Gender-related variation expressions of neuroplastin TRAF6, GluA1, GABA(A) receptor, and PMCA in cortex, hippocampus, and brainstem in an experimental epilepsy model.

Epileptic seizures are seen as a result of changing excitability balance depending on the deterioration in synaptic plasticity in the brain. Neuroplastin, and its related molecules which are known to play a role in synaptic plasticity, neurotransmitter activities that provide balance of excitability and, different neurological diseases, have not been studied before in epilepsy. In this study, a total of 34 Sprague-Dawley male and female rats, 2 months old, weighing 250-300 g were used. The epilepsy model in rats was made via pentylenetetrazole (PTZ). After the completion of the experimental procedure, the brain tissue of the rats were taken and the histopathological changes in the hippocampus and cortex parts and the brain stem were investigated, as well as the immunoreactivity of the proteins related to the immunohistochemical methods. As a result of the histopathological evaluation, it was determined that neuron degeneration and the number of dilated blood vessels in the hippocampus, frontal cortex, and brain stem were higher in the PTZ status epilepticus (SE) groups than in the control groups. It was observed that neuroplastin and related proteins TNF receptor-associated factor 6 (TRAF6), Gamma amino butyric acid type A receptors [(GABA(A)], and plasma membrane Ca2+ ATPase (PMCA) protein immunoreactivity levels increased especially in the male hippocampus, and only AMPA receptor subunit type 1 (GluA1) immunoreactivity decreased, unlike other proteins. We believe this may be caused by a problem in the mechanisms regulating the interaction of neuroplastin and GluA1 and may cause problems in synaptic plasticity in the experimental epilepsy model. It may be useful to elucidate this mechanism and target GluA1 when determining treatment strategies.

Interstitial flow, pressure and residual stress in the aging carotid artery model in FEBio.

Vascular smooth muscle cells (VSMCs) are subject to interstitial flow-induced shear stress, which is a critical parameter in cardiovascular disease progression. Transmural pressure loading and residual stresses alter the hydraulic conductivity of the arterial layers and modulate the interstitial fluid flux through the arterial wall. In this paper, a biphasic multilayer model of a common carotid artery (CCA) with anisotropic fiber-reinforced soft tissue and strain-dependent permeability is developed in FEBio software. After the verification of the numerical predictions, age-related arterial thickening and stiffening effects on arterial deformation and interstitial flow are computed under physiological geometry and physical parameters. We found that circumferential residual stress shifts outward in each layer and its gradient increases up to 6 times with aging. Internally pressurized CCA displays nonlinear deformation. In the aged artery, the circumferential stress becomes greater on the media layer (82-158 kPa) and lower on the intima and adventitia (19-23 kPa and 25-28 kPa, respectively). The radial compression of the intima reduces the total hydraulic conductivity by 48% in the young and 16% in the aged arterial walls. Consequently, the average radial interstitial flux increases with pressure by 14% in the young and 91% in the aged arteries. Accordingly, the flow shear stress experienced by the VSMCs becomes more significant for aged arteries, which may accelerate cardiovascular disease progression compared to young arteries.

The role of acoustofluidics and microbubble dynamics for therapeutic applications and drug delivery.

Targeted drug delivery is proposed to reduce the toxic effects of conventional therapeutic methods. For that purpose, nanoparticles are loaded with drugs called nanocarriers and directed toward a specific site. However, biological barriers challenge the nanocarriers to convey the drug to the target site effectively. Different targeting strategies and nanoparticle designs are used to overcome these barriers. Ultrasound is a new, safe, and non-invasive drug targeting method, especially when combined with microbubbles. Microbubbles oscillate under the effect of the ultrasound, which increases the permeability of endothelium, hence, the drug uptake to the target site. Consequently, this new technique reduces the dose of the drug and avoids its side effects. This review aims to describe the biological barriers and the targeting types with the critical features of acoustically driven microbubbles focusing on biomedical applications. The theoretical part covers the historical developments in microbubble models for different conditions: microbubbles in an incompressible and compressible medium and bubbles encapsulated by a shell. The current state and the possible future directions are discussed.

Curcumin regulates intracellular calcium release and inhibits oxidative stress parameters, VEGF, and caspase-3/-9 levels in human retinal pigment epithelium cells.

In this study, we aimed to observe whether curcumin (cur), a polyphenolic compound derived from the dietary spice turmeric, a yellow substance obtained from the root of the plant Curcuma longa Linn, has any protective effect against blue light irradiation in human retinal pigment epithelium (ARPE-19) cells. For this purpose, we evaluated the intracellular calcium release mechanism, poly ADP ribose polymerase (PARP), procaspase-3/-9 protein expression levels, caspase activation, and reactive oxygen species levels. ARPE-19 cells were divided into four main groups, such as control, cur, blue light, and cur + blue light. Results were evaluated by Kruskal-Wallis and Mann-Whitney U tests as post hoc tests. The cells in cur and cur + blue light samples were incubated with 20 µM cur. Blue light exposure was performed for 24 h in an incubator. Lipid peroxidation and cytosolic-free Ca2+ [Ca2+]i concentrations were higher in the blue light exposure samples than in the control samples; however, their levels were determined as significantly lower in the cur and cur + blue light exposure samples than in the blue light samples alone. PARP and procaspase-3 levels were significantly higher in blue light samples. Cur administration significantly decreased PARP and procaspase-3 expression levels. Reduced glutathione and glutathione peroxidase values were lower in the blue light exposure samples, although they were higher in the cur and cur + blue light exposure samples. Caspase-3 and -9 activities were lower in the cur samples than in the blue light samples. Moreover, vascular endothelial growth factor (VEGF) levels were significantly higher in the blue light exposure samples. In conclusion, cur strongly induced regulatory effects on oxidative stress, intracellular Ca2+ levels, VEGF levels, PARP expression levels, and caspase-3 and -9 values in an experimental oxidative stress model in ARPE-19 cells.

A review on wax printed microfluidic paper-based devices for international health.

Paper-based microfluidics has attracted attention for the last ten years due to its advantages such as low sample volume requirement, ease of use, portability, high sensitivity, and no necessity to well-equipped laboratory equipment and well-trained manpower. These characteristics have made paper platforms a promising alternative for a variety of applications such as clinical diagnosis and quantitative analysis of chemical and biological substances. Among the wide range of fabrication methods for microfluidic paper-based analytical devices (µPADs), the wax printing method is suitable for high throughput production and requires only a commercial printer and a heating source to fabricate complex two or three-dimensional structures for multipurpose systems. µPADs can be used by anyone for in situ diagnosis and analysis; therefore, wax printed µPADs are promising especially in resource limited environments where people cannot get sensitive and fast diagnosis of their serious health problems and where food, water, and related products are not able to be screened for toxic elements. This review paper is focused on the applications of paper-based microfluidic devices fabricated by the wax printing technique and used for international health. Besides presenting the current limitations and advantages, the future directions of this technology including the commercial aspects are discussed. As a conclusion, the wax printing technology continues to overcome the current limitations and to be one of the promising fabrication techniques. In the near future, with the increase of the current interest of the industrial companies on the paper-based technology, the wax-printed paper-based platforms are expected to take place especially in the healthcare industry.

Vitamin C attenuates methotrexate-induced oxidative stress in kidney and liver of rats.

Like several other anticancer drugs, methotrexate (MTX) causes side effects, such as neuropathic pain, hepatotoxicity, and nephrotoxicity. Abnormal production of reactive oxygen species has been suspected in the pathophysiology of MTX-induced hepatorenal toxicity. Therefore, the aim of this study was to investigate the probable protective role of vitamin C (Vit C) on oxidative stress induced by MTX in the liver and kidney tissues of rats. A total of 32 rats were randomly and equally divided into four groups. The first group served as the control group. The second group received a single dose of 20 mg/kg of MTX intraperitoneally. To demonstrate our hypothesis, the third and the fourth groups received 250 mg/kg of Vit C for 3 days by oral gavage, with or without MTX treatment. At the end of the study, the liver and kidney tissues of the rats were collected and examined using histology. Both the tissues were assayed for malondialdehyde concentration and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities. In hepatic and renal tissues, lipid peroxidation levels were increased, whereas SOD, CAT, and GSH-Px levels were decreased by MTX. All parameters, including CAT levels in hepatic tissue, were significantly restored after the administration of Vit C for 3 days. Similar to the biochemical findings, evidence of oxidative damage was examined in both types of tissues by histopathological examination. From the results of this study, we were able to observe that Vit C administration modulates the antioxidant redox system and reduces the renal and hepatic oxidative stress induced by MTX. Vit C can ameliorate the toxic effect of MTX in liver and kidney tissues of rat.

Screening applications in drug discovery based on microfluidic technology.

Microfluidics has been the focus of interest for the last two decades for all the advantages such as low chemical consumption, reduced analysis time, high throughput, better control of mass and heat transfer, downsizing a bench-top laboratory to a chip, i.e., lab-on-a-chip, and many others it has offered. Microfluidic technology quickly found applications in the pharmaceutical industry, which demands working with leading edge scientific and technological breakthroughs, as drug screening and commercialization are very long and expensive processes and require many tests due to unpredictable results. This review paper is on drug candidate screening methods with microfluidic technology and focuses specifically on fabrication techniques and materials for the microchip, types of flow such as continuous or discrete and their advantages, determination of kinetic parameters and their comparison with conventional systems, assessment of toxicities and cytotoxicities, concentration generations for high throughput, and the computational methods that were employed. An important conclusion of this review is that even though microfluidic technology has been in this field for around 20 years there is still room for research and development, as this cutting edge technology requires ingenuity to design and find solutions for each individual case. Recent extensions of these microsystems are microengineered organs-on-chips and organ arrays.

The effects of electromagnetic radiation (2450 MHz wireless devices) on the heart and blood tissue: role of melatonin.

OBJECTIVE: This study was designed to investigate the effects of 2450 MHz EMR on the heart and blood in rat and possible ameliorating effects of melatonin. MATERIAL AND METHOD: Thirty-two female Wistar Albino rats were randomly grouped (by eight in each group) as follows:  Group I: cage-control group (dimethysulfoxide (DMSO), 10mg/kg/day i.p. without stress and EMR. Group II: sham-control rats stayed in restrainer without EMR and DMSO (10mg/kg/day i.p.). Group III: rats exposed to 2450 MHz EMR. Group IV: treated group rats exposed to 2450 MHz EMR+melatonin (MLT) (10mg/kg/day i.p.). RESULTS: In the blood tissue, there was no significant difference between the groups in respect of erythrocytes GSH, GSH-Px activity, plasma LP level and vitamin A concentration (p > 0.05). However, in the Group IV, erythrocytes' LP levels (p < 0.05) were observed to be significantly decreased while plasma vitamin C, and vitamin E concentrations (p < 0.05) were found to be increased when compared to Group III. In the heart tissues, MDA and NO levels significantly increased in group III compared with groups I and II (p < 0.05). Contrary to these oxidant levels, CAT and SOD enzyme activities decreased significantly in group III compared with groups I and II (p 0.05). Besides, MLT treatment lowered the MDA and NO levels compared with group III. DISCUSSION: In conclusion, these results demonstrated that contrary to its effect on the heart, the wireless (2450 MHz) devices cause slight oxidative-antioxidative changes in the blood of rats, and a moderate melatonin supplementation may play an important role in the antioxidant system (plasma vitamin C and vitamin E). However, further investigations are required to clarify the mechanism of action of the applied 2450 MHz EMR exposure (Tab. 3, Fig. 1, Ref. 49).

Is a High Body Mass Index Still a Risk Factor for Complications of Donor Nephrectomy?

BACKGROUND AND AIM: The incidence of obesity is increasing all around the world and Turkey is no exception. In Turkey, 80.1% of all kidney transplants performed in 2013 were living donor kidney transplants. In this study we compare the early postoperative complications of living kidney donors with a body mass index (BMI) over 30 to those with BMIs under 30. PATIENTS AND METHOD: All donor nephrectomies performed at the Ege University School of Medicine Hospital between May 2013 and May 2014 were included in the study. Donors' demographics, preoperative BMI, operation time, length of hospital stay, postoperative complications, and perioperative blood creatinine levels were analyzed. RESULTS: There were a total of 72 donors, 50 of whom had a BMI below 30 (group 1), whereas 22 had a BMI of 30 or higher (Group 2). The median age was 47 (±12.6) and 52.2 (±8.4) for Groups 1 and 2, respectively. The median BMI was 26.1 (±2.3) for Group 1 and 31.8 (±1.5) for Group 2. There was no significant difference in operation time (P = .980) between the 2 groups. There was no difference in the length of hospitalization with an average hospital stay of 3 days for both groups. No major complications were observed in either group. There was no difference in minor complication rates for both groups. CONCLUSION: High BMI donors can safely donate their kidney with no significant increase in complication rates at high-volume transplantation centers.

Comparison of Preemptive Kidney Transplantation With Nonpreemptive Kidney Transplantation in a Single Center: A Follow-up Study.

BACKGROUND AND AIM: The effect of preemptive transplantation of kidneys from living donors on patient and allograft survival is controversial. In this study, we aimed to evaluate whether preemptive kidney transplantation performed without the development of patient dialysis-related complications has a favorable effect on patient and graft survival. PATIENTS AND METHOD: The study included 334 adult renal transplant recipients. Patients who underwent renal transplantation between January 2008 and December 2012 at a tertiary referral teaching hospital were followed, and outcomes were obtained by retrospective chart review. A total of 244 patients underwent dialysis before renal transplantation, whereas 90 patients underwent preemptive transplantation. RESULTS: There were no significant differences between the 2 groups with regard to patients and graft survival rates (P > .05). Patient survival rates in preemptive and nonpreemptive groups were 98.9% and 96.3% in the first year, respectively (P = .199). Graft survival rates in preemptive and nonpreemptive groups were 96.7% and 93.0% in the first year, respectively (P = .163). Patient survival rates in preemptive and nonpreemptive groups were 98.9% and 95.7% in the third year, respectively (P = .155). Graft survival rates in preemptive and nonpreemptive groups were 93.5% and 88.5% in the third year, respectively (P = .138). There was a significant difference among years with regard to ratio of patients with preemptive transplantation (P = .009). The ratio was 17.5% in 2008, whereas it rose to 43.1% in 2012. CONCLUSION: Although preemptive kidney transplantation does not provide a significant patient and allograft survival advantage compared to nonpreemptive kidney transplantation, both therapeutic modalities provide good outcomes. Preemptive kidney transplantation has been an increasingly frequent renal replacement therapy option in recent years.

Comparison of Patients in Whom Double-J Stent Had Been Placed or Not Placed After Renal Transplantation in a Single Center: A Follow-up Study.

BACKGROUND: Double-J (DJ) stents play an important role in modern urology to prevent undesirable side effects after surgery. We aimed to investigate the relationship of DJ stents with the demographic characteristics, surgical complications, urinary tract infection (UTI), and hematuria in the patients who underwent renal transplantation (Tx). METHODS: Data of 354 patients who underwent renal Tx between 2008 and 2011 at Ege University were evaluated retrospectively; 331 patients were included in this study. The term DJ (-) represents patients in whom a DJ stent was not placed. "Primary DJ term" represents patients in whom the DJ stent was placed during the first Tx. "Secondary DJ term" represents the patients who had DJ after Tx for any complication. RESULTS: Two hundred fifty-four (76.7%) patients were in the DJ (-) group, 52 (15.7%) were in the primary DJ group, and 25 (7.6%) were in the secondary DJ group. There were significant differences between the groups in terms of anastomosis type (P = .000), stay-in-hospital time (P = .000), surgical complication (P = .000), re-operation (P = .000), percutaneous nephrostomy (P = .000), UTI (P = .000), first-time UTI (P = .000), recurrent UTI (P = .000), positive hemoculture (P = .000), hematuria (P = .000), duration of dialysis before Tx (P = .000), live/deceased donor (P = .000), and delayed graft function (P = .009). CONCLUSIONS: Our choice is to use the DJ stent in selected high-risk patients and to keep the indications for DJ stent wider in deceased donor transplants by considering possible surgical complications. The use of the stent only in selected cases will decrease surgical complications due to stent placement.

Melatonin and amfenac modulate calcium entry, apoptosis, and oxidative stress in ARPE-19 cell culture exposed to blue light irradiation (405 nm).

PURPOSE: Under conditions of oxidative stress, cell apoptosis is triggered through the mitochondrial intrinsic pathway. Increased levels of reactive oxygen species (ROS) are linked to excess cell loss and mediate the initiation of apoptosis in a diverse range of cell types. The aims of this study were to assess intracellular Ca(2+) release, ROS production, and caspase-3, and -9 activation in ARPE-19 cells during the blue light-mediated cell death, and to examine a potential protective effect of melatonin and amfenac, in the apoptotic cascade. METHODS: ARPE-19 cells were cultured in their medium. First, MTT tests were performed to determine the protective effects of amfenac and melatonin. Cells were then exposed to blue light irradiation in an incubator. Intracellular Ca(2+) release experiments, mitochondrial membrane depolarization, apoptosis assay, glutathione (GSH), glutathione peroxidase (GSH-Px), and ROS experiments were done according to the method stated in the Materials and methods section. RESULTS: Cell death was clearly associated with increased levels of ROS production, as measured by 2',7'-dichlorofluorescein fluorescence, and associated increase in Ca(2+) levels, as measured by Fura-2-AM. Blue light-induced cell death was associated with an increased level of caspase-3 and 9, suggesting mediation via the apoptotic pathway. Cell death was also associated with mitochondrial depolarization. Melatonin was shown to delay these three steps. CONCLUSION: Melatonin, amfenac, and their combination protect ARPE-19 cells against blue light-triggered ROS accumulation and caspase-3 and -9 activation. The antiapoptotic effect of melatonin and amfenac at doses inhibiting caspase synthesis modified Ca(2+) release and prevented excessive ROS production, suggesting a new therapeutic approach to age-related macular degeneration.

A rare association of leiomyosarcoma with squamous cell carcinoma of the larynx: two cases.

OBJECTIVE: To discuss the histopathogenesis and treatment choices for synchronous tumours of the larynx. CASE REPORTS: We present two cases of synchronous laryngeal leiomyosarcoma and squamous cell carcinoma. The first case was an early-stage tumour and the second an advanced-stage tumour of the larynx. Selection of adequate treatment for synchronous tumours is difficult because of different spreading rates and metastatic patterns. Treatment choices for both the primary tumour site and the neck should be related to the stage of the squamous component of the tumour. CONCLUSION: In such cases, the tumour location, tumour stage and lymphatic metastases must be carefully evaluated in order to make the optimum treatment choice. Treatment evaluation of the neck should be related to the stage of the squamous component of these synchronous tumours. Partial laryngectomy techniques may be preferred if the extent of the disease permits.

Colchicine modulates oxidative stress in serum and leucocytes from remission patients with Family Mediterranean Fever through regulation of Ca²+ release and the antioxidant system.

We investigated the effects of colchicine on oxidative stress and Ca²+ release in serum and polymorphonuclear leucocytes (PMNs) of Familial Mediterranean Fever (FMF) patients with attack, remission and unremission periods. Eighteen FMF patients and six age-matched healthy subjects in four groups were used. The first group was a control. The second group included patients with active FMF. The third and fourth groups were patients with remission and unremission, respectively. Colchicine (1.5 mg/day) was given to the third and fourth groups for 1 month. PMN cells, serum lipid peroxidation and intracellular Ca²+-release levels in the attack and unremission groups were higher than in those in controls, although they were lower in the remission group than in the attack group. Serum vitamin E and ß-carotene concentrations were higher in the remission group than in the control and attack groups. However, PMN, serum lipid peroxidation and Ca²+-release levels were further increased in the unremission group compared to the attack group. Glutathione peroxidase, reduced glutathione and vitamin A values in the four groups did not change by FMF and colchicine. In conclusion, we observed that colchicine induced protective effects on oxidative stress by modulating vitamin E, ß-carotene and Ca²+-release levels in FMF patients with a remission period.

Effects of vitamin C and E combination on element and oxidative stress levels in the blood of operative patients under desflurane anesthesia.

We investigated effects of vitamin C and E (VCE) administration on desflurane-induced oxidative toxicity and element changes in the blood of operative patients under desflurane general anesthesia. Forty American Society of Anesthesiologists I or II Physical Status adult patients were scheduled for elective surgery. The patients were randomly divided into two groups. Control and VCE group was introduced to anesthesia with desflurane. VCE was administreted to patients in the control and VCE group before 1 hour of anesthesia with desflurane. Baseline (preoperative) and postoperative (at the 1(st), the 24(th), and 72(th) h), blood samples were taken from the first and second groups. Erythrocyte and plasma lipid peroxidation levels at the 1(st), 24(th), and 72(th) hours were higher in the control than in baseline group, although their levels at the same periods were lower in the VCE group than in the control. Vitamin E levels at the postoperative 1(st) and 24(th) hours and erythrocyte glutathione peroxidase (GSH-Px) activity at the postoperative 1(st), 24(th), and 72(th) hours was lower than in baseline values. Erythrocyte GSH-Px activity and plasma vitamins A, C, and E levels at the postoperative 1(st), 24(th), and 72(th) hours were higher in the VCE group than in the control group. Erythrocyte and plasma reduced glutathione, plasma ß-carotene, and serum copper, while zinc, selenium, aluminum, iron, magnesium, and calcium levels did not differ between preoperative and postoperative periods in both groups. In conclusion, VCE combination prevented the desflurane-induced vitamin E and GSH-Px consumptions to strengthen the antioxidant levels in the blood of operative patients.

A rare devastating complication of LASIK: bilateral fungal keratitis.

Purpose. To report an unusual case of severe bilateral fungal keratitis following laser in situ keratomileusis (LASIK). Method. A 48-year-old man developed bilateral diffuse corneal infiltration two weeks after LASIK. The corneal scrapings revealed fungal filaments but cultures were negative. Results. The corneal ulceration was improved on the left eye whereas spontaneous perforation occurred and finally evisceration was needed on the right eye despite topical and systemic antifungal treatment. Conclusions. Fungal keratitis, especially with bilateral involvement, is a very rare and serious complication of LASIK surgery. Clinical suspicion is crucial because most of fungal keratitis are misdiagnosed as bacterial keratitis and can lead serious visual results, even eye loss.

An experimental study of the stability of liquid bridges subject to shear-induced closed-flow.

This paper shows via experiments, the effect of closed-flows on the stability of a liquid bridge. Experiments were conducted with a 3M HFE-7500 liquid as the liquid bridge and a mixture of sodium polytungstate solution and glycerine as the outer liquid, which is encapsulated in a cylindrical cavity. Depending on the glycerine content, the Bond number ranged from 0.04 to 0.25. It was shown that a closed-flow in both the encapsulating liquid and the bridge would increase the stability of a non-cylindrical bridge depending on the direction of shear, the Bond number and the bridge volume. It was also shown that, for a given bridge volume and Bond number, there is a capillary number that gives the maximum percentage stabilization. Any further increase in the capillary number flips the direction of the bulge from top to bottom or vice versa thereby decreasing the stabilization and at some capillary number even destabilizing the bridge. The scaling of the problem was analyzed through experimental data.

Acetaminophen at different doses protects brain microsomal Ca2+-ATPase and the antioxidant redox system in rats.

Acetaminophen, an analgesic and antipyretic drug, rescues neuronal cells from mitochondrial redox impairment and reactive oxygen species (ROS). Excessive administration of acetaminophen above the recommended daily dose range has some negative effects on the brain. We investigated the effects of different doses of acetaminophen on Ca(2+)-ATPase and the antioxidant redox system in rats. Seventy rats were randomly divided into seven equal groups. The first was used for the control. One dose of 5, 10, 20, 100, 200, and 500 mg/kg acetaminophen was intraperitoneally administered to rats constituting the second, third, fourth, fifth, sixth, and seventh groups, respectively. After 24 h, brain cortical samples were taken and brain microsomal samples were obtained by ultracentrifugation. Brain and microsomal lipid peroxidation (LP) and brain calcium levels in the sixth and seventh groups were increased compared to control. LP levels in the second, third, and forth groups; brain vitamin E levels; brain and microsomal glutathione peroxidase (GSH-Px); and Ca(2+)-ATPase activity in the sixth and seventh groups were lower than in control, although brain vitamin E concentrations in the second, third, fourth, and fifth groups and microsomal GSH-Px activity in the third and fourth groups were higher than in control. Brain cortical beta-carotene and vitamin A concentrations did not differ in the seven groups. In conclusion, 5-100 mg/kg acetaminophen seems to have protective effects on oxidative stress-induced brain toxicity by inhibiting free radicals and supporting the antioxidant redox system.

Mucormycosis-associated fungal infections in patients with haematologic malignancies.

Among patients with haematologic disorders, mucormycosis most commonly occurs in those with acute leukaemia or lymphoma who have developed neutropenia due to malignancy or to chemotherapy, and in transplanted patients receiving immunosuppressive treatment. Here, we aim to present a retrospective study conducted over a 5-year period (2001-2005). The study included 20 patients with haematologic malignancies with a proven mucormycosis admitted in Medical Oncology Divisions in Cukurova University Hospital. The most frequent sites of infection were paranasal sinuses (95%) and lung (5%). Antifungal treatment was empirically administered in 18 (90%) patients; 18 patients underwent radical surgical debridement (90%). The therapy was successful for only eight patients (40%). Eleven patients died within 1 months of the diagnosis of fungal infection: the cause of death was only by mucormycosis in four patients (36.6%), mucormucosis and systematic inflamatuar response syndrome (SIRS) in two patients (18.2%) and progression of haematologic disease in five patients (45.5%). At univariate analysis, the factors that correlated with a positive outcome from infection were the following: amphotericin B treatment, neutrophil recovery from postchemotherapy aplasia. At multivariate analysis, the factors that significantly correlated with recovery from infection were the liposomal amphotericin B treatment (p = 0.026), doses of L-AmB (p = 0.008) and the length of the treatment (p = 0.01), respectively. It seems to have increased in recent years. Although a reduction of mortality has been observed recently, the mortality rate still remains high. Extensive and aggressive diagnostic and therapeutic procedures are essential to improve the prognosis in these patients.

Cystic lesions of the head and neck: cytohistological correlation in 63 cases.

OBJECTIVE: To investigate the accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of cystic masses of the head and neck (H&N), excluding thyroid lesions. METHODS: A total of 198 cases, 63 of whom had consequent surgical specimens, were retrieved from the files of two university hospitals and reviewed. RESULTS: FNAC correctly diagnosed 25 of 36 neoplasms with a cystic component. Five Warthin's tumours, two squamous cell carcinomas, two mucoepidermoid carcinomas and two schwannomas yielded non-representative aspirates. Four of the missed Warthin's tumours and two mucoepidermoid carcinomas which were misdiagnosed as benign cysts were aspirated by their clinician. One branchial cleft cyst was cytologically interpreted as highly suspicious for carcinoma. CONCLUSIONS: Disparate entities may present with similar cytological findings in the H&N region. A detailed description of differential diagnosis should be given in the cytology report in suspicious cases. Repeated aspirations from different sites of the lesion may reduce the false-negative rate.