Esthesioneuroblastoma located in the thoracic extradural space: Case report.

OBJECTIVE: Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB's are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article. CASE HISTORY: A 52-year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and intranasal biopsy with local anesthesia was performed. Histopathologic diagnosis of the tumor was Kadish stage B esthesioneuroblastoma. Tumor was excised by using bilateral endoscopic endonasal resection and lateral rhinotomy approach and paranasal radiotherapy performed postoperatively. Ten months after surgery, neck metastasis was occured and patient was underwent neck dissection. Twenteeth months after initial treatment, distant metastasis was identified on the T 10 vertebra and following the cranial and spinal radiotherapy to the neck he was free of local recurrence at follow up 13 months after surgery. CONCLUSION: It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment.

Life-threatening angiomyxoma of the larynx.

BACKGROUND: Angiomyxoma is a benign proliferative mesenchymal tumor and a very rare mass in the larynx. There is not enough information about the etiology, clinical finding, treatment and prognosis of laryngeal angiomyxoma. CASE DETAILS: A 52 years old man presented with respiratory distress. Also, he had suffered from dysphagia, dysphonia, cough, and obstructive sleep apnea in the supine position for 6 months. He was operated on via transoral approach under general anesthesia with orotracheal intubation. The mass was encapsulated and completely removed. The histopathologic diagnosis was reported as angiomyxoma. CONCLUSION: Angiomyxoma should be considered in the differential diagnosis of the larynx masses. The treatment of angiomyxomas of the larynx is surgical. The mass can be usually excised intraorally or endoscopically.

Neuroprotective effect of atorvastatin in spinal cord ischemia-reperfusion injury.

OBJECTIVES: Prevention of the development of paraplegia during the repair of the damage caused by descending thoracic and thoracoabdominal aneurysms remains an important issue. Therefore, we investigated the protective effect of atorvastatin on ischemia-induced spinal cord injury in a rabbit model. METHOD: Thirty-two rabbits were divided into the following four equally sized groups: group I (control), group II (ischemia-reperfusion), group III (atorvastatin treatment) and group IV (atorvastatin withdrawal). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation. Seventy-two hours postoperatively, the motor function of the lower limbs of each animal was evaluated according to the Tarlov score. Spinal cord and blood samples were obtained for histopathological and biochemical analyses. RESULTS: All of the rabbits in group II exhibited severe neurological deficits. Atorvastatin treatment (groups III and IV) significantly reduced the level of motor dysfunction. No significant differences were observed between the motor function scores of groups III and IV at the evaluated time points. Light microscopic examination of spinal cord tissue samples obtained at the 72nd hour of reperfusion indicated greater tissue preservation in groups III and IV than in group II. CONCLUSION: This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model.

Neuroprotective effect of atorvastatin in spinal cord ischemia-reperfusion injury

OBJECTIVES: Prevention of the development of paraplegia during the repair of the damage caused by descending thoracic and thoracoabdominal aneurysms remains an important issue. Therefore, we investigated the protective effect of atorvastatin on ischemia-induced spinal cord injury in a rabbit model. METHOD: Thirty-two rabbits were divided into the following four equally sized groups: group I (control), group II (ischemia-reperfusion), group III (atorvastatin treatment) and group IV (atorvastatin withdrawal). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the iliac bifurcation. Seventy-two hours postoperatively, the motor function of the lower limbs of each animal was evaluated according to the Tarlov score. Spinal cord and blood samples were obtained for histopathological and biochemical analyses. RESULTS: All of the rabbits in group II exhibited severe neurological deficits. Atorvastatin treatment (groups III and IV) significantly reduced the level of motor dysfunction. No significant differences were observed between the motor function scores of groups III and IV at the evaluated time points. Light microscopic examination of spinal cord tissue samples obtained at the 72nd hour of reperfusion indicated greater tissue preservation in groups III and IV than in group II. CONCLUSION: This study demonstrates the considerable neuroprotective effect of atorvastatin on the neurological, biochemical and histopathological status of rabbits with ischemia-induced spinal cord injury. Moreover, the acute withdrawal of atorvastatin therapy following the induction of spinal cord ischemia did not increase the neuronal damage in this rabbit model. .

Association between survivin gene polymorphisms and the susceptibility to colon cancer development in the Turkish population.

BACKGROUND: Colon cancer is one of the most common cancers worldwide. Apoptosis is a necessary physiological process for cell elimination which is very important both cellular homeostasis and cell proliferation and differantiation. Dysregulation can lead to uncontrolled cell growth and tumor development. Survivin, a member of the IAP family, plays a key role in promotion of cell proliferation as well as inhibition of apoptosis in cancer cells. The aim of this study was to investigate whether specific genetic polymorphisms of survivin could be associated with colon cancer development and progression in a Turkish population. Our study is the first to our knowledge to investigate the relationship between colon cancer risk and survivin gene polymorphisms. MATERIALS AND METHODS: The relation between colon cancer and survivin -31 G/C (rs9904341), -241 C/T (rs17878467) and -625 C/G (rs8073069) polymorphism in promotor site of survivin gene associated with apoptosis was investigated using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: Individuals with -31C allele and CC genotype were found to have a higher risk of developing colon cancer (OR=13.4, p=0.01). The -241 CT genotype considerably increased the risk of colon cancer (OR=12.0, p=0.0001). However, there was no significant varaition of the survivin -625 C/G polymorphism among colon cancer patients and controls in our study. CONCLUSIONS: This study provides the first evidence that survivin -31 G/C and -241 C/T SNP significantly contribute to the risk of colon cancer in the Turkish population.

Mast cells numbers and peritumoral microvessel density of the prostatic adenocarcinomas and correlation with prognostic parameters.

AIM: To determine the utility of mast cell numbers and microvascular density (MVD) in evaluating acinar type of prostatic adenocarcinoma (PCa), and to ascertain a relationship between the number of mast cells with prognostic parameters (larger tumor volume, high Gleason score, lymphovascular, perineural, seminal vesicles invasion, metastatic lymph node). METHODS: The study comprised 97 radical prostatectomy specimens. The paraffin sections were stained with anti-CD31, anti- CD34 and Toluidine Blue. The numbers of positive staining of cells and microvessels in 10 high-power fields were counted systematically. RESULTS: A statistically significant relationship was found between MVDn and number of MC (r=0.218 and p=0. 032). There was no correlation between age and MC and MVD (p=0.406 and p=0.671, respectively). CONCLUSION: A correlation between mast cell number and microvascular density cannot depend on tumor angiogenesis or this relationship can be an independent parameter. More comprehensive studies could reveal relationship with prognostic parameters.

Can safe and long-term exposure to extremely low frequency (50 Hz) magnetic fields affect apoptosis, reproduction, and oxidative stress?

PURPOSE: To determine whether 50 Hz extremely low frequency-magnetic fields (ELF-MF) affects apoptotic processes, oxidative damage, and reproductive characteristics such as sperm count and morphology in rat testes. MATERIALS AND METHODS: Thirty male Sprague-Dawley rats were used in the present study, which were divided into three groups (sham group, n = 10, and two experimental groups, n = 10 for each group). Rats in the experimental group were exposed to 100 and 500 µT ELF-MF (2 h/day, 7 days/week, for 10 months) corresponding to exposure levels that are considered safe for humans. The same experimental procedures were applied to the sham group, but the ELF generator was turned off. Tissues from the testes were immunohistochemically stained for active (cleaved) caspase-3 in order to measure the apoptotic index by a semi-quantitative scoring system. The levels of catalase (CAT), malondialdehyde (MDA), myeloperoxidase (MPO), total antioxidative capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were also measured. Additionally, epididymal sperm count and sperm morphology was evaluated. RESULTS: There were no significant differences in the reproductive and oxidative stress parameters between the sham group and the exposed groups (p > 0.05). While no difference was observed between the final apoptosis score of the sham and the 100 µT ELF-MF group (p > 0.05), the final apoptosis score was higher in the 500 µT ELF-MF exposure group than in the sham group (p < 0.05). CONCLUSION: Long-term exposure to 100 µT and 500 µT ELF-MF did not affect oxidative or antioxidative processes, lipid peroxidation, or reproductive components such as sperm count and morphology in testes tissue of rats. However, long-term exposure to 500 µT ELF-MF did affect active-caspase-3 activity, which is a well-known apoptotic indicator.

Expression of AEG-1 and p53 and their clinicopathological significance in malignant lesions of renal cell carcinomas: a microarray study.

The aim of this study was to investigate the relationship of AEG-1 and p53 with the prognostic parameters of renal cell carcinoma (RCC). In this study, 50 paraffin blocks were histopathologically diagnosed at the Department of Pathology of the Medical Hospital of Duzce University, between 2005 and 2011. The cases consisted of 24 clear cell (CC) and 26 non-clear cell (NCC) RCC subtypes as follows: 24 (48%) clear cell RCC, 12 (24%) papillary RCC, 4 (8%) multilocular cystic RCC and 10 (20%) chromophobe RCC; none had sarcomatoid changes. By immunohistochemical analysis we investigated AEG-1 and p53 expression in carcinomas of the kidney, and by statistical analysis determined their relationship with clinicopathological parameters. Significant relationships were found between increasing tumor diameter and the increase of p53 (p = 0.028). In addition, p53 was significantly related to renal sinus invasion (p = 0.05) and Fuhrman grade (p = 0.026). There was a significant relationship between increased AEG-1 staining scores and CC and NCC carcinoma subtypes (p = 0.032), tumor capsule invasion (p = 0.01) and lymphovascular invasion (p = 0.015). There was also a significant correlation between tumor size and capsule and lymphovascular invasion (p = 0.02). We concluded that high AEG-1 and p53 expression correlates with the prognostic parameters in RCC patients, and in addition may be associated with tumor progression.

Leiomyoma of the urinary bladder in asymptomatic women.

Most bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare. Leiomyomas account for less than 0.43% of all bladder tumors. Genitourinary leiomyomata may arise in any anatomic structure containing smooth muscle. They have been reported to involve single or multiple organs. Since they may also mimic malignant lesions, they should always be considered in the differential diagnosis of any pelvic mass, with a possibility of being asymptomatic and discovered incidentally by radiographic imaging. We, herein, report a case illustrating clinical and pathological features in particular immunohistochemistry, and discuss its etiology and differential diagnosis.

Intussusception of the appendix induced by sessile serrated adenoma: a case report.

Intussusception of the appendix vermiformis is a rare condition. It occurs mainly in infants and children. Here, we report an intussusception case that occurred in a 65-year-old male presenting with repeated periumbilical pain, nausea, vomiting and febrile sensation. The appendix was seen to be intussuscepted at laparoscopy. The invaginated segment was reducted and simple appendicectomy was carried out. Histopathologic examination revealed a sessile serrated adenoma at the wall of the appendix, suggesting it as the cause of the intussusception.

Myxoma of the renal sinus: case report and literature review.

Myxoma is a rare mesenchymal tumor and it is mainly seen in heart and skin. Renal myxoma is extremely rare. To date, eleven cases of kidney myxomas have been reported in the literature. One of them is myxoma of the renal sinus. Our case was an 82-year-old man admitted to our hospital symptoms related to the urinary tract obstruction. Abdominal computerized tomography revealed a solid, hypodense mass 9 cm in diameter infiltrating the renal parenchyma in the renal pelvis. The patient underwent nephrectomy. The resected kidney contained gelatinous tumor with indistinct borders. The tumor was composed of slender, bland, spindle-shaped cells with large amounts of mucoid material. Tumor cells were positively stained with vimentin, focally stained positive for smooth muscle actin and had negative reactivity for S-100 protein, epithelial membrane antigen and pancytokeratin. Herein we report the second case of renal myxoma arising from the renal sinus.

Posttraumatic giant proliferating trichilemmal cysts on the parietal region of the scalp.

Proliferating trichilemmal (pilar) cysts, also known as pilar tumors, are most commonly found on the scalp of elderly women. Proliferating trichilemmal cysts are rare, slowly growing, lobular masses inherited autosomal dominantly and localized on scalps, and believed to arise due to a complication of a trauma and inflammation, and 5-10% of people are reported to be effected. Herein, we present the case of a 70-year-old woman with a 23-year history of multiple enlarging scalp masses. Clinically, squamous cell carcinoma was considered in the differential diagnosis, and the lesion was totally excised. Our case emphasizes the necessity for detailed clinical and pathological correlation for differential diagnosis.

Diffuse infiltration of Aspergillus hyphae in the thyroid gland with multinodular goiter.

A 35-year-old woman presented with a thyroid mass, weakness and shortness of breath of 3 years duration. On physical examination, she had a diffusely enlarged thyroid gland with multiple nodules. There were no signs to suggest immune suppression. The patient farmed and raised livestock. Biochemical tests and hemogram were normal. She underwent surgery, and a histological examination of the surgical specimen revealed nodular hyperplasia. Microscopically, silver methenamine (PASM) stain-positive hyphae that divided into branches at 45° and conidia were detected beside the thyroid capsule, with conidia in the cystic nodule. Moreover, ischemic changes of the thyroid tissue were observed closer to the capsule. We report a case of Aspergillosis of the thyroid of a patient who underwent surgery for a multinodular goiter.

Effects of extremely low-frequency magnetic field on caspase activities and oxidative stress values in rat brain.

This study was aimed to investigate the effect of extremely low-frequency magnetic field (ELF-MF) on apoptosis and oxidative stress values in the brain of rat. Rats were exposed to 100 and 500 µT ELF-MF, which are the safety standards of public and occupational exposure for 2 h/day for 10 months. Brain tissues were immunohistochemically stained for the active (cleaved) caspase-3 in order to measure the apoptotic index by a semi-quantitative scoring system. In addition, the levels of catalase (CAT), malondialdehyde (MDA), myeloperoxidase (MPO), total antioxidative capacity (TAC), total oxidant status (TOS), and oxidative stress index (OSI) were measured in rat brain. Final score of apoptosis and MPO activity were not significantly different between the groups. CAT activity decreased in both exposure groups (p < 0.05), while TAC was found to be lower in ELF 500 group than those in ELF-100 and sham groups (p < 0.05). MDA, TOS, and OSI values were found to be higher in ELF-500 group than those in ELF-100 and sham groups (p < 0.05). In conclusion, apoptosis was not changed by long-term ELF-MF exposure, while both 100 and 500 µT ELF-MF exposure induced toxic effect in the rat brain by increasing oxidative stress and diminishing antioxidant defense system.

The effect of topical ciprofloxacin and steroid-containing ear drops for chronic suppurative otitis media on the internal ear.

Aim of the study is to evaluate the effects of topical ciprofloxacin and prednisolone-containing ear drops for chronic suppurative otitis media on hearing threshold, cochlear reserve and cochlea morphology in healthy subjects and to determine the proper drug dose. Sixty-eight guinea pigs, all of which had healthy hearing, were used for the study. The first group (n = 30) was administered ciprofloxacin three times a day, the second group (n = 30) was administered prednisolone three times a day and the third group (n = 8) was administered sterile distilled water three times a day. The therapies lasted for 7 days and were administered intratympanically. The first group and second group were divided into three sub-groups of ten subjects. The first sub-group (n = 10) was administered an equivalent dose per kilogram as in humans, the second sub-group (n = 10) was administered one-third of the human-equivalent dose and the third sub-group (n = 10) was administered tenfold the human-equivalent dose. All subjects underwent brainstem evoked response audiometry (BERA) and distortion product otoacoustic emission (DPOAE) testing on the seventh and twenty-first days following the therapy. Following the tests, two subjects from each group were decapitated and examined under electron microscope. BERA and DPOAE testing results of the sub-group (n = 10) which was administered tenfold the human-equivalent dose were significantly different from the control group and other groups (P < 0.05). According to electron microscopic examination of the cochlea, the group which was administered a tenfold human-equivalent dose of intratympanic ciprofloxacin and prednisolone showed atrophy in cells and degenerations in cilia. This case was statistically significant when compared with the control group and other groups (P < 0.05). Ciprofloxacin and prednisolone applied at a human-equivalent dose per kilogram did not affect the hearing and cochlear histology of subjects.

Effect of mobile phone exposure on apoptotic glial cells and status of oxidative stress in rat brain.

The aim of this study was to investigate the effects of mobile phone exposure on glial cells in brain. The study carried out on 31 Wistar Albino adult male rats. The rat heads in a carousel exposed to 900 MHz microwave. For the study group (n:14), rats exposed to the radiation 2 h per day (7 days in a week) for 10 months. For the sham group (n:7), rats were placed into the carousel and the same procedure was applied except that the generator was turned off. For the cage control (n:10), nothing applied to rats in this group. In this study, rats were euthanized after 10 months of exposure periods and brains were removed. Brain tissues were immunohistochemically stained for the active (cleaved) caspase-3, which is a well-known apoptosis marker, and p53. The expression of the proteins was evaluated by a semi-quantitative scoring system. However, total antioxidative capacity (TAC), catalase, total oxidant status (TOS), and oxidative stress index were measured in rat brain. Final score for apoptosis in the exposed group was significantly lower than the sham (p < 0.001) and the cage control groups (p < 0.01). p53 was not significantly changed by the exposure (p > 0.05). The total antioxidant capacity and catalase in the experimental group was found higher than that in the sham group (p < 0.001, p < 0.05). In terms of the TOS and oxidative stress index, there was no statistically significant difference between exposure and sham groups (p > 0.05). In conclusion, the final score for apoptosis, total antioxidant capacity and catalase in rat brain might be altered by 900 MHz radiation produced by a generator to represent exposure of global systems for mobile communication (GSM) cellular phones.

Mobile phone exposure does not induce apoptosis on spermatogenesis in rats.

BACKGROUND: Some studies have reported that microwave radiation can have adverse effects on reproduction. Therefore, the purpose of this study was to investigate the apoptosis-inducing effect of mobile phone exposure on spermatogonia in seminiferous tubules. METHODS: The study was carried out on 31 Wistar albino adult male rats. The rats were separated into three groups in this study (cage control: 10, sham group: 7, and exposed group: 14). For the study group, rats were exposed to radiation 2 h/day (7 days/week) for 10 months. For the sham group, rats were placed into the carousel and the same procedure was applied except that the generator was turned off. For the cage control, nothing was applied to the rats in this group and they completed their life cycle in the cage during the study period. In this study, rats were sacrificed after 10 months of exposure and their testes were taken. Testes tissue was immunohistochemically stained for the active (cleaved) caspase-3. Positively stained cells were counted in up to ten different areas, and the frequency of positive cells was determined in percentage. Scoring was done by taking into account both the intensity of staining and the distribution of positively stained cells. Therefore, protein expression was evaluated by a semiquantitative scoring system. RESULTS: The final score for apoptosis of testes in the exposed group was not statistically significant according to the sham and the cage control groups (p>0.05). CONCLUSIONS: The results of this study showed that 2 h/day (7 days/week) exposure of 900 MHz radiation over a period of 10 months does not affect the active (cleaved) caspase-3 levels in testes, a well-known feature of typical apoptosis.

Pituitary adenoma coexisting with a suprasellar arachnoid cyst.

OBJECTIVE: Biochemical and radiological properties of sellar and parasellar lesions are quite similar in some instances. This leads to a difficulty in preoperative diagnosis. Here, a pituitary adenoma and a suprasellar arachnoid cyst in the same patient is presented, and possible etiopathogenetic mechanisms and surgical treatment are discussed. CASE: A 56-year-old male patient was admitted to the hospital with a history of seizures, urinary incontinence and visual disturbances. Preoperative MRI revealed a mass lesion in the sella turcica with suprasellar extension and a coexisting large supra- and parasellar cyst. DISCUSSION AND CONCLUSION: A slow-growing mass lesion beneath the defective mesencephalic leaf of the Liliequist membrane may lead to a one-way valve system on its surface. It might be speculated that CSF will become trapped in the cyst during tumor growth. The other possible mechanism to explain the coexistence is discussed. In light of these comments and intraoperative observations, we suggest a third type of suprasellar arachnoid cyst. a semi-communicative type.