The first case of myxoinflammatory fibroblastic sarcoma affecting the maxillary bone.

Myxoinflammatory fibroblastic sarcoma (MIFS) is rare and malignant soft-tissue neoplasms that typically present in the extremities. In the literature, MIFS has been reported in the groin, back, neck, nose, and temporal regions in addition to the extremities. We report a case of MIFS presenting with the complaints of nasal bleeding, purulent nasal discharge, and swelling on the right side of his face. Polypoid tissues protruded from the middle meatus were observed and initial diagnosis was inverted papilloma. The painless tumor was initially mistaken for low-grade myxofibrosarcoma in biopsy. Maxillectomy was performed and made the rare diagnosis of MIFS. Fibroblastic proliferation with extensive local spread from subcutaneous tissue to the epithelium of the maxillary sinus mucosa, maxillary bone, and especially along the bone marrow was observed. To the best of our knowledge, this is the first reported case of MIFS involving the maxillary bone.

Expressions of Putative Cancer Stem Cell Markers, CD44 and CD133, are Correlated with Pathological Tumour Stage in Gastric Adenocarcinoma.

OBJECTIVE: To analyse partial and total gastrectomy specimen in items of immunohistochemical staining of the stem cell CD44 and CD133; and to determine their relationship to pathological stage, other clinicopathological prognostic parameters, and their predictive value. STUDY DESIGN: Derscriptive study. PLACE AND DURATION OF STUDY: Department of Pathology, Bolu Abant Izzet Baysal University, Medical School, Turkey, from 2013 to 2018. METHODOLOGY: Eighty-three cases, diagnosed with adenocarcinoma from stomach partial and total gastrectomy slides and blocks, were included in the study. Adenocarcinoma cases, that had received neoadjuvant treatment before gastrectomy, cases diagnosed with lymphoma and other malignancies and cases of resection performed for reasons other than tumours, were excluded. Formalin-fixed and paraffin wax-embedded gastric adenocarcinoma blocks were sliced. CD44 and CD133 were stained onto the slides in a Leica Bond Max staining device in compliance with immunohistochemical staining datasheets. Membranous staining for CD44 and cytoplasmic, membranous or luminal staining for CD133 were evaluated. Mann-Whitney U-test and Kruskal- Wallis test were used for group comparisons. For pairwise comparisons, post-hoc Dunn's tests were used. The results were assessed on the significance level of p <0.05. The analyses were performed using the Statistical Package for the Social Sciences version 22.0 for Windows (SPSS Inc., Chicago, Illinois, USA). RESULTS: Considering CD44 and CD133 expressions in terms of pathological stage, there was significantly more intense expression in the T3 and T4 cases (p=0.009, and p=0.002, respectively). CONCLUSION: Although CD44 is regarded to be associated with more prognostic parameters compared to CD133, both immunohistochemical stains were shown to be related to pathological stage. Thus, these may be guiding for determining the tumour depth. Key Words: Gastric adenocarcinoma, CD44, CD133, Stem cell marker, Prognosis.

Does smoking change expression patterns of the tumor suppressor and DNA repair genes in the prostate gland?

OBJECTIVES: Somatic mutations can be present in clonally expanded cell populations in nonmalignant tissues, which are detectable at tissue-level resolution. Some of the mutational changes may arise due to smoking. We aimed to find out changes in carcinogenic gene expressions related to smoking in nonmalignant prostate gland epithelia. MATERIALS AND METHODS: The patients who came to the Department of Urology at Abant Izzet Baysal University Medical Faculty from December 2006 to December 2009 for prostate biopsy were questioned for cigarette smoking. The patients were divided into 2 groups, namely, smokers and nonsmokers. Paraffin sections were stained immunohistochemically with p53, PTEN, p16INK4a, MSH2, CHK2, RB, and E-cadherin. RESULTS: Smoking was the main independent factor that had an effect on the immunohistochemical expressions for p53, p16, and PTEN (P = 0.007, P = 0.036, P = 0.015, respectively). Age and inflammation had no statistically significant effects on gene expressions. No difference was found between smokers and nonsmokers for immunohistochemical expressions of E-cadherin, MSH2, RB, and CHK2. CONCLUSIONS: Smoking-related carcinogens can alter the expressions of some suppressor genes in a prostate tissue, and these alterations can be determined immunohistochemically. Alterations in these genes in prostate gland epithelia could possibly increase the risk for prostate carcinoma.

Facial pigmentation with demodex Mite; a mere coincidence or an association?

Demodex mites may induce inflammatory cutaneous reactions such as papulopustular rosacea and demodex folliculitis; both may lead to post inflammatory pigmentation. A 59-year-old man presented with an asymptomatic, hyperpigmented plaque on his face. Histological and clinical findings displayed Riehl-like facial pigmentation. Multiple demodex mites at the follicular infundibulum in the biopsy material were remarkable. There are limited publications about demodex-associated pigmentation. We report this case to point out that various hyperpigmentation disorders may occur simultaneously with demodex mites.

Evaluation of different p16 immunostaining methods and the prognostic role of p16/Ki-67 combined expression in non-muscle invasive bladder cancers.

There are many scoring methods evaluating the expression of p16 in the bladder immunohistochemically. In this study our aim was to determine an optimal p16 scoring method by discussing different staining methods related with p16 expression in bladder cancers and to establish the association of p16 and Ki-67 expressions, alone or in combination, with recurrence and progression. Ninety patients undergoing their first transurethral resection for bladder cancer and newly diagnosed papillary urothelial carcinoma (pTa and pT1) were included in the study. Four different scoring methods were used for p16 (p16a, p16b, p16c, p16d). The patients were divided into two groups based on recurrence and progression. There was a statistically significant difference between recurrence and abnormal p16d staining (p = 0.005). In other staining patterns of p16, there was no statistically significant difference in terms of recurrence or progression.In the multivariate logistic regression analysis, combined Ki-67 ≥ 10 and abnormal p16d staining was found to be the only independent predictive factor for recurrence (OR = 2.26, 95% CI: 0.13-46.41, p = 0.035) and no independent predictive factor for progression was found. Determining an adequate expression scoring by taking normal transitional epithelial staining pattern as a reference would be an objective approach in p16 evaluation. Moreover, it was found that evaluating p16d and Ki-67 in combination would be significant in predicting recurrence in pTa and pT1 urothelial carcinomas.

The effects of ankaferd blood stopper on the recovery process in an experimental oesophageal perforation model.

BACKGROUND: Oesophageal perforation is a life-threatening pathology that is generally treated conservatively; however, surgical procedures are frequently performed. A topical haemostatic agent, Ankaferd Blood Stopper (ABS), also has beneficial wound-healing effects. AIMS: This study aimed to determine the effects of ABS following experimental oesophageal perforations. STUDY DESIGN: Animal experiment. METHODS: The experimental rats were classified into 6 groups (with 7 rats in each group). Pairs of groups (primary repair alone and primary repair + ABS) were terminated in the 1(st), 2(nd), and 3(rd) weeks following injury. The oesophageal perforations, which were 8-10 mm in length, were created using a nasogastric tube. The perforation sites were repaired with a 6-0 polyglactine thread in the primary repair groups. Additionally, ABS was sprayed over the perforation site in the treatment groups. Each oesophagus was evaluated histopathologically. RESULTS: There were fewer microabscesses and areas of necrosis in the ABS groups compared with the primary repair groups. The histopathological evaluation revealed that the ABS groups had less inflammation and more re-epithelisation compared to the primary repair groups (p=0.002 and p=0.003, respectively). Fibrosis in the ABS groups was moderate in the 2(nd) week and mild in the 3(rd) week. Comparing the groups with respect to the time intervals, only the 1(st) week groups showed a significant difference in terms of re-epithelialisation (p=0.044). CONCLUSION: Topical ABS application on the repaired experimental oesophageal perforation regions led to positive wound-healing effects compared with the rats that were administered the primary repair alone.

Intraosseous epidermoid cyst associated with impacted mandibular wisdom teeth: an uncommon entity.

Epidermoid and dermoid cysts of the jaws are seen rarely. The formation theories of the intraosseous epidermoid cyst (IEC) are not clear. The radiographic appearance is similar with unilocular cysts. Surgical enucleation is the suggested treatment method for epidermoid cysts. This case report presents bilateral mandibular intraosseous epidermoid cysts with impacted wisdom teeth which is the first documented case in the literature.

A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia.

INTRODUCTION: There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. MATERIAL AND METHODS: A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. RESULTS: Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001). CONCLUSION: In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.

Ureteral quadruplication with three blind-ending branches.

A case of left-sided ureteral quadruplication with 3 blind-ending branches detected in a 16-year-old boy was presented by its step by step diagnostic work-up and treatment plan which is the first published case in the literature.

The effect of octreotide, an analog of somatostatin, on bleomycin-induced interstitial pulmonary fibrosis in rats.

In this study, octreotide (OCT), a synthetic somatostatin analog, was tested for its beneficial effects in the prevention of interstitial pulmonary fibrosis (IPF) induced by bleomycin (BLM) in rats by histological examination and by evaluating tissue OH-proline levels. Thirty male Wistar rats were divided randomly into three groups: group I: intratracheal (i.t.) BLM (7.5 mg/kg, single dose) + saline solution [0.9% NaCl, subcutaneously (s.c.), once-daily for 7 days]; group II: i.t. BLM (7.5 mg/kg, single dose) + OCT acetate (82.5 µg/kg, s.c., once-daily for 7 days); and the control group. At the end of the 7 days, lung tissues were excised and examined by histopathological methods. Levels of tissue hydroxyproline (OH-proline) were determined. BLM administration resulted in prominent histopathologic findings, such as diffuse alveolar damage and interstitial pulmonary fibrosis, as well as a significant increase in OH-proline level, as compared to controls. OCT application explicitly attenuated the histopathologic changes to a significant extent. OCT decreased paranchymal fibrosis and structural deformities in BLM-induced lung fibrosis. These results suggest that OCT administration to rats with BLM-induced IPF has a protective effect. Further studies are necessary to reveal the molecular mechanism(s) of OCT-induced protective effect.

The evaluation of topical administration of Bellis perennis fraction on circular excision wound healing in Wistar albino rats.

CONTEXT: Bellis perennis L. (Asteraceae) has been used traditionally in the treatment of bruises, broken bones, and wounds by European people. OBJECTIVE: To investigate the wound healing activity of B. perennis flowers in Wistar albino rats. MATERIALS AND METHODS: Dried B. perennis flowers were extracted with ethanol, then fractioned with n-butanol and an oinment was prepared. Twelve male adult Wistar rats were used. Six wounds were created for each animal by using circular excision wound model. The first two wounds were treated topically with HOTBp (hydrophilic ointment treatment containing n-butanol fraction). The second two wounds were control group and not treated with anything. The third two wounds were treated only with HOT (hydrophilic ointment treatment without n-butanol fraction). Treatments were applied once a day and lasted for 30 days. Wound samples were excised on days 5(th), 10(th) and 30(th). The percentage of wound healing was calculated by Walker's formula after measurement of the wound area and the tissue samples were examined histopathologically. RESULTS: The percentages of wound closure (HOTBp: 100%; HOT: 85% and control: 87%) and histopathological observations showed that there were statistically significant differences between HOTBp, HOT and control groups (p < 0.05) at 30(th) day. DISCUSSION AND CONCLUSION: Topically administered ointment prepared from the n-butanol fraction of B. perennis flowers has a wound healing potential without scar formation in circular excision wound model in rats. Thus, traditional usage of wound healing activity of B. perennis was scientifically verified for the first time.

Impression cytology of the ocular surface and tear function in patients with periocular vitiligo.

PURPOSE: We evaluated the ocular surface and tear function in patients with periocular vitiligo in this prospective, case-control study. METHODS: Sixty eyes of 30 vitiligo patients with periocular involvement and 100 eyes of 50 control subjects were included in the study. Patients and control subjects were compared for Schirmer test and tear film break-up time (BUT) results and impression cytology findings graded according to Nelson's classification. RESULTS: The mean BUT value was 9.5 ± 4.1 seconds in patients with periocular vitiligo and 13.1 ± 4.2 seconds in the control group. The difference was statistically significant (p=0.005). Thirty-seven eyes (61.7%) in the vitiligo group and 28 eyes (28.0%) in the control group had BUT values less than 10 seconds (p<0.001). The mean Schirmer test value was 14.6 ± 4.3 mm in patients with periocular vitiligo and 15.1 ± 4.4 mm in the control group (p>0.05). Nineteen eyes (31.7%) in patients with periocular vitiligo and 8 eyes (8.0%) in the control group had grade 2-3 changes according to Nelson's classification (p<0.001). Three eyes (5.0%) in the periocular vitiligo group and none of the eyes in the control group had inflammation signs in the impression cytology analysis. CONCLUSIONS: In patients with periocular vitiligo, ocular surface and tear function alterations may occur. Further studies on ocular surface involvement in periocular vitiligo patients may help to increase understanding of the pathophysiology of vitiligo.

Effect of Ankaferd Blood Stopper on air leakage in the lung and prevention of bleeding: an experimental study.

BACKGROUND: Air leakage and hemorrhage are important causes of morbidity and mortality in operations and traumas of the lung. Ankaferd Blood Stopper is a herbal product used for stopping hemorrhage. In our study, we investigated the efficacy of Ankaferd Blood Stopper in the prevention of air leakage in the lung and bleeding. METHODS: A total of twenty-one Wistar-Albino rats weighing 240 ± 20 grams were used in our study. An equal amount of injury was created in all groups by performing left thoracotomies. No interventions were made on tissue injury in the first group, and suturing was performed in the second group, and Ankaferd was applied in the third group. Air leakage and duration of bleeding were recorded in all groups. RESULTS: A statistically significant difference was found between the three groups in terms of air leakage time (p = 0,0001) and bleeding time (p = 0,0001). While a significant effect of Ankaferd was detected in terms of air leakage compared to standard surgery (p = 0,017), no difference was found in terms of bleeding time. CONCLUSIONS: Ankaferd Blood Stopper ceases the air leakage in the lung parenchyma significantly and effectively. No significant difference is seen compared to the standard surgery group, although it ceases bleeding significantly.

Reliability of the 34ßE12, keratin 5/6, p63, bcl-2, and AMACR in the diagnosis of prostate carcinoma.

OBJECTIVE: In this study, we aimed to investigate which basal cell marker should be used with α-methylacyl coenzyme A racemase (AMACR) to increase diagnostic accuracy in the diagnosis of prostate carcinoma. MATERIALS AND METHODS: A total of 98 cases of prostate biopsy, comprising 65 cases with prostate adenocarcinoma and 33 cases without adenocarcinoma, were included in this study. Prostate-specific antigen (PSA) serum levels before biopsies were obtained. The number of cores with malignant glands and Gleason scores for each case were determined. Paraffin sections were stained immunohistochemically with 34ßE12, keratin 5/6, p63, bcl-2, and AMACR. RESULTS: According to staining pattern, extensiveness, and intensity of basal cell markers in benign glands, 34ßE12 gave the best results. As negative markers for prostate adenocarcinoma, the best markers were p63 and 34ßE12. According to the AUC values in ROC curves for both extensiveness and intensity, the arrangement from the best to the worst was 34ßE12, p63, bcl-2, and keratin 5/6. The 34ßE12 had the best sensitivity and specificity values (95% and 98%, respectively). Staining extensiveness and intensity of keratin 5/6 in malignant glands, and those of bcl-2 in benign glands had statistically significant positive correlation with serum PSA levels. Even though AMACR is a negative marker for benignity, some of the benign glands also had positive immune reaction with AMACR. However, AMACR positivity was usually focal and weak. Nevertheless, intensively stained subjects were also present. No correlation was present between AMACR and basal cell markers. CONCLUSIONS: As a result, we suggest that keratin 5/6 and bcl-2 should not be used to identify benign glands in prostate biopsy since they show high positivity in malignant glands and high negativity in benign glands. 34ßE12 should be the first choice as a basal cell marker. p63 can be used together with 34ßE12, but it may not give additional diagnostic information. When we evaluated the correlation of basal cell markers, we did not find any complementary staining results among basal cell markers. Our study showed that 34ßE12 is the most appropriate negative marker to combine with AMACR as a positive marker for the diagnosis of prostate adenocarcinoma.

Submandibular gland pleomorphic adenoma in a seven-year-old child: a case report.

Salivary gland neoplasms are rare in the pediatric age group. Pleomorphic adenomas in the submandibular gland are rarer. In this article, we present a seven-year-old female with a slowly growing mass in her right submandibular area. The firm, mobile and painless mass was about 2x3 cm in size and with bimanual palpation it was indiscriminated from the submandibular gland. Magnetic resonance imaging with contrast revealed a heterogeneous and minimally lobulated mass within the submandibular gland with clearly defined borders. Fine needle aspiration biopsy revealed a diagnosis of pleomorphic adenoma and we performed right submandibular gland excision under general anesthesia. The histopathological diagnosis was pleomorphic adenoma with sparse mitotic figures that may be interpreted as having a potential of malignant transformation. This patient who was followed up for one year without any complication is to our knowledge the youngest case cited in the English-language literature.

Acquired toxoplasmosis of the buccal area with extranodular involvement: report of an unusual case.

Acquired toxoplasmosis is a common parasitic infection in humans. It can be caused by ingestion of infected meat or other food that has been contaminated by the feces of infected cats. Approximately 90% of immunocompetent patients with acquired toxoplasmosis are asymptomatic and undiagnosed; in the other 10%, toxoplasmosis manifests as a nonspecific, self-limited illness that usually does not require treatment. In symptomatic cases, cervical lymphadenopathy is one of the most common clinical findings. We report the case of a 33-year-old woman who experienced unilateral facial swelling secondary to toxoplasmosis. In addition to the atypical location of her disease (i.e., the buccal area), the atypical histopathologic findings in this case (e.g., extranodular involvement) constituted a very unusual presentation of toxoplasmosis.