, CD105, and Ki-67 staining) of ten IPEH cases. METHODS: Ten IPEH cases were re-examined for a panel of histomorphological and immunohistochemical features. CD31, CD34, FVIII, Type IV collagen, SMA and MSA antibodies utilized for immunohistochemical analysis.The histomorphological and immunohistochemical findings were evaluated by two independent pathologists using light microscopy. RESULTS: All ten cases involved intraluminal lesions with characteristic features of IPEH. All ten cases (100%) were stained positive for CD31 and CD34. The degree of staining with FVIII, type IV collagen, SMA, and MSA was variable. CONCLUSION: In this series of specimens, CD31 and CD34 were the most sensitive markers indicating the vascular origin of the lesion. Staining for the other vascular markers (FVIII, type IV collagen, SMA and MSA) was variable. Different maturation degrees of lesions may account for the variation in immunohistochemical staining. Few previous investigations evaluated a wide range of antigen panels in IPEH sections. In our opinion, the evaluation of immune markers in a larger sample set will reveal new features in the maturity and developmental pathogenesis of vascular lesions and angiogenesis. IPEH is a benign lesion, which must be differentiated from malignant tumors such as angiosarcoma and Kaposi's sarcoma. Improved definition of IPEH lesions using immunohistochemical markers may enhance the ability to differentiate between various vascular lesions. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1381849312101856.

A coenzima Q10 produz efeito sobre a prevenção da miringoesclerose?: Estudo experimental com ratos / Is there any effect of coenzyme Q10 on prevention of myringosclerosis?: Experimental study with rats

Estudos recentes demonstram que a formação de miringoesclerose pode ser reduzida pela aplicação de enzimas e elementos antioxidantes. OBJETIVO: Investigar a eficácia da coenzima Q10 na prevenção de miringoesclerose experimentalmente induzida. MÉTODO: Quarenta e oito ratas Wistar albinas saudáveis sofreram miringotomia e foram divididas aleatoriamente em quatro grupos. O Grupo A não recebeu tratamento algum; o Grupo B recebeu coenzima Q10 por via oral; o Grupo C foi tratado com soro fisiológico tópico; e o Grupo D recebeu coenzima Q10 tópica. No 15º dia de tratamento, as membranas timpânicas foram examinadas por otomicroscopia. As lesões miringoescleróticas foram documentadas de forma semiquantitativa por meio de uma escala de quatro pontos. Após a coleta, as membranas timpânicas foram avaliadas por histopatologia. RESULTADOS: No grupo D (coenzima Q10 tópica) foi observada a ocorrência de otite nos primeiros quatro dias do estudo, o que levou à sua exclusão do estudo. O exame de otomicroscopia não revelou diferenças significativas entre grupos em termos de formação de miringoesclerose (p = 0,241). Diferenças estatisticamente significativas foram observada quando os exames histopatológicos do grupo A foram comparados aos dos grupos B e C (p = 0,004; p < 0,001, respectivamente). Não houve diferença significativa entre os grupos B e C (p = 0,160). CONCLUSÃO: A administração oral de coenzima Q10 não reduziu a formação de miringoesclerose nos ratos submetidos à miringotomia.

Recent studies have shown that the formation of myringosclerosis could be reduced by the application of antioxidant enzymes and elements. OBJECTIVE: The aim of this study was to investigate the effectiveness of coenzyme Q10 on the prevention of experimentally induced myringosclerosis. METHOD: Forty-eight healthy female wistar albino rats were bilaterally myringotomized and divided into four groups randomly. Group A received no treatment, group B was administered oral coenzyme Q10. Group C was treated with topical saline solution, group D received topically coenzyme Q10. On the 15th day of treatment, tympanic membranes were examined by otomicroscopy. Myringosclerotic lesions were documented semiquantitatively by using 4-point scale. After harvesting tympanic membranes were evaluated histopathologically. RESULTS: In group D (topical coenzyme Q10), we observed otitis within the first four days of the study and this group was excluded from the study. Regarding otomicroscopic examinations, there were no significant differences among groups in myringosclerosis formation (p = 0.241). When group A (non treatment) compared to groups B and C regarding histopathologic examination, the results demonstrated statistical significant differences (p = 0.004; p < 0.001), respectively. There was no statisticaly significant difference between groups B and C (p = 0.160). CONCLUSION: Oral administration of coenzyme Q10 did not reduce myringosclerosis formation in myringotomized rats.

Recovery of fertility in azoospermia rats after injection of adipose-tissue-derived mesenchymal stem cells: the sperm generation.

The recent reports on the treatment of azoospermia patients, in which spermatozoa could not be traced in their testes, are focused more on the potential use of adult stem cells, like mesenchymal stem cells (MSCs). The aim of this study was to demonstrate the potential use of MSCs derived from adipose tissue in the treatment of azoospermia using rat disease models. After busulfan application, the rats (n = 20) were injected with the GFP(+) MSCs into left rete testes. After 12 weeks, the testes with cell injection (right testes) were compared to control (left testes) after dimensional and immunohistochemical analyses. Testes treated with MSCs appeared morphologically normal, but they were atrophic in rats without stem cell treatment, in which the seminiferous tubules were empty. Spermatogenesis was detected, not in every but in some tubules of cell-treated testes. GFP(+)/VASA(+) and GFP(+)/SCP1(+) cells in testes indicated the transdifferentiation of MSCs into spermatogenetic cells in the appropriate microenvironment. Rats with cell treatment were mated to show the full recovery of spermatogenesis, and continuous generations were obtained. The expression of GFP was detected in the mesenchymal stem cells derived from adipose tissue and bone marrow and also in the sperms of offspring. In conclusion, MSCs might be studied for the same purpose in humans in future.

Changes in conjunctival cytology and tear function tests with radioiodine treatment for hyperthyroidism.

OBJECTIVES: Radioiodine (RAI) is used in the treatment of hyperthyroidism and differentiated thyroid cancer. Radioiodine therapy is associated with dry eyes and some side effects are seen especially due to beta rays. In this study, the functional and cytological status of lacrimal glands after RAI therapy was evaluated. METHODS: Twenty-five patients with a mean age of 55.16 years with planned low-dose RAI therapy were evaluated. Just before and 6 months after the treatment, the lacrimal glands were evaluated with tear break-up time (BUT), Schirmer's test, impression cytology and "Ocular Surface Disease Index (OSDI)" questionnaire. RESULTS: The mean value of Schirmer's test was 16.20 ± 3.61 pre-treatment and 11.28 ± 4.39 post-treatment for the right eye, and 15.76 ± 3.27 and 10.60 ± 4.42 for the left eye, respectively. The mean value of Schirmer's test decreased significantly post-treatment in both eyes (p = 0.0001). The BUT score also decreased significantly post-treatment (p = 0.001). The mean value of OSDI score was 27.5 ± 8.02 pre-treatment and 46.36 ± 10.27 post-treatment. The mean value of OSDI score increased post-treatment (p = 0.0001). The impression scores also increased post-treatment in both eyes (p = 0.0001). CONCLUSION: Even low-dose (≤30 mci) RAI treatment affects lacrimal gland functions. Low-dose RAI causes a decrease in the value of Schirmer's test and the BUT test, and an increase in the value of OSDI score and impression scores.

Antioxidant role of selenium in rats with experimental acute otitis media.

The aim of this prospective experimental animal study was to determine whether selenium had a protective effect on oxidative stress in rats with acute otitis media, by measuring the alterations of antioxidant parameters and lipid peroxidation on days 4 and 10 after inoculation into the middle ear. Streptococcus pneumoniae was inoculated into the middle ear cavities of 32 rats in animal laboratory of a tertiary medical center. Group 1 served as the control group and the animals were administered 1.5 ml/day saline. Group 2 received 0.2 mg/kg/day oral selenium for 10 days. The blood samples of each group were obtained on post-inoculation days 4 and 10. The levels of thiobarbituric acid reactive substances, albumin, total sulphydryl, superoxide dismutase and glutathione peroxidase were investigated. Day 10 level of thiobarbituric acid reactive substance in group 2 was lower than the day 4 level of the same substance in the control group. Although glutathione peroxidase and superoxide dismutase levels significantly decreased starting from 4th day until 10th day in group 1, their levels increased in group 2. Day 10 levels of albumin and total sulphydryl in group 1 were significantly higher than day 4 levels in group 2. We found that selenium supplementation for 10 days decreased thiobarbituric acid reactive substances and increased glutathione peroxidase and superoxide dismutase levels when compared to the control group. We believe that selenium supplementation may be beneficial to prevent the clinical sequelae and recurrence of otitis media.

Keratoconus in a case of lipoid proteinosis.

PURPOSE: To report a patient of lipoid proteinosis (LP) with bilateral keratoconus. METHODS: A 16-year-old boy presented to our institution with a complaint of gradual decrease in vision over the past 4 years in both eyes and a contact lens intolerance. He had a hoarse voice and multiple areas of hyperpigmented lesions over the head and neck region. Slit lamp biomicroscopy of the both eyes showed multiple round solid pearly lesions along the upper and lower lid margins and a mild central corneal ectasia in both eyes. Central corneal thickness and the keratometric values were measured by using Scheimpflug imaging (Pentacam), and the results were compatible with keratoconus. The histopathologic examination of the lesions taken from bilateral eyelid margins showed hyalinosis, papillomatosis, and depositions of eosinophilic material around the blood vessels, which were compatible with LP. CONCLUSIONS: With this report, we describe a case of LP with keratoconus. As seen in our case, LP and its characteristic eyelid margin lesions in keratoconus patients can be associated with a contact lens intolerance.

Preventive effect of dexmedetomidine in ischemia-reperfusion injury.

BACKGROUND: The aim of this study was to evaluate the effects of dexmedetomidine on ischemia-reperfusion injury of epigastric island flaps of rats. METHODS: Eighty Wistar rats were divided into 4 groups. After the flap elevation, in group 1, the flaps were sutured back without ischemic insult. Groups 2, 3, and 4 were exposed to ischemia for 12 hours. In groups 1 and 2, saline, in group 3, 10 µg/kg dexmedetomidine, and in group 4, 30 µg/kg dexmedetomidine were administered i.p. 45 minutes before I/R periods. Each group was subdivided further into 2 equal groups (a and b). Tissue samples of groups 1a, 2a, 3a, and 4a were obtained 12 hours after the reperfusion, and those of groups 1b, 2b, 3b, and 4b were obtained after 7 days. The necrotic areas were also calculated. Nitric oxide, malondialdehyde (MDA), and myeloperoxidase (MPO) activity were assessed in the tissue samples. RESULTS: Nitric oxide, MDA, and MPO activity levels in group 2a were significantly higher those in group 1a (P < 0.05). The levels in groups 3a and 4a were lower than those in group 2a (P < 0.05). Nitric oxide, MDA, and MPO activity levels were significantly higher in group 2b compared with group 1b (P < 0.05). The levels were lower in Groups 3b and 4b compared with group 2b (P < 0.05). Flap necrosis area was significantly lower in groups 3b and 4b than that in group 2b (P < 0.05). CONCLUSIONS: We conclude that administering dexmedetomidine before I/R periods can reduce ischemia-reperfusion injury of flaps, and it has a beneficial effect on flap survival.

Fine-needle aspiration of follicular patterned lesions of the thyroid: diagnosis, management, and follow-up according to thyroid Bethesda system.

OBJECTIVE: The goal of this study was to report an experience with thyroid fine-needle aspiration (FNA) cases that can be placed into National Cancer Institute-designated thyroid FNA diagnostic categories for follicular patterned lesions divided into three diagnostic categories: follicular lesion of undetermined significance/atypia of undetermined significance (AUS/FLUS), suspicious for follicular neoplasm (SFON), and suspicious for malignancy. STUDY DESIGN: The study cohort included 4,284 cases for the period between January 2007 and July 2011 and all available follow-up data was obtained. All cases classified as 'atypical' and 'rule out follicular neoplasm' were included in the AUS/FLUS category (n = 3,903), whereas cases classified as 'suspicious for' or 'consistent with follicular or Hürthle cell neoplasm' (n = 381) were included in the SFON diagnostic category and compared with histopathologic follow-up. RESULTS: During this period, 14,628 thyroid FNAs were reported in 12,238 patients. Repeat FNA (RFNA) was performed in 1,366/3,903 (35%) patients classified as AUS/FLUS. Histologic outcome data was available in 1,756/3,903 (45%) cases diagnosed as AUS/FLUS and 243/381 (64%) cases diagnosed as SFON. The rate of malignancy in AUS/FLUS cases with and without RFNA was 29 and 14% respectively, and it was 26% in SFON cases. CONCLUSION: The current data shows that the malignancy rates differ between categories and AUS/FLUS cases are best managed by RFNA for selection of cases that can benefit from surgical excision.

The effect of formoterol on peritoneal VEGF levels in rats with endometriosis.

AIM: The aim of this study is to investigate the effect of formoterol (ß2 adrenergic receptor agonist) on peritoneal VEGF levels in rats with endometriosis. MATERIALS AND METHODS: Experimental endometriosis was constituted with implantation of endometrial tissue. The implants were examined by second laparatomy and rats were divided randomly into four groups. One cc saline was applied ip to the control (C) group (n=8) daily, 22.5µg/kg/day ip formoterol was applied to the second (F) group (n=10) daily, 22.5µg/kg/day ip formoterol and 10mg/kg/day ip propranolol were applied to the third (FP) group (n=10) daily, 45µg/kg/day ip formoterol was applied to the fourth (FF) group (n=9). Before treatment and after 30 days treatment period, peritoneal VEGF levels, the volumes and histopathological properties of the implants were evaluated. RESULTS: There were significant differences in between the peritoneal VEGF levels before and after treatment in group 2(F) and group 4(FF) (p(a): 0.01, 0.01 respectively). But there were no significant changes in between the volumes of implants before and after treatment among the groups (p>0.05). There were no significant differences among the groups in histopathological parameters (p>0.05). CONCLUSION: Formoterol treatment was seen to have no effect on the volumes and histopathological structure of endometriotic implants in our study. On the other hand, based on the group 2(F) and 4's (FF) VEGF levels after the treatment, low dose or high dose formoterol may be effective with long term therapy. Formoterol may reduce the development of endometriosis.

Evaluation of the effectiveness of topical ciprofloxacin and prednisolone in the prevention of myringosclerosis.

An antibacterial drug, ciprofloxacin, has been reported to modulate the inflammatory and immune responses on monocytes. Our objective is to evaluate the effectiveness of ciprofloxacin in the prevention of myringosclerosis that is created by myringotomy in rats and to compare it with prednisolone. In this study, 24 healthy Sprague-Dawley type rats of age 3-4 months and 250-300 g weight were used. Rats have been divided into three random groups. Topical ciprofloxacin was administered to the rats in the first group and topical prednisolone was administered to the rats in the third group; no medication was applied to their opposite ears and they were determined as control group. Prednisolone was administered to one ear of the rats and ciprofloxacin was administered to their opposite sides in the second group. After bilateral myringotomies the treatments were applied for 20 days as five drops two times a day. Otomicroscopic examination was made on the 10th day and reperforations were made when necessary. Rats were killed on the 21st day and temporal bone dissections were done. When we evaluate in terms of myringosclerosis and tympanic membrane thickness, in the first group, myringosclerosis and thickness have been observed in two of seven ears (28.6%) where ciprofloxacin was administered and in five of the seven ears (71.4%) where no treatment was applied. In the second group where prednisolone and ciprofloxacin were compared, myringosclerosis and thickness have been observed in six of the ten ears (60.0%) where prednisolone was administered and in four of the ten ears (40.0%) where ciprofloxacin was administered. In the third group, myringosclerosis and thickness have been observed in three of seven ears (42.9%) where prednisolone was administered and in four of the seven ears (57.1%) where no treatment was applied. All histopathological evaluations were made by one pathologist in a blinded manner. In our study, the effect of the ciprofloxacin and prednisolone was similar in preventing the experimental myringosclerosis and TM thickness in rats. When compared with the control groups, this preventive effect was more obvious in the ciprofloxacin treatment group than that of prednisolone.