Evaluation of topical Dexmedetomidine administration in postlaminectomy epidural fibrosis rat model.

Epidural fibrosis is a challenging topic in spinal surgery. Numerous clinical and experimental studies have been focused on this issue to clarify problems faced in spinal procedures for the patient as well as the surgeon and find out new methodologies. Dense cytokines and growth factors which are released from inflammatory cells have been suggested to play a major role in the inception and progression of fibrosis. One of the most investigated and important actor in epidural fibrosis is assumed to be the transforming growth factor-1ß (TGF-1ß) formation. Studies showed that Dexmedetomidine (DEX) downregulates TGF-ß pathway with its anti-inflammatory and antioxidant effects. From this point of view, for the first time in the literature we try to observe if there will be an effect of topical DEX administration over epidural fibrosis in a rat model. We hypothesized that DEX might have preventive effects on epidural fibrosis via anti-inflammatory and antioxidant effects. Twenty-four adult male Wistar albino rats were randomly assigned to three groups (Topical DEX, Spongostan, Laminectomy). A total laminectomy was performed at the L3-L5 level and then the ligamentum flavum and epidural fat tissue were cleared away from the surgical site. Histopathological assessment was performed postoperatively after 4 weeks. Our study revealed that topical DEX administration may have effects on reducing epidural fibrosis. Topical DEX administration may be helpful in preventing epidural fibrosis after laminectomy in rats through multiple anti-inflammatory and antioxidant mechanisms as well as through TGF -1ß pathway.

Giant congenital melanocytic naevus associated with Dandy-Walker malformation, lipomatosis and hemihypertrophy of the leg.

A 30-year-old woman presented with congenital hyperpigmented plaques and multiple tumoral lesions. Her left leg was hypertrophic, although the bones were normal. Dermatological examination revealed hyperpigmented macules and plaques with hair on the legs, abdominal and lumbar areas (covering > 60% of the total body surface) and multiple naevi on the face, arms, back and chest. Multiple soft masses of various sizes, some of which colocalized with hyperpigmented plaques, were seen on the trunk and legs. Malignant melanoma was excluded by histopathological examinations of multiple biopsy specimens obtained from the pigmented lesions. Histopathological examination of one of the soft masses showed that it was a lipoma. Cranial magnetic resonance imaging and computed tomography scans showed an enlarged fourth ventricule and vermis hypoplasia (Dandy-Walker malformation; DWM). Neurocutaneous melanosis is a rare combined abnormality of the skin and central nervous system. A few case reports relating to the coexistence of giant congenital melanocytic naevus, lipomatosis and hemihypertrophy have been published in the literature. We report this very rare case of giant melanocytic naevus with lipomatosis, hemihypertrophy of the leg, and DWM.

Sialadenoma papilliferum of nasal cavity: case report.

OBJECTIVE: We report a rare case of sialadenoma papilliferum. METHOD: A case report of sialadenoma papilliferum is presented. RESULTS: A 67-year-old woman presented with recurrent epistaxis. She was found to have an exophytic, well circumscribed mass on the nasal septum mucosa. The lesion was completely excised. A diagnosis of sialadenoma papilliferum was made based on the characteristic histological pattern. Follow up showed no evidence of recurrence. Subsequently, the patient remained well without complaint of epistaxis. CONCLUSION: To our knowledge, this is the first report in the world literature of sialadenoma papilliferum of the nasal cavity. This case indicates that this rare tumour can present with epistaxis, and can be resolved by means of total excision.

Myoepithelioma of the parotid gland: a report of two cases.

We describe the clinical and pathologic features of two benign myoepitheliomas of the parotid gland. Through 1985, only 42 other cases had been reported in the literature--39 benign and three malignant. Fewer than 100 cases had been reported through 1993. Since then, two other reports have been published. But are these tumors really rare, or are they simply not well recognized? It is our opinion that they are not as rare as is generally believed because the number of case reports is increasing as pathologists have become more aware of their existence.

Primary chest Hodgkin's disease diagnosed by pleural biopsy: case report.

Hodgkin's disease involving the lung and pleura is rare. A case of a 40-year-old woman with one year history of pain in the left arms spreading into chest is presented. Computed tomography showed a mass of 5 x 7 cm in the left hemithorax mediastinum and pleura, pleural effusion and mediastinal lymphadenopathy. Diagnostic methods including percutaneous needle aspiration biopsy of pleura, brochoscopic biopsies, bronchoalveolar lavage, cytological examination of the pleural fluid did not disclose any pathological diagnosis. Lastly, we performed pleural biopsy by video-assisted thoracoscopic surgery and we showed that the lesion was HD of nodular sclerosing type.

Diffuse panbronchiolitis observed in a white man in Turkey.

Diffuse panbronchiolitis (DPB) is a distinct clinicopathological entity which is characterized by chronic recurrent sinopulmonary infection and inflammation. It is prevalent in the Far East, but extremely rare in western countries. In this report, we described the first Turkish case of DPB and also evaluated demographic and diagnostic characteristics of 18 patients with DPB, previously reported from non-Asian countries. We believe that DPB patients described from these countries may also increase if this disease is taken into consideration in differential diagnosis of sinopulmonary diseases. Another consideration is that, since the treatment and prognosis of DPB are different from other obstructive pulmonary diseases, it should not be mistaken for others.

The effects of vagotomy on bacterial translocation: an experimental study.

The effects of truncal vagotomy and proximal gastric vagotomy on bacterial translocation in rats were investigated in this experiment. The rats were divided into three groups. Only esophageal and gastric manipulations were performed in the control group (Group I). The anterior and posterior vagi were found and 0.5- to 1-cm pieces were taken out in the truncal vagotomy + pyloric dilatation group. In addition, pyloric dilatation was performed using a Fogarty catheter (Group II). The branches of the vagi, which lead to the rumen and corpus, were first tied with 5/O silk and then resected in the proximal gastric vagotomy group (Group III). All animals were sacrificed on the 7th day. Qualitative and quantitative tissue cultures of cecum, liver, spleen, mesenteric lymph node, and blood from vena cava were taken and a tissue sample from the ileum was obtained for histopathological examination with light microscopy. At the end of microbiologic study, the bacterial concentration on the cecal wall was 10.68 x 10(8) in the truncal vagotomy group, while it was 0.53 x 10(8) in the proximal gastric vagotomy group. Bacterial translocation was observed more in vagotomy groups than in control groups on the mesenteric lymph node, liver, and spleen. Bacterial translocation was greater in the truncal vagotomy group than in the proximal gastric vagotomy group (P < 0.05). Bacterial translocation was observed mostly in the liver, spleen, and mesenteric lymph node in the proximal gastric vagotomy group. No microorganisms could be cultured on systemic blood cultures. Cultures were positive only for one rat in the proximal gastric vagotomy group and for two rats in the truncal vagotomy group. At the end of histopathologic examination, when histopathologic parameters given for each rat were calculated, they were 5.44 +/- 2.12 in the truncal vagotomy group and 4.77 +/- 2.12 the in proximal gastric vagotomy group. The difference between these two groups was statistically significant (P < 0.05). Thus, there was damage to the intestinal wall in vagotomy groups, and it was greater in the truncal vagotomy group than in the proximal gastric vagotomy group. It was observed that bacterial translocation occurs after vagotomy, that this translocation occurs more after truncal vagotomy than after proximal gastric vagotomy, and that the translocation that occurred after vagotomies was not effective enough to create bacteremia.