Investigation of the Effect of Tenoxicam on Neural Tube Defect Using Chick Embryo Model.

AIM: Our study focuses on neural tube defects (NTDs), which are central nervous system malformations resulting from incomplete neural tube closure in embryos. We aimed to evaluate tenoxicam's effects on embryonic neural tube formation to identify potential teratogenicity and determine the underlying mechanisms leading to NTD. This study enhances our understanding of embryonic neural tube development and the risks of tenoxicam exposure during pregnancy. MATERIAL AND METHODS: This study was conducted at our University's Neuro-embryology Laboratory. A total of 100 fertile chicken eggs were opened using the windowing method after 24 hours of incubation. The embryo cultures were divided into four groups based on tenoxicam dosage: 0.01, 0.02, 0.10 µg, and control group (0.9% SF was administered). The tenoxicam groups were administered 20 µL volume sub-blastodermally. The eggs were incubated for another 24 hours after being covered with sterile draping. All the eggs were opened at the 48th hour, and the embryos were evaluated. RESULTS: Each group consisted of 25 chicken embryos. Normal neural tube development was observed in Group 1 (0.01µg) with 23 out of 25 embryos, Group 2 (0.02µg) with 20 out of 25 embryos, Group 3 (0.10µg) with 16 out of 25 embryos, and Group 4 (control group) with 24 out of 25 embryos. Additionally, the absence of development rate was 8%, 8%, 12%, and 4% in Groups 1, 2, and 3 and the control group, respectively. CONCLUSION: We observed that tenoxicam use caused midline closure defects in early chicken embryos in a dose-dependent manner. Further studies are required to determine the mechanisms underlying the embryonic damage and teratogenic effects due to genetic and environmental factors and minimize the development of congenital defects.

Symptomatic Spinal Seeding Metastasis of a Low-grade Oligodendroglioma.

Extracranial metastases from primary brain tumours are mostly caused by high-grade tumours. Metastases from low-grade intracranial tumours are much rare and usually asymptomatic. We present a case of a symptomatic spinal cord compression with intradural extramedullary and diffuse leptomeningeal infiltration observed approximately 51 months after the first diagnosis of a 52-year male patient with WHO Grade 2 oligodendroglioma with temporoparietal localisation. This patient, who had the complaint of weakness in the lower extremity, was operated on due to a thoracic intradural extramedullary mass. The result of the pathological examination came out as WHO Grade 2 oligodendroglioma, and radiotherapy was planned for this seeding metastasis. The patient who experienced refractory seizures died before his radiotherapy treatment was completed. It should be kept in mind that spinal metastases may also be seen in low-grade intracranial tumours without malignant transformation as in the present case. Key Words: Spinal seeding, Spinal metastases, Low-grade oligodendroglioma.

Can chlorogenic acid reduce oxidative stress and in an experimental spinal cord injury?

BACKGROUND: We aimed to investigate antioxidant and neuroprotective properties of chlorogenic acid in spinal cord injury (SCI). METHODS: Twenty-one rats were divided into three groups. Laminectomy was performed in group L (n=7), spinal cord trauma was induced in group T (n=7), and spinal cord trauma was induced and chlorogenic acid treatment was started in group C (n=7). Blood samples were collected to analyze baseline values and the 12th h, 1st day, 3rd day, and 5th day catalase, native thiol (NT), total thiol (TT), disulfide (SS), SS/TT, SS/NT, and NT/TT levels. Functional analysis with Basso-Beattie and Bresnahan scores was performed at the same time points. Total antioxidant status (TAS), total oxidative stress, oxidative stress index, and cyclooxygenase-2 (Cox-2) were examined in the spinal cord of rats euthanized on day 7; results were statistically analyzed. RESULTS: On day 7, catalase levels in Group C were significantly higher than baseline levels, whereas those in Group T were significantly lower than baseline levels; Group L showed no significant difference (p=0.008). SS values on day 7 were lower in Group T than in Groups C and L. Group C showed the lowest decrease in NT/TT level after trauma. On day 7, SS/TT level was high in Group T but stable in Groups C and L (p=0.04). Histopathological examination revealed significantly lower Cox-2 and TAS levels in Group C than in Group T (p=0.003, p=0.017, respectively). CONCLUSION: In this study, SCI was primarily examined through thiol-SS balance, and it was demonstrated by experimental models that chlorogenic acid has antioxidant and neuroprotective effects in SCI.

Triple mapping for axillary staging after neoadjuvant therapy: Axillary reverse mapping with indocyanine green and dual agent sentinel lymph node biopsy.

Axillary staging is 1 of the major issues of current breast cancer management after neoadjuvant systemic therapy (NST). Sentinel lymph node biopsy (SLNB) is an option for clinically node negative patients. Axillary reverse mapping (ARM) was introduced to identify and preserve the lymphatic drainage from the arm. The aim of the presented study is to employ triple mapping (radiocolloid, blue dye and indocyanine green [ICG]) to assess the crossover rate and metastatic involvement of ARM nodes after NST. Clinically node positive patients before NST who were converted to N0 and scheduled for targeted axillary dissection were included. sentinel lymph node (SLN) mapping was performed via dual agent mapping. ICG was used for ARM procedure. Blue, hot and fluorescent nodes and lymphatics were visualized in the axilla using infrared camera system and dual opto-nuclear probe (Euoroprobe3). Fifty-two patients underwent targeted axillary dissection and ARM procedures 12 out of whom had axillary node dissection. 45 of the 52 patients had at least 1 hot or blue SLN identified intraoperatively. Of these, 61.5% cases had hot SLNs, 42.3% had hot and blue, 15.4% had hot/blue/fluorescent, 7.7% had blue/fluorescent, 6 11.5% had hot/fluorescent and 7 13.5% had only clipped nodes. The overall identification rate of ARM-nodes by means of ICG technique was 86.5%. Overall crossover of ARM nodes with SLNs was determined in 36.5%. The ICG intensity was found to be higher in both hot and blue SLNS (8 out of 18 ICG positive cases, 44.4%). In 3 of 52 patients (5.7%) metastatic SLNs were hot or blue but fluorescent which predicts metastatic involvement of the ARM-nodes. More than 1-third of the patients revealed a crossover between arm and breast draining nodes. The higher observed rate of overlap might partially explain why more patients develop clinically significant lymphedema after NST even after sentinel lymph node biopsy alone. The triple mapping provides valuable data regarding the competency of lymphatic drainage and would have the potential to serve selecting patients for lymphovenous by-pass procedures at the index procedure. NST reduces the metastatic involvement of the ARM nodes. However, conservative axillary staging with sparing ARM nodes after NST necessitates further studies with larger sample size and longer follow-up.

Carotid Artery-Cavernous Segment Injury during an Endoscopic Endonasal Surgery: A Case Report and Literature Review of the Overlooked Option for Surgical Trapping in the Hyperacute Phase.

Internal carotid artery (ICA) injury is a catastrophic complication of endoscopic endonasal surgery (EES). However, its standard management, emergent endovascular treatment, may not always be available, and the transnasal approach may be insufficient to achieve hemostasis. A 44-year-old woman with pituitary adenoma underwent EES complicated with the ICA cavernous segment injury (CSI). In urgent intraoperative angiogram, a good collateral flow from the contralateral carotid circulation was observed. Due to the unavailability of intraoperative embolization, emergent surgical trapping was performed by combined transcranial and cervical approach. The patient recovered but later developed a giant cavernous pseudoaneurysm. During the pseudoaneurysm embolization, ICA was directly accessed via a 1.7-F puncture hole using a bare microcatheter technique. Then, both the aneurysm and parent artery were obliterated with coils. At the 4-year follow-up, the patient was asymptomatic without a residual tumor. To our knowledge, this is the first case of ICA-CSI during EES successfully treated with ICA trapping as a lifesaving urgent surgery that achieved a complete recovery after a pseudoaneurysm embolization. Although several studies reported that EES-related ICA-CSIs with percutaneous carotid artery access, neither our surgical salvage technique nor our carotid access and tract embolization techniques were previously described.

Probable viremia and positive placental swabs for SARS-CoV-2 in a preterm pregnant woman with mild COVID-19.

This study aimed to report a case of mild novel coronavirus disease (COVID-19) in a pregnant woman with probable viremia, as reverse transcription-polymerase chain reaction (RT-PCR) testing of endometrial and placental swabs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive. A 26-year-old multigravida at 35 weeks 2 days of gestation, who had extensive thigh and abdominal cellulitis, tested SARS-CoV-2 positive by RT-PCR performed on samples from the endometrium and maternal side of the placenta. However, other samples (amniotic fluid, fetal side of the placenta, umbilical cord, maternal vagina, and neonatal nasopharynx) tested negative for SARS-CoV-2. This is one of the rare reports of probable SARS-CoV-2 viremia with the presence of SARS-CoV-2 in the endometrium and placenta, but not leading to vertical transmission and neonatal infection. Because knowledge about transplacental transmission and results is very limited, we conclude that more RT-PCR tests on placental and cord blood samples are needed in order to safely make definite conclusions.

Uniportal VATS pleural biopsy in the diagnosis of exudative pleural effusion: awake or intubated?

BACKGROUND: The aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions. METHODS: The diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under local anesthesia and sedation performed by the same surgeon in patients with undiagnosed exudative pleural effusion between 2007 and 2020 were retrospectively evaluated. Test sensitivity, specificity, positive predictive value and negative predictive value were compared as well as age, gender, comorbidities, procedure safety, additional pleural-based interventions, duration time of operation and length of hospital stay. RESULTS: Of 154 patients with undiagnosed exudative pleural effusion, 113 (73.37%) underwent pleural biopsy and drainage with VATS, while 41 (26.62%) underwent AVATS pleural biopsy. Sensitivity, specificity, positive predictive value and negative predictive value were 92, 100, 100, and 85.71% for VATS, and 83.3, 100, 100, and 78.9% for AVATS, respectively. There was no significant difference in diagnostic test performance between the groups, (p = 0.219). There was no difference in the rate of complications [15 VATS (13.3) versus 4 AVATS (9.8%), p = 0.557]. Considering additional pleural-based interventions, while pleural decortication was performed in 13 (11.5%) cases in the VATS group, no pleural decortication was performed in AVATS group, (p = 0.021). AVATS group was associated with shorter duration time of operation than VATS (22.17 + 6.57 min. Versus 51.93 + 8.85 min., p < 0.001). Length of hospital stay was relatively shorter in AVATS but this was not statistically significant different (p = 0.063). CONCLUSIONS: Our study revealed that uniportal AVATS pleural biopsy has a similar diagnostic efficacy and safety profile with VATS in the diagnosis and treatment of patients with undiagnosed pleural effusion who have a high risk of general anesthesia due to advanced age and comorbidities. Accordingly, uniportal AVATS pleural biopsy may be considered in the diagnosis and treatment of all exudative undiagnosed pleural effusions.

Anti-inflammatory and antioxidative effects of genistein in a model of spinal cord injury in rats.

Background: Neurological damage from spinal cord injury (SCI) is a result of primary mechanical injury and secondary damage from oxidative stress and neuroinflammation. Although genistein has been shown to have potent antioxidant and anti-inflammatory effects in studies of brain injury, its effect on secondary damage in SCI has remained unknown. Objective: To determine effects of genistein in a model of SCI in rats. Methods: We divided 21 rats evenly into 3 groups, a control group, in which only a laminectomy was performed; a trauma group in which SCI was induced; and a genistein group in which genistein was administered subcutaneously after SCI. The rats were assessed using a Basso-Beattie and Bresnahan functional score at the 12th hour and on the 1st, 3rd, 5th, and 7th days. Biochemical analyses were conducted at the same time points to determine the serum levels of catalase, ischemia-modified albumin (IMA), disulfide (SS), total thiol (TT), native thiol (NT), disulfide/total thiol (SS/TT), and native thiol/total thiol (NT/TT). Total oxidant and antioxidant capacity, and oxidative stress index were determined in spinal cord tissue obtained on the 7th day together with immunohistochemistry for cyclooxygenase-2 levels. Result: Catalase activity on the 7th day was significantly (P = 0.001) higher in the genistein-treated rats than in other groups, and IMA levels became stable earlier (3rd day) in the genistein group. SS values were significantly (P = 0.004) lower in the genistein group. NT/TT ratio were significantly (P = 0.049) higher in the genistein-treated rats on the 7th day. Conclusion: Genistein has antioxidant, anti-inflammatory, and protective effects in a model of SCI in rats and warrants further study.

Efficacy of uniportal video-assisted thoracoscopic pericardial window creation using two lung ventilation in chronic large pericardial effusions.

OBJECTIVE: To demonstrate that two lung ventilation under general anaesthesia may also be safely performed to create pericardial window with uniportal video-assisted thoracoscopic surgery. METHOD: The single-centre, retrospective, comparative study was conducted at Bulent Ecevit University, Zonguldak, Turkey, comprised data from March 2011 to March 2018 of patients with recurrent and/or with chronic large pericardial effusions unresponsive to medical therapy and/or to pericardiocentesis and who underwent pericardial window creation with uniportal video-assisted thoracoscopic surgery. Group 1 had data of patients in whom pericardial windows were created under general anaesthesia, while group 2 had patients with two lung ventilation. Parameters compared between the groups were gender, age, operation side, operation time amount of drainage, complication, recurrences and survival. Data was analysed using SPSS 19. RESULTS: Of the 20 patients, 9(45%) were males and 11(55%) were females. Group 1 had 14(70%) patients, while group 2 had 6(30%). The age of patients in group 2 was significantly higher than those in group 1 (p=0.041). There was no significant difference between the groups with respect to gender, amount of drainage, operation time and post-operative complications (p>0.05). There was no recurrence or mortality in either of the two groups. CONCLUSIONS: Pericardial window could be created safely with video-assisted thoracoscopic surgery under two lung ventilation for patients carrying high risk for one lung ventilation.

Neuroprotective effects of quercetin on cerebral vasospasm following experimental subarachnoid haemorrhage in rats

Background/aim: We examined the protective effects of the natural flavonoid, quercetin, against cerebral vasospasm in an experimental rat subarachnoid haemorrhage (SAH) model. Materials and methods: Thirty-eight albino Wistar rats were divided into five groups as follows: group 1 (G1, n=8), no experimental intervention; group 2 (G2, n=8), subarachnoid physiological saline; group 3 (G3, n=8), SAH; group 4 (G4, n=7) SAH and low-dose (10 mg/kg) quercetin treatment; group 5 (G5, n=7), SAH and high-dose (50 mg/kg) quercetin treatment. Subarachnoid haemorrhage was induced by injection of 0.15 cc of autologous blood taken from the tail artery into the cisterna magna from the craniocervical junction and basilar arteries and blood samples were taken for biochemical and histopathological analyses. Results: Malondialdehyde (MDA) levels were significantly higher in G2 and G3 than in G1 (P < 0.05). Significant decreases in MDA were observed in G4 and G5 compared with G2 (P < 0.05, G4­G2; P < 0.05, G5­G2). There were no significant differences between G2 and G3 or among G1, G4, and G5. No statistically significant differences were found in total antioxidant capacity between the groups (P > 0.05). There were no significant differences in basilar artery (BA) wall thickness between G3 and G4 or between G3 and G5, but G4 and G5 showed greater luminal diameters than G3 (P < 0.05). There were no significant differences in BA thickness or luminal diameter between G4 and G5. Conclusion: Our results suggested that quercetin may be beneficial in SAH therapy by preventing vasospasm.

Microsurgical Management of Ventral Intradural-Extramedullary Cervical Meningiomas: Technical Considerations and Outcomes.

OBJECTIVE: Cervical meningiomas are uncommon intradural-extramedullary tumors that have a tendency to be situated anterior to the spinal cord. The optimal surgical corridor to reach purely ventral cervical meningiomas has not been established. This article presents a series of patients with ventral cervical meningiomas treated via 1 of 2 microneurosurgical approaches: the anterior approach with corpectomy and fusion or the posterolateral approach. METHODS: Eight patients who underwent surgical resection of solitary, histopathologically confirmed, intradural-extramedullary cervical meningiomas of purely ventral location were retrospectively examined. Preoperative and postoperative Nurick scores quantified the degree of ambulatory function. Patients were followed for an average of 2.1 years after surgery. Postoperative imaging was performed to determine the extent of resection and to assess for tumor recurrence. RESULTS: Two patients with lower cervical meningiomas underwent resection via an anterior approach with single-level corpectomy and fusion. Six patients were treated via a posterolateral approach including ipsilateral hemilaminectomy and partial facetectomy without fusion. No intraoperative or postoperative complications were observed. Gross total resection was achieved in 8 of 8 patients, although 1 patient exhibited tumor recurrence. Improvement in ambulatory function was observed in all patients. CONCLUSIONS: Purely ventral cervical meningiomas are uncommon and pose unique technical challenges for neurosurgeons. We document favorable outcomes from 2 cases of lower cervical meningioma treated via an anterior approach and 6 cases of upper cervical tumors treated via a posterolateral approach. This series demonstrates operative considerations for effectively managing ventral cervical meningiomas.

Intraoperative ultrasonography-guided surgery: An effective modality for breast conservation after neo-adjuvant chemotherapy.

Margin status is one of the significant prognostic factors for recurrence in breast-conserving surgery (BCS). The issue that merits consideration for oncologic safety and cost-effectiveness about the modalities to assure clear margins at initial surgical intervention remains controversial after neo-adjuvant chemotherapy (NAC). The presented study aimed to assess the impact of intraoperative ultrasound (IOUS)-guided surgery on accurate localization of tumor site, adequacy of excision with clear margins, and healthy tissue sacrifice in BCS after NAC. Patients who had IOUS-guided BCS ater NAC were reviewed. No patient had preoperative localization with wire or radiotracer. Intraoperative real-time sonographic localization, sonographic margin assessment during resection, macroscopic and sonographic examination of specimen, and cavity shavings (CS) were done as the standard procedure. No frozen assessment was performed. One hundred ninety-four patients were included, in which 42.5% had pCR. IOUS-guided surgery accomplished successful localization of the targeted lesions in all patients. Per protocol, all inked margins on CS specimens were reported to be tumor-free in permanent histopathology. No re-excision or mastectomy was required. For a setting without CS, the negative predictive value (NPV) of IOUS rate was 96%. IOUS was found to over and underestimate tumor response to NAC both in 2% of patients. IOUS-guided surgery seems to be an efficient modality to perform adequate BCS after NAC with no additional localization method. Especially, when CS is integrated as a standard to BCS, IOUS seems to provide safe surgery for patients with no false negativity and a high rate of NPV.

The protective and anti-inflammatory effect of methylene blue in corrosive esophageal burns: An experimental study.

BACKGROUND: In developing countries, esophageal burns are quite common. They are caused by the ingestion of corrosive substances that may lead to esophageal perforation in the short-term and stricture formation in the long-term. Prevention of stricture progression in the esophagus is the main aim of the treatment for corrosive esophageal burns. We aimed to investigate the protective and anti-inflammatory effects of methylene blue (MB) treatment on corrosive esophageal burns. METHODS: Twenty-eight rats were used in the study and randomly divided into four equal groups; group 1 (Sham), group 2 (control), group 3 (topical treatment), and group 4 (topical plus systemic treatment). Except for group 1 (Sham group), all three groups received sodium hydroxide (NaOH) in order to generate esophageal burns. In addition, group 2 was given normal saline, group 3 topical MB, and group 4 topical and systemic MB. RESULTS: Hydroxyproline levels were found to be lower in each of the treatment groups as compared to the control group (p=0.005 for group 3 and p=0.009 for group 4). There were no differences in the tumor necrosis factor-α (TNF-α) levels between the groups. The stenosis index (SI) in the treatment groups was also lower than the control group (p=0.016 for group 3 and p=0.015 group 4). The histopathologic damage score (HDS) was prominently lower in group 4 as compared to the control group (p=0.05). CONCLUSION: MB is effective in treating tissue damage caused by corrosive esophageal burns and in preventing esophageal stenosis. Complication rates of corrosive esophageal burns may be decreased by using MB in the initial treatment stage.

The Effect of Phenyramidol on Neural Development in Early Chicken Embryo Model.

AIM: To investigate the effects of Phenyramidol (Phe) on neural development in an early chicken embryo model. MATERIAL AND METHODS: Sixty fertile non-pathogenic Super Nick eggs were incubated for 24 hours (h) and divided into four groups of 15 eggs each. Phe was administrated through the sub-blastoderm, and the eggs were incubated for another 24 h. All eggs were opened after 48 h of incubation, and the embryos were evaluated morphologically and histopathologically. RESULTS: In Group 1 (control group), none exhibited neural tube defects (NTDs) (0%), 1 (6.6%) was undeveloped; in Group 2 (low dosages), 1 did not develop (6.6%); in Group 3 (normal dosages), 2 (13.4%) had NTDs, 1 (6.6%) was undeveloped; in Group 4 (high dosages), 5 (33.3%) had NTDs, 2 (13.3%) were undeveloped. CONCLUSION: In light of the results, it was determined that the use of increasing doses of Phe led to defects in midline closure in early chicken embryos. This is the first report in the literature on Phe used in an early chicken embryo model.

Neuroprotective Effects of Hesperidin on Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage in Rats: Biochemical, Pathologic, and Histomorphometric Analysis.

OBJECTIVE: We examined the protective effects of hesperidin on cerebral vasospasm by establishing an experimental rat model of subarachnoid hemorrhage and performing biochemical, pathologic, and histomorphometric analysis on these data. METHODS: Forty albino Wistar rats were randomly divided into 5 groups of n = 8 in each: group (G)1, no experimental interventions; G2, subjected to subarachnoid hemorrhage; G3, subjected to subarachnoid hemorrhage and administered saline (100 mg/kg); G4, subjected to subarachnoid hemorrhage and treated with low-dose hesperidin (50 mg/kg); and G5, subjected to subarachnoid hemorrhage and treated with high-dose hesperidin (100 mg/kg). Subarachnoid hemorrhage was created by injecting 0.15 cc of autologous blood taken from the rat-tail artery and injected into the cisterna magna from the craniocervical junction. Drugs were administered intraperitoneally as twice daily doses for 48 hours. Rats were euthanized at the end of this period. RESULTS: No statistically significant decrease was observed in malondialdehyde levels, which is the end-product of lipid peroxidation, among the drug groups (G4 and G5). Thin sections prepared from the basilar artery were examined morphologically. Severe luminal narrowing and vessel-wall thickening were observed in the subarachnoid hemorrhage groups (G2, G3). In the hesperidin-administered groups (G4, G5), it was determined that vessel wall thickness measurements revealed thinner walls than in the subarachnoid hemorrhage groups (G2, G3) and the luminal diameters were significantly larger than in the subarachnoid hemorrhage groups (G2, G3). CONCLUSIONS: These findings suggest that hesperidin has no effect on malondialdehyde-associated lipid-peroxidation activity; however, it might be useful in subarachnoid hemorrhage therapy because of its beneficial effects on vessel wall thickness and luminal diameters.

Atypical spindle cell/pleomorphic lipomatous tumor: A clinicopathologic, immunohistochemical, and molecular study of 20 cases.

Lipomatous tumors accompanied by spindle cell component are not frequently encountered, and there are still problems regarding their differential diagnosis, nature, and nomenclature. To contribute to ongoing efforts, we present the clinical, histologic, and immunohistochemical characteristics of 20 cases of spindle cell lipomatous tumors with atypical features that may also be called atypical spindle cell/pleomorphic lipomatous tumors. Of the patients, 13 were men and 7 were women with an average age of 57.5 years. The most commonly affected site was the extremities. Twelve tumors arose in the subcutaneous tissue, while eight cases were located in the deep soft tissues. Tumor margins were often ill-defined with invasion into the surrounding tissues. Microscopic examination revealed a wide spectrum of histologic features. All cases consisted of poorly marginated proliferation of mildly atypical spindle cells set in a fibrous or myxoid stroma with a variable amount of adipocytic component showing variation in adipocyte size and scattered nuclear atypia and frequent univacuolated or multivacuolated lipoblasts. Tumor cellularity and the relative proportion of the components were highly variable. One tumor showed morphologic features evocative of dedifferentiation and another one exhibited histological features resembling pleomorphic liposarcoma. None of the patients had recurrence or metastasis at follow-up.

Effect of Riluzole on Spinal Cord Regeneration with Hemisection Method Before Injury.

OBJECTIVE: The pathophysiology of spinal cord injury (SCI) with the information obtained to date has not been elucidated fully. A safe drug or treatment protocol that results in cell regeneration for SCI remains unknown. Neuroprotective and neuroregenerative effects of riluzole, administered after a SCI, have been shown in experimental studies. This study aimed to investigate the effect of riluzole on neural regeneration in a rat SCI model. METHODS: Thirty-two rats were divided into 8 groups, with 4 rats in each group. Hemisection method was performed after T7-T9 laminectomy. Rats were intraperitoneally aministered with riluzole (6 mg/kg). Locomotor recovery of the rats was assessed at 1 day, and 1, 2, 3, and 4 weeks after the 21-point Basso, Beattie, and Bresnahan test. Subsequently, the spinal cords of the rats were scored according to a semiquantitative grading system using a light microscope, and the numbers of myelinated axons, neurons, and glial cells were calculated. RESULTS: Basso, Beattie, and Bresnahan test changes were statistically significant when groups 4-6 and 8 were compared with the other groups (P < 0.05, P < 0.00625). The results of the numbers of neurons, glial cells, and myelinated axons were statistically significant. Especially group 8, in which riluzole was administered 5 days before injury, more positive clinical and histopathologic results were obtained. CONCLUSIONS: Riluzole treatment is more effective when provided before injury. Riluzole may contribute to functional recovery when used in the preoperative period in patients who are at a high risk for permanent neurologic deficit.

A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study.

OBJECTIVE: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. MATERIAL AND METHOD: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. RESULTS: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. CONCLUSION: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.

Beneficial effects of garlic (Allium sativum) oil in experimental corrosive esophageal burns effects of garlic oil in esophageal burns.

BACKGROUND: Corrosive esophageal burns, particularly common in developing countries, lead to different problems in different age groups. The ingestion of corrosive substances can cause such problems as stricture of the esophagus, to acute perforation, and even death. Because stricture formation is related to the severity of the initial injury, the prevention of stricture constitutes a main goal of treatment. The aim of this study was to investigate the protective and anti-inflammatory effects of garlic (Allium sativum) oil in corrosive esophageal burn. METHODS: Twenty-eight rats were randomly divided into 4 equal groups: group 1 (sham), group 2 (control), group 3 (topical treatment), and group 4 (topical and systemic treatment). In groups 2, 3, and 4, corrosive esophageal burns were generated by applying sodium hydroxide to a 1.5-cm segment of the abdominal esophagus. Normal saline was applied to group 2, topical garlic oil to group 3, and topical and systemic garlic oil were used in group 4. RESULTS: The level of hydroxyproline was lower in the topical treatment groups than in the control group (p=0.023). There was difference in tumor necrosis factor alpha level between the systemic treatment groups and the control group (p=0.044). Treatment with garlic oil decreased stenosis index (SI) and histopathological damage score (HDS) in corrosive esophageal burn rats. The SI in the topical treatment group was significantly lower than that of the control group (p=0.016). The HDS was significantly lower in group 4 when compared with the control group (p=0.019). CONCLUSION: Garlic oil is an effective agent in promoting the regression of esophageal stenosis and tissue damage caused by corrosive burns. While the protective effect of garlic oil on tissue damage is more significant when applied topically, the anti-inflammatory effect is more pronounced when applied systemically. Therefore, we believe that the application of garlic oil in patients with corrosive esophageal burns can reduce complication rates.

Surgeon performed continuous intraoperative ultrasound guidance decreases re-excisions and mastectomy rates in breast cancer.

BACKGROUND: Intraoperative ultrasound guided (IUG) breast conserving surgery (BCS) is being increasingly embraced by breast surgeons worldwide. We aimed to compare the efficacy of IUG-BCS for palpable and nonpalpable breast cancer with respect to margin status, re-excision rate, tissue sacrifice and cost-time analysis. METHODS: Intraoperative localization protocol includes intraoperative ultrasound prior to excision to localize the lesion and guide the initial resection. The excised specimen was then examined visually and by palpation and the specimen and cavity was examined with ultrasound. Frozen sections were obtained routinely from a portion of all six faces of the resected specimen, and shaved cavity margins were sent for permanent histology. RESULTS: Of the 208 patients, 57.2% had nonpalpable tumors. The sensitivity of ultrasound localization was 100%. Negative margins were achieved in 92.43% of nonpalpable and 91.01% of palpable lesions at initial procedure. The involved margins were correctly identified by the surgeon via specimen sonography in 95.4% of cases. Final positive margin rate was 2.4%. Calculated resection ratio and time analysis revealed nothing significant. CONCLUSION: IUG-BCS is an invaluable and effective modality for obtaining clear surgical margins with optimum resection volumes and reducing re-operations. Furthermore, by means of this algorithm, in case of shaving cavity margins of the tumor bed for permanent analysis, frozen section evaluation might be omitted.