Amifostine enhances the antioxidant and hepatoprotective effects of UW and HTK preservation solutions.

AIM: To investigate whether amifostine contributes to the antioxidant and cytoprotective effects of histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) preservation solutions. METHODS: Forty-eight Sprague Dawley male rats were equally divided into six groups: (1) ringer Lactate (RL) group; (2) RL + amifostine (RL + A) group; (3) HTK group; (4) HTK + A group; (5) UW group; and (6) UW + A group. Rats in the RL + A, HTK + A and UW + A groups were administered amifostine intraperitoneally at a dose of 200 mg/kg prior to laparotomy. The RL group was perfused with RL into the portal vein. The RL + A group were perfused with RL into the portal vein after amifostine administration. The HTK group received an HTK perfusion while the HTK + A group received an HTK perfusion after administration of amifostine. The UW group received a perfusion of UW, while the UW + A group received a UW perfusion after amifostine administration. Liver biopsy was performed to investigate histopathological, immunochemical [transferase mediated dUTP nick end labeling (TUNEL), inducible nitric oxide syntetase (iNOS)] and ultrastructural alterations. Biochemical alterations were determined by examining levels of alanine aminotransferase, alkaline phosphatase and nitric oxide in the perfusion fluid. RESULTS: Pathological sinusoidal dilatation and centrilobular hydropic alteration were significantly lower in the groups that received amifostine prior to preservation solution perfusion. Although the best results were obtained in the UW + A group, we did not observe a statistically significant difference between the UW + A and HTK + A groups. iNOS grades were significantly lower in the amifostine groups 12 h after treatment. When the amifostine groups were compared against each other, the iNOS grades obtained from the UW + A and HTK + A groups were similar while the RL + A group had a much poorer score. TUNEL assays demonstrated a lower apoptosis ratio in the amifostine groups than in the non-amifostine groups 12 h after treatment. No statistically significant difference was observed between the UW + A and HTK + A groups for apoptosis. Cellular ultrastructure was best preserved in the UW + A and HTK + A groups. CONCLUSION: Here, we show that preoperative administration of a single dose of amifostine is sufficient to minimize the preservation damage in hepatic cells.

Lymph node human papillomavirus DNA positivity in uterine cervical cancers and its relationship with prognostic factors.

INTRODUCTION: Uterine cervical cancer is a major health care issue worldwide. Human papillomavirus (HPV) DNA positivity in regional lymph nodes has been proposed as a risk factor for recurrence in a number of studies. The aim of our study was to determine the correlation between well-known prognostic factors and HPV DNA positivity in regional lymph nodes of patients with cervical cancer who were treated surgically. METHODS: Thirty-seven patients who underwent radical hysterectomy (Piver class III) with regional lymph node dissection for International Federation of Gynecology and Obstetrics stage IB uterine cervical cancer were assessed for nodal HPV DNA status using polymerase chain reaction. Human papillomavirus DNA presence and types were analyzed in paraffin-embedded tissues from all primary tumors and 746 regional lymph nodes. The correlation between HPV DNA positivity of the lymph nodes and prognostic factors (stage at the time of diagnosis, status of the regional nodes, status of parametrial and surgical margins, tumor size, histological type, cervical stromal invasion depth, and lymphovascular space invasion was investigated. RESULTS: Lymph node HPV DNA positivity increased in larger tumors (P < 0.05). In addition, lymph node metastasis and primary tumor HPV DNA status were closely correlated with the HPV DNA status of the lymph nodes (P < 0.05). CONCLUSIONS: Human papillomavirus DNA presence in the lymph nodes of patients with uterine cervical cancer may have an influence on disease survival and requires further research. Future studies with prospective design and large sample sizes using fresh operative specimens and quantitative HPV DNA detection methods are needed.

MRI of recurrent isolated cerebral Whipple's disease.

Whipple's disease is a rare systemic bacterial infection, characterized predominantly by gastrointestinal symptoms. Neurological symptoms are frequent in the course of the disease; however, a purely neurological presentation is uncommon. Diagnosis is confirmed with biopsy and polymerase chain reaction studies. Magnetic resonance imaging (MRI) findings vary, most commonly showing increased signal intensity on T2-weighted images. Contrast-enhanced images and diffusion- weighted imaging are useful to demonstrate meningeal enhancement and any accompanying infarcts. Brain biopsy is often performed, and MRI is crucial to guide the biopsy. Cerebral Whipple's disease is a long-lasting infection requiring long-term follow-up of these patients. MRI should be performed to detect any potential recurrence. We present a case of recurrent isolated cerebral Whipple's disease in a 68-year-old man with atypical presentation and MRI findings.

Intramedullary bronchogenic cyst of the conus medullaris.

Spinal bronchogenic cysts are rare congenital lesions. The authors describe their experience in the treatment of a 17-year-old boy who presented with back pain and paresthesia in both lower extremities. Lumbar MR imaging revealed the presence of an intramedullary cystic lesion at the conus medullaris and histopathological analysis revealed a bronchogenic cyst. To the best of the authors' knowledge, this is the first report of an intramedullary spinal bronchogenic cyst arising at the conus; all previously reported spinal bronchogenic cysts were either intradural extramedullary or not located at the conus.

Effect of obstruction on morbidity and mortality in patients with right-sided colon carcinoma: a case-matched study.

In this retrospective case-matched study, our aim was to assess the influence of an obstruction on mortality, morbidity, and long-term survival in patients with right-sided colon cancer. Thirty-seven patients who had undergone curative emergency surgery for the treatment of right-sided colon cancer were matched according to age, American Society of Anesthesiology score, and disease stage with 37 control patients who had undergone curative elective surgery, and the outcomes were compared. There was a trend toward a higher rate of recurrence and a lower rate of survival in patients with an obstruction; however, the difference was not statistically significant. The only independent prognostic factor was tumor site, with hepatic flexure tumors having the worst results. Emergency surgery performed to treat an obstruction does not negatively influence early postsurgical morbidity and mortality. Survival of patients with obstructive colorectal cancer is correlated with certain pathological variables and less strongly associated with clinical variables.