Predictive Value of Preoperative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio in Determining the Stage of Colon Tumors.

Introduction Biomarkers such as the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) are associated with the colon tumor stage and prognosis. Therefore, in our study, we investigated whether these biomarkers are important in determining the colon cancer stage. Materials and methods The outcomes in 268 patients operated on with the diagnosis of colon cancer between January 2011 and March 2019 were retrospectively analyzed. The relationship of the stage of the patients with the NLR or PLR was evaluated. In addition, according to the stage of colorectal tumors, stage I and other stages (stages II, III, and IV) were compared in terms of NLR and PLR. Groups that had lymph node (LN) metastasis were compared with those that did not. Finally, groups with and without metastasis were also compared. Results In our cohort, 144 patients (57.6%) were male, and 84 (42.4%) were female. The mean age was found to be 68.28 ±12.71 years. The patients were evaluated according to their stages: 26 patients were stage I, 78 patients were stage II, 75 patients were stage III, and 19 patients were stage IV. There was a significant difference in NLR values between the groups (p: 0.05). Also, 104 patients were LN-negative (stages I-II), and 94 patients were LN-positive (stages III-IV). When PLR was compared between the two groups, no significant difference was found between tumor stages and these values (p: 0.099). However, there was a significant difference in NLR values (p: 0.034). Conclusion  Based on our findings, it has been concluded that increased PLR may not be associated with the colon cancer stage. However, the increase in NLR was found to be correlated with tumor stage and LN metastasis.

Chemoresistance in Malignant Intracranial Tumors: Longer Survival with Negative MDR1 Expression.

AIM: To analyze the Glutathione S-transferase (GST)-P, GST-M, cytochrome p450 (CYP)1-A1, CYP1-B1, and multidrug resistance (MDR)-1 expressions in malignant intracranial tumor (ICT)s, and to elicit their role on patient survival. MATERIAL AND METHODS: GST-P, GST-M, CYP1-A1, CYP1-B1, and MDR-1 expressions were analyzed using immunostaining in 149 samples from 141 patients with preoperative ICT diagnosis. The case characteristics were reviewed, and the enzyme expressions were equated based on the age, gender, and tumor type. Then, 77 of 141 patients with malignant ICT and complete medical records postoperative were also investigated in detail for the relationship between the diagnosis, enzyme expression, and overall survival. RESULTS: The average age was 49.44 years, with 83 (58.45%) male patients. Among the 77 malignant ICTs, 38 (49.3%) and 29 were glial tumors and metastases, respectively, with a 13.35-month overall survival. Patients with metastatic tumor have approximately threefold higher GSTP level than those with glial tumors. MDR-1 expression was approximately twofold higher in > 60-year-old patients. No statistically significant association was found between patients? smoking behaviors, alcohol consumption, and overall survival. Only MDR-1 expression was correlated with overall survival. Better overall survival was observed in patients with a negative MDR-1 expression than those with a positive one. CONCLUSION: MDR-1 is an important indicator of survival in malignant intracranial tumor patients. Longer survival is associated with negative MDR-1 expression.

Survivin expression starts before hepatocellular cancer development in the liver of chronic hepatitis B patients: a pilot, cross-sectional study.

INTRODUCTION: Survivin expression is well known feature of hepatocellular carcinoma (HCC); however, there is no information about survivin expression in chronic hepatitis B (CHB). AIM: Investigating survivin expression in the liver of CHB patients. MATERIAL AND METHODS: This is a single-centre, cross-sectional study. Seventy-five CHB patients and eight control patients were enrolled into the study between 2008 and 2018. Immunohistochemical study was performed by using anti-survivin antibody to evaluate survivin immunoreactivity. RESULTS: Survivin immunoreactivity was significantly higher in CHB patients compared to controls (p = 0.008). Also, the degree of survivin immunoreactivity was significantly higher in CHB patients (p = 0.027). Between the anti-survivin-positive and anti-survivin-negative groups, baseline laboratory parameters and initial pathology features were not significantly different. CONCLUSIONS: This is the first study evaluating survivin expression in CHB patients. Understanding the possible relationship between survivin expression and HCC development in this population can promote new studies in terms of new therapies and treatment timing.

Effects of Different Doses of Systemic Isotretinoin on Eyes: A Histopathological and Immunohistochemical Study in Rats.

PURPOSE: To evaluate ocular side effects associated with systemic isotretinoin histopathologically. METHODS: In this multicenter study, a total of 15 male and 15 female rats were randomly divided into 3 equal groups according to the oral dose of isotretinoin they were administered: 0 mg/kg/d (group A), 7.5 mg/kg/d (group B), and 15 mg/kg/d (group C). Biopsy specimens were taken from the globe conjunctiva, cornea, and eyelid conjunctiva. Expression levels of human beta-defensin-1, human beta-defensin-2, toll-like receptor (TLR)-2, and TLR-4 were evaluated by immunohistochemical methods. RESULTS: The number of goblet cells in eyelid conjunctiva was significantly lower in group B than that in group A and group C (P = 0.002). The sizes of meibomian gland acini were significantly smaller in group B and group C than those in group A (P < 0.001). Fibrosis of eyelid conjunctiva was significantly higher in group C and group B than that in group A (P = 0.002). The levels of staining of TLR-4 in the cornea with group B were significantly lower compared with group C (P = 0.035). CONCLUSIONS: Our study suggests that isotretinoin in the early period affects eyelid conjunctiva and meibomian glands without affecting the globe conjunctiva and cornea. Occurrence of the initial symptoms of isotretinoin on the eyelids, especially on the meibomian glands, suggests that the symptoms of patients occur because of evaporative dry eye.

The importance of complete blood count parameters in the screening of gastric cancer.

INTRODUCTION: Gastric cancer is ranked fourth among all cancers in the world and second in cancer-related deaths. Gastritis leads to the activation of neutrophils, lymphocytes, macrophages, and platelets. Long-term inflammation leads to multistage histopathologic changes called Correa tract, which includes gastritis, atrophy, intestinal metaplasia (IM), dysplasia, and cancer stages. AIM: To determine if there is any difference in haematological parameters between gastric cancer (GC) patients, patients with IM, and healthy controls (HC). MATERIAL AND METHODS: Seventy-three GC patients, 79 patients with IM, and 70 HCs were included in the study. Demographics and laboratory parameters of complete blood count were extracted from the hospital medical database records. RESULTS: The mean Hb levels were statistically significant between all three groups. Mean red cell distribution width (RDW), white blood cells (WBC), mean platelet volume (MPV), platelet distribution width (PDW), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and monocyte-to-lymphocyte (MLR) levels were statistically significantly different between gastric cancer and healthy controls. Mean RDW, MPV, and PDW levels were statistically significantly different between the IM and healthy control groups. Mean WBC, NLR, PLR, and MLR levels were statistically significantly different between the gastric cancer and IM groups. CONCLUSIONS: RDW, platelet count, NLR, MLR, and PLR have diagnostic value and can help to distinguish patients with GC from those with IM. These parameters are accessible easily, the cost is not high, and it may help patients not to delay endoscopic screening.

Clinical Significance of Serum Vascular Endothelial Growth Factor, Pigment Epithelium-Derived Factor, Tumor Necrosis Factor Alpha, and Progranulin Levels in Patients with Gastric Cancer and Gastric Precancerous Lesions.

BACKGROUND: The purpose of this study is to evaluate serum levels of vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), tumor necrosis factor alpha (TNF-α), and progranulin in patients with gastric cancer (GC) and precancerous lesions (PCL) and to determine the usefulness of these markers as diagnostic biomarkers in these diseases. METHOD: A total of 32 GC patients, 35 PCL patients, and 23 healthy controls participated in the study. The serum levels of VEGF, PEDF, TNF-α, and progranulin were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean serum VEGF levels were 30.6 ± 12.98 pg/mL in GC, 18.2 ± 5.72 pg/mL in PCL, and 17.5 ± 5.59 pg/mL in controls. GC VEGF levels were significantly higher than both PCL and control groups (p < 0.001). The mean serum PEDF levels were 1516.1 ± 993.8 pg/mL in GC, 1039.1 ± 1002.3 pg/mL in PCL, and 767.5 ± 661.5 pg/mL in controls. The serum PEDF level in the GC group was significantly higher than that in both PCL and control groups (p = 0.004 and p = 0.038, respectively). The mean serum TNF-α levels were 46.7 ± 14.82 pg/mL in GC, 38.4 ± 11.89 pg/mL in PCL, and 33.8 ± 12.77 pg/mL in controls. There was a significant difference between GC and controls (p = 0.022) in TNF-α levels. The mean serum progranulin levels in GC were 2496.6 ± 737.8 pg/mL, 2332.0 ± 482.1 pg/mL in PCL, and 1288.7 ± 830.9 pg/mL in controls. Progranulin levels in both GC and PCL groups were significantly higher than that in the control group (p < 0.001 for both). CONCLUSION: There were significant differences among patients with GC and PCL and healthy controls in terms of serum VEGF, PEDF, TNF-α, and progranulin levels.

Expression of Sigma-Class Glutathione-S-Transferase in Fetal and Pediatric Filum Terminale Samples: A Comparative Study.

Background and objectives: The pathophysiology of tethered cord syndrome (TCS) in children is not well elucidated. An inelastic filum terminale (FT) is the main factor underlying the stretching of the spinal cord in TCS. Our study aimed to investigate the expression of glutathione-S-transferase (GST) in children and fetal FT samples in order to understand the relationship between this enzyme expression and the development of TCS. Materials and Methods: FT samples were obtained from ten children with TCS (Group 1) and histological and immunohistochemical examinations were performed. For comparison, FT samples from fifteen normal human fetuses (Group 2) were also analyzed using the same techniques. Statistical comparison was made using a Chi-square test. Results: Positive GST-sigma expression was detected in eight (80%) of 10 samples in Group 1. The positive GST-sigma expression was less frequent in nine (60%) of 15 samples from Group 2. No statistically significant difference was detected between the two groups (p = 0.197). Conclusions: Decreased FT elasticity in TCS may be associated with increased GST expression in FT. More prospective studies are needed to clarify the mechanism of the GST-TCS relationship in children.

Glutathione S-Transferases and Cytochrome P450 Enzyme Expression in Patients with Intracranial Tumors: Preliminary Report of 55 Patients.

OBJECTIVE: Intracranial tumors are one of the most frightening and difficult-to-treat tumor types. In addition to surgery, protocols such as chemotherapy and radiotherapy also take place in the treatment. Glutathione S-transferase (GST) and cytochrome P450 (CYP) enzymes are prominent drug-metabolizing enzymes in the human body. The aim of this study is to show the expression of GSTP1, GSTM1, CYP1A1, and CYP1B1 in different types of brain tumors and compare our results with those in the literature. SUBJECTS AND METHODS: The expression of GSTP1, GSTM1, CYP1A1, and CYP1B1 was analyzed using immunostaining in 55 patients with intracranial tumors in 2016-2017. For GST and CYP expression in normal brain tissue, samples of a portion of surrounding normal brain tissue as well as a matched far neighbor of tumor tissue were used. The demographic features of the patients were documented and the expression results compared. RESULTS: The mean age of the patients was 46.72 years; 29 patients were female and 26 were male. Fifty-seven specimens were obtained from 55 patients. Among them, meningioma was diagnosed in 12, metastases in 12, glioblastoma in 9, and pituitary adenoma in 5. The highest GSTP1, GSTM1, and CYP-1A1 expressions were observed in pituitary adenomas. The lowest GSTP1 expression was detected in glioblastomas and the lowest CYP1B1 expression in pituitary adenomas. CONCLUSION: GSTP1 and CYP expression is increased in intracranial tumors. These results should be confirmed with a larger series and different enzyme subtypes.

Expression of M30 and M65 in celiac disease. Analytical cross-sectional study

ABSTRACT BACKGROUND: The role of villous atrophy in apoptosis, a distinctive feature of celiac disease, is a matter of controversy. The aim of this study was to determine the apoptosis rate through immunohistochemical staining for M30 and M65 in celiac disease cases. DESIGN AND SETTING: Analytical cross-sectional study in a tertiary-level center. METHODS: Duodenal biopsies from 28 treatment-naive patients with celiac disease, 16 patients with potential celiac disease, 10 patients with a gluten-free diet and 8 controls were subjected to immunohistochemical staining for the end-apoptotic marker M30 and the total cell death marker M65. H-scores were compared. Several laboratory parameters were recorded concomitantly, and at the one-year follow-up for celiac disease and potential celiac disease patients. RESULTS: There was a significant difference in H-score for M30 expression between the celiac disease, potential celiac disease and gluten-free diet groups (P = 0.009). There was no significant difference in H-score for M65 expression. There was a positive correlation between the H-score for M30 expression and the anti-tissue transglutaminase immunoglobulin A (anti-tTgIgA) and anti-tissue transglutaminase immunoglobulin G (anti-tTgIgG) levels (R = 0.285, P = 0.036; and R = 0.307, P = 0.024, respectively); and between the H-score for M65 expression and the anti-tTgIgA and anti-tTgIgG levels (R = 0.265, P = 0.053; and R=0.314, P = 0.021, respectively). There was no difference between celiac disease and potential celiac disease patients regarding the laboratory parameters selected. CONCLUSION: The rates of apoptosis and nutritional deficiencies in patients with potential celiac disease were similar to those in patients with celiac disease.

Expression of M30 and M65 in celiac disease. Analytical cross-sectional study.

BACKGROUND: The role of villous atrophy in apoptosis, a distinctive feature of celiac disease, is a matter of controversy. The aim of this study was to determine the apoptosis rate through immunohistochemical staining for M30 and M65 in celiac disease cases. DESIGN AND SETTING: Analytical cross-sectional study in a tertiary-level center. METHODS: Duodenal biopsies from 28 treatment-naive patients with celiac disease, 16 patients with potential celiac disease, 10 patients with a gluten-free diet and 8 controls were subjected to immunohistochemical staining for the end-apoptotic marker M30 and the total cell death marker M65. H-scores were compared. Several laboratory parameters were recorded concomitantly, and at the one-year follow-up for celiac disease and potential celiac disease patients. RESULTS: There was a significant difference in H-score for M30 expression between the celiac disease, potential celiac disease and gluten-free diet groups (P = 0.009). There was no significant difference in H-score for M65 expression. There was a positive correlation between the H-score for M30 expression and the anti-tissue transglutaminase immunoglobulin A (anti-tTgIgA) and anti-tissue transglutaminase immunoglobulin G (anti-tTgIgG) levels (R = 0.285, P = 0.036; and R = 0.307, P = 0.024, respectively); and between the H-score for M65 expression and the anti-tTgIgA and anti-tTgIgG levels (R = 0.265, P = 0.053; and R=0.314, P = 0.021, respectively). There was no difference between celiac disease and potential celiac disease patients regarding the laboratory parameters selected. CONCLUSION: The rates of apoptosis and nutritional deficiencies in patients with potential celiac disease were similar to those in patients with celiac disease.

Investigation of Glutathione S-Transferase Isoenzyme Protein Expression in Patients With Pterygium.

PURPOSE: We investigated glutathione S-transferase (GST) enzymes in terms of their potential effects on the pathogenesis of pterygium. METHODS: Twenty-six pterygium specimens and 15 normal conjunctival specimens of 15 control subjects were investigated. Expressions of GST (alpha, mu, pi, and theta) enzymes were assessed by immunohistochemical staining. A brown color in the cytoplasm and/or nuclei of epithelial cells was evaluated as positive staining for GST enzymes. For each antibody, the intensity of the reaction [negative (-), weak (1+), moderate (2+), or strong (3+)] was determined to describe the immunoreactions. RESULTS: The median age was 52 years in the both groups. There was no significant difference between the groups in terms of age, sex, and intraocular pressure measurements (P > 0.05 for all). Of the 26 pterygium specimens, 15 (57.7%) (8 weak, 4 moderate, and 3 strong staining) were identified with GST pi-1 (GSTP1) expression and 20 (76.9%) (12 weak, 7 moderate, and 1 strong staining) with GST theta-1 (GSTT1) expression. Of the 15 control specimens, 4 (26.7%) (4 weak staining) were identified with the GSTP1 expression, and 1 (6.7%) with GSTT1 expression. GSTP1 and GSTT1 expressions were significantly higher in the pterygium specimens than in the controls (P = 0.043, P < 0.001; respectively). None of tissue specimens had positive staining for GST mu-1 or GST alpha-1 in both groups (both; P = 1.00). CONCLUSIONS: The significant increase of GSTP1 and GSTT1 expressions in pterygium may be because of the increased activation of GST in response to excessive free radical formation from ultraviolet exposure to maintain antioxidant capacity in pterygium.

Histological structure of the medial and lateral walls of cavernous sinus in human fetuses.

PURPOSE: The aim of this study is to elucidate the architecture of these fine structures in human fetuses. METHODS: The histological examination of medial wall (MW) and lateral wall (LW) was performed in 15 normal human fetuses. Eleven fetuses were female and four were male. The gestational age ranged between 14 and 35 weeks. The weight ranged between 180 and 1750 g. The wall samples (two MW and two LW from each fetus) were obtained by microsurgical technique and underwent histological examination. Each wall was examined for the structure and composition of collagen and elastic fibers, ganglions, peripheral nerves, and vessels. RESULTS: A total of 60 wall samples (30 MW and 30 LW) were examined in 15 fetuses. Loose connective tissue composed of type III collagen was observed in both of the walls. Elastic fibers were observed only in three wall samples (two MW and one LW). Ganglion was detected in 11 samples (nine in LW and two in MW), and peripheral nerve was found in 28 walls (18 LW and 10 MW). Vessels were observed in 51 samples (26 LW and 25 MW). None of the walls was stained with type I collagen. CONCLUSIONS: The structure of LW and MW of the cavernous sinus (CS) in fetuses is mainly composed of collagen tissue while some elastic fibers are supported by this tissue. Type III collagen is the main component of fetal CS walls. Because of the weak histological structure, CS may be more prone to tumor invasion in infants.

Tamoxifen citrate: a glimmer of hope for silicosis.

BACKGROUND: Inhalation of crystalline silica nanoparticles causes pulmonary damage resulting in progressive lung fibrosis. Currently, there is no effective treatment for silicosis. Tamoxifen citrate is a selective estrogen receptor modulator, which is one of the adjuvant treatment choices for breast cancer. It is also known with its inhibitory effect on the production of transforming growth factor-beta (TGF-ß) and studied for the anti-fibrotic effect in some fibrotic diseases. The aim of the study was to determine the effect of tamoxifen citrate on the prevention of pulmonary fibrosis and the treatment of silicosis. METHODS: A total of 100 adult female Wistar Albino rats (200-250 g) were used in this study. The rats were divided into five groups including 20 rats in each. Rats were exposed to silica for 84 d in all groups. In group 1, rats were sacrificed on the day 84 without receiving treatment. In group 2, rats received 1 mg/kg tamoxifen (tmx1 + 1), from the first day of the study for the whole 114 d of the study. In group 3, (tmx10 + 10) rats were given 10 mg/kg tamoxifen from the first day of the study for the whole 114 d of the study. In group 4 (tmx1), rats were started 1 mg/kg of tamoxifen on day 84 and were given until day 114. In group 5 (tmx10), rats were fed with 10 mg/kg tamoxifen starting from day 84 to day 114. All rats except group 1 were sacrificed on 114 day of the study. Lung inflammation and fibrosis scores, serum TGF ß levels, lung smooth muscle antigen and tissue transforming growth factor ß (t-TGF-ß) antibody staining levels, and number of silicotic rats were compared between groups. RESULTS: Silicosis was caused successfully in all rats in group 1. There were six silicotic rats in group 3 and it was the lowest number of all groups. Plasma TGF-ß levels and fibrosis score were significantly lower in all groups when compared with the control group. Tamoxifen could have preventive or treating effects in silicosis and found that lung fibrosis score was significantly lower in rats treated with tamoxifen. CONCLUSIONS: Tamoxifen treatment after and/or before induction of silicosis decreased lung fibrosis score with blood TGF-ß levels. We hope that this study may introduce a new indication as prophylactic use of tamoxifen in high-risk groups for silicosis and for treatment of silicosis.

Effect of cauterization on the subconjunctival fibrovascular reaction in rabbit eyes.

OBJECTIVE: The purpose of our study is to investigate the effect of episcleral cauterization during conjunctival autograft surgery on subconjunctival fibrovascular reaction in rabbit eyes. METHODS: Twenty-four healthy male New Zealand white rabbits were divided into Control Group (n = 12) and Cautery Group (n = 12). In the Control Group, a 4 × 4 mm free conjunctival graft was elevated, the underlying Tenon's capsule was excised, and the free graft was sutured back to its original place with 10-0 nylon sutures. In the Cautery Group, in addition to the same surgical steps, the episclera was cauterized with six gentle touches before the conjunctival graft was sutured back to its original place. The scleroconjunctival block of the operated area was excised at the first month. The sections were stained with hematoxylin and eosine and Masson trichrome and were evaluated using light microscopy. RESULTS: Subconjunctival collagen fibers were increased, and the fibroblast density increased more significantly in the Cautery Group than in the Control Group. The groups were similar regarding vascularization, lymphocytic, and plasmocytic infiltration. Macrophage density was normal in all animals in both groups. CONCLUSION: Our histopathological examinations indicate that cauterization seems to lead to an increase in subconjunctival fibrosis at the first postoperative month in rabbit eyes.

Histological structure of filum terminale in human fetuses.

OBJECT: The structure of the filum terminale (FT) is important in the development of tethered cord syndrome (TCS) in children. Although many studies have been performed on the histological structure of the FT in adults, there has been no detailed investigation for those of fetuses. The aim of this study was to examine the histological structure of the FT in normal human fetuses and to compare the results with those of previous studies. METHODS: The histological examination of the FT was performed in 15 normal human fetuses; 11 of them were female and 4 were male. The gestational age of the fetuses ranged between 14 weeks and 35 weeks, and they weighed between 180 g and 1750 g. The FT of each fetus was cut and examined for adipose tissue, fibrous tissue, peripheral nerve, ganglion, ependymal cells, gliosis, elastic fibers, and collagen types (Types I and III). RESULTS: Adipose tissue was observed in 2 specimens (13%), whereas fibrous tissue was found in 8 specimens. Peripheral nerve was detected in 11 (73%), ganglion in 6, ependymal cells in 5, and glial tissue in 7 FT samples. Type III collagen was present in 12 specimens (80%) with different concentrations, whereas Type I collagen and elastic fibers were not detected. CONCLUSIONS: The normal structure of the FT in fetuses is different from its structure in adults. The FT has no elasticity during intrauterine life because of the lack of elastic fibers. More detailed studies are needed to understand the histological basis of TCS in children.

Effect of systemic isotretinoin therapy on mucociliary clearance and nasal surface mucosa in acne patients.

BACKGROUND: Currently, there are no studies investigating the topical or systemic effects of retinoids on human nasal mucosa. We aimed to investigate the effect of systemic isotretinoin therapy on mucociliary transport and nasal surface mucosa using the saccharine test (ST) and nasal cytology techniques. METHODS: A total of 30 patients with severe or moderate acne were enrolled in this study. The median prescribed dose of isotretinoin was 0.75 mg per kg per day. Clinical and biochemical examinations were carried out periodically. The ST and nasal cytology were performed before treatment and during the third month of therapy. RESULTS: Of the 30 patients who initially agreed to participate in the research, 21 completed the study (18 female and 3 male, mean ± standard deviation (SD) aged 20.9 ± 4.7 years, range 15-32 years). There was a significant difference between the mucociliary clearance time for subjects in the pre- and post-treatment periods (173.8 ± 89.2 seconds vs 245.2 ± 191.6 seconds, respectively; P=.009). Cytological examination revealed that the squamous cell ratio was significantly lower and the reactive changes of the respiratory epithelium were significantly higher 3 months after isotretinoin therapy than before therapy (P=.010, P=.002, respectively). There were mild signs of inflammation according to the number of neutrophilic leukocytes (8.3% vs 26.6%, P=.06) after 3 months of isotretinoin therapy. CONCLUSION: Systemic isotretinoin alters the mucociliary transport, decreases the squamous cell ratio, increases the reactive changes in the respiratory epithelium significantly, and increases neutrophils in the nasal surface mucosa in the third month of treatment

Is there a role for on-site evaluation of thyroid fine needle aspiration to reduce the nondiagnostic rate?

The use of immediate on-site evaluation of fine-needle aspiration biopsy (FNAB) specimens can determine the adequacy of specimens and provides a specific preliminary diagnosis. In this prospective study, we evaluated the impact of on-site assessment of thyroid FNAB performed under ultrasound guidance. Totally, 204 (170 female, 34 male) patients (102 on site, 102 control group) were included. The patients were randomized on site and regular cytologic examination groups. Quick May-Grünwald Giemsa stain was used for on-site examination and FNA was continued until adequate aspirate for optimal cytological examination. Two (2.0 %) of the 102 patients evaluated with on-site examination had a nondiagnostic result. However, 16 (15.7 %) of the 102 patients examined by regular cytologic examination method, had nondiagnostic result. The difference between these two groups was statistically significant (p < 0.0001). The major cause of a nondiagnostic thyroid FNAB specimen is the failure to aspirate a sufficient number of cells necessary for diagnosis cystic lesions. Immediate on-site evaluation can significantly decrease the nondiagnostic rate of thyroid FNAB specimens.

A segmental neurofibromatosis case with eruptive seborrheic keratoses.

Segmental neurofibromatosis (SNF) is a rare variant of neurofibromatosis (NF) type 1 characterized by a restricted distribution of cafe-au-lait macules, and/or neurofibromas, and rarely freckling to a single dermatomal segment. Patients with NF type 1 have an associated increased risk for benign or malignant tumours. The prevalence of typical NF type 1 complications including malignancies in SNF is much lower than the generalized form. Seborrheic keratosis is one of the more common benign epidermal tumour which can be a paraneoplastic syndrome when it arises with an eruptive appearance. To our knowledge in the literature no case of SNF associated with eruptive seborrheic keratoses has been defined. We report the case of a man, aged 51, who had SNF and abruptly developed eruptive seborrheic keratoses.

The Value of Ensari's Proposal in Evaluating the Mucosal Pathology of Childhood Celiac Disease: Old Classification versus New Version.

OBJECTIVE: Small intestinal biopsy remains the gold standard in diagnosing celiac disease (CD); however, the wide spectrum of histopathological states and differential diagnosis of CD is still a diagnostic problem for pathologists. Recently, Ensari reviewed the literature and proposed an update of the histopathological diagnosis and classification for CD. MATERIALS AND METHODS: In this study, the histopathological materials of 54 children in whom CD was diagnosed at our hospital were reviewed to compare the previous Marsh and Modified Marsh-Oberhuber classifications with this new proposal. RESULTS: In this study, we show that the Ensari classification is as accurate as the Marsh and Modified Marsh classifications in describing the consecutive states of mucosal damage seen in CD. CONCLUSIONS: Ensari's classification is simple, practical and facilitative in diagnosing and subtyping of mucosal pathology of CD.