Antimicrobial Resistance of E. coli and Salmonella Isolated from Wild Birds in a Rehabilitation Center in Turkey.

Wildlife plays a critical role as a reservoir for zoonosis especially pathogenic enteric bacteria. In this study we evaluated the presence of E. coli and Salmonella isolates from wild birds and determined their antimicrobial resistance. Intestine and fecal samples from 82 dead wild birds obtained from rehabilitation centre, were examined by microbiological analysis, antibiotic susceptibilities against of 18 antimicrobials and presence of tetracycline resistance genes by multiplex and singleplex PCR were investigated. A total of 51 E. coli were identified as well as Salmonella Kentucky and Salmonella Bisberg. A majority of the E. coli isolates were resistant to lincomysin (100%), penicilline (96.1%), kanamycin (80.4%), tetracycline (68.6%), and oxytetracycline (64.7%). All Salmonella serotypes were resistant to lincomycin, nalidixic acid and penicilline.In addition, 58.82% of E. coli isolates had phenotypic resistance to at least three or more antimicrobials. Our results indicated that the high frequency of tetracycline resistance (68.62%) due to the tet (A), tet (B), and tet (D) genes. This is the first report isolating S. Bisberg and determining antibiotic susceptibility of E.coli and Salmonella isolates from wild birds in Turkey. These results will help providing better understand of the dissemination of antibiotic resistancy in the environment, which can be used to potentially decrease spread through bird migration. Moreover, these results help assess the risk of spread of resistance from wild birds to humans.

Characterization of class 1, 2, 3 integrons, ESBL genes and antibiotic susceptibility of Salmonella serotypes from broiler and cattles in Turkey.

Antimicrobial resistance in Salmonella has been associated with the presence of integrons and many other resistance mechanisms contributing to the spread of antimicrobial-resistant genes within and between livestock and human populations. In this study, the presence of Salmonella serovars from broiler and cattle samples and their antimicrobial resistance, integrons, tet resistance, ESBL and resistance genes carriage were investigated. Total of 209 litter (broiler farms) and fecal samples (cattle farms) were examined by bacteriological procedures, susceptibilities against 18 antimicrobials and genes carriages were detected by singleplex and multiplex PCR. A total of 46/209 (22 %) Salmonella strains were isolated. Six different Salmonella serotypes from 46 Salmonella isolates were identified and the most common serotype was S. Infantis 38 (82.6%) from broiler litter; followed by S. Kitenge 3 (6.5 %) from fecal sample. The highest occurrence of resistance observed for penicilline (46/46, %100), lincomycin (43/46, 93.5%) and 42 isolates (43/46, 93.5%) exhibited MDR. The overall occurrence of class 1, 2 and 3 integrons carrying Salmonella in tested samples were 63.04% (29/46), 43.5% (20/46) and 84.8% (39/46) respectively. Out of the 27 isolates produced an ESBL, mostly CTX and TEM. On 46 Salmonella isolates, in 16 (34.8%) Tcr' genes were determined. Genotypic and phenotipic detection of ESBL genes found within integrons from Salmonella isolates from different sources (broiler and cattle) can provide powerful information about health and economic risk associated with transferable multidrug resistance.

Non-functional recurrent pituitary adenoma with intracranial metastasis-Pituitary carcinoma: A case report and review of the literature.

INTRODUCTION: Pituitary carcinomas are rare, with only a few case reports to date. We present a null cell type non-functioning pituitary carcinoma (NFPC) with intracranial metastases and a review of the literature. CASE REPORT: A 56-year-old male with a history of an aggressive pituitary adenoma was admitted. Initial MRI highlighted a large intracranial mass with leptomeningeal involvement, simulating meningioma. Based on his previous pathology report of the sellar mass, a diagnosis of null cell type non-functioning pituitary carcinoma has been made. CONCLUSIONS: An aggressive recurrent pituitary tumor with suprasellar and/or cavernous sinus invasion is the main characteristics of the NFPC. Single or multiple enhancing dural-based mass(es) mimicking meningioma is the most common MRI finding. The proof of malignancy is the same histopathological features of the recurrent aggressive pituitary tumor in the metastases. The histology alone is not distinctive in terms of malignancy. Most patients require a combined surgery, radiotherapy and chemotherapy.

Ectopic pituitary adenoma located at the pituitary stalk. Case report.

Suprasellar located ectopic pituitary adenomas are unusual tumors. We report a rare case of suprasellar prolactinoma arising from the pars tuberalis in a 37-year-old woman. Menstrual disregulation and bitemporal hemianopsia were the main complaints. Blood tests revealed hyperprolactinemia. In magnetic resonance the tumor was totally supradiaphragmatic. Pterional craniotomy and total tumor excision was performed. The pituitary stalk was preserved. Histopathologic diagnosis was a pituitary adenoma immunoreactive for prolactin. Pituitary hormonal functions returned to normal at 6 months postoperatively. No complications were seen in the postoperative period. An ectopic adenoma should be suspected in a patient with suprasellar tumor and hyperprolactinemia. Surgical excision of this tumor may result with normal pituitary functions and normal visual acuity.

Microsurgical anatomy of the lateral walls of the pituitary fossa.

BACKGROUND: The aim was to evaluate the microanatomy of the lateral wall of the pituitary fossa in cadavers. METHODS: Histological sections of sellar-parasellar specimens from 13 cadaver heads were examined. The thickness of the pituitary capsule and inferior and lateral walls of the pituitary fossa were measured, and the collagenous structure of these layers was evaluated. FINDINGS: The pituitary gland is enveloped by a tough, thin, fibrous capsule. The inferior wall of the pituitary fossa is composed of relatively thick dura (mean thickness in the 13 specimens, 171 microm). Each lateral wall of the fossa has a thin layer of dura (mean thickness in the specimens, 85 microm). The pituitary capsule and the dural layers in the lateral and inferior walls of the fossa were immunopositive for collagen types I and II. Collagen types III, IV and V were detected only in the pituitary capsule. CONCLUSIONS: Weakness of the lateral walls of the pituitary fossa and the degree to which collagen fibres in the pituitary capsule have been biochemically damaged are important factors in infiltration of the cavernous sinus by a pituitary adenoma.

The pathobiologic spectrum of Schwannomas.

In terms of their morphology, clinical associations and behavior, peripheral nerve sheath tumors are among the most varied of human neoplasm. Not surprisingly, such tumors are subject to frequent misdiagnosis. This is particularly true of the spectrum of schwannomas which include: a) conventional schwannoma, a histologically benign tumor which, on occasion, is destructive of surrounding osseous structures, b) the relatively recently described cellular schwannoma, a tumor that histologically simulates malignant peripheral nerve sheath tumor (MPNST), c) plexiform schwannoma which, particularly in cellular form and when occurring in childhood, simulates MPNST, and d) melanotic schwannoma which is often mistaken for melanoma. The psammomatous form of the latter is often associated with Carney complex, a rare heritable disorder that: a) includes cutaneous lentigines, b) myxomas of skin, subcutaneous tissue, and heart, c) and endocrine neoplasms. The tendency to misdiagnose schwannomas and to overestimate their grade makes schwannomas worthy of note. Herein, we discuss the four major schwannoma variants, their essential clinicopathologic features, and differential diagnosis. The distinction from MPNST is given particular attention.

Schwannoma with rhabdomyoblastic differentiation: a unique variant of malignant triton tumor.

A 54-year-old woman presented with intractable perianal, bilateral buttock, and radiating thigh/calf pain. An MRI scan showed an intradural, contrast-enhancing, ovoid mass in the cauda equina region at L1-L2. At laminectomy, the ovoid mass arose from a nerve root and, intact, was gross totally resected. Histologically, the dominant pattern was that of schwannoma. One year thereafter, the symptoms recurred. An MRI scan demonstrated an irregular, heterogeneously enhancing tumor recurrence. A repeat laminectomy disclosed a large fleshy tumor involving multiple nerve roots. The lesion was subtotally resected and showed pluridirectional differentiation toward embryonal rhabdomyosarcoma, primitive neuroectodermal tumor, and rare malignant epithelial cells. Review of the original tumor disclosed only foci of embryonal rhabdomyosarcoma and primitive neuroectodermal tumor. Based upon available data regarding divergent differentiation in peripheral nerve sheath tumors, this is a unique, previously undescribed tumor demonstrating rhabdomyosarcomatous, primitive neuroectodermal tumor and scant epithelial differentiation in a schwannoma. In essence, it is a variant of malignant Triton tumor because of its origin in a tumor consisting of well-differentiated Schwann cells. It supports the contention that the Schwann cell is the source of a variety of heterologous elements in nerve sheath tumors.

Pituitary adenoma in Carney complex: an immunohistochemical, ultrastructural, and immunoelectron microscopic study.

First described in 1985, Carney complex is a rare, heritable disorder featuring abnormal skin pigmentation, cardiac and cutaneous myxoma, melanotic schwannoma of psammomatous type, and endocrine abnormalities, including pituitary adenomas. Patients with the latter present with elevated growth hormone (GH) levels and acromegaly or gigantism. Prolactin (PRL) elevation may also be seen. The authors have investigated 2 resected pituitary adenomas from patients with Carney complex. One, a 19-year-old female acromegalic with elevated GH, IgF-1, and PRL levels, had a mammosomatotroph adenoma immunoreactive for GH and PRL. Ultrastructurally, GH and PRL were present in the same secretory granules. The second patient, a 27-year-old acromegalic, had a sparsely granulated GH cell adenoma that by immuno-electron microscopy revealed GH immunoreactivity only. The lack of morphologic similarity between the 2 adenomas indicatesthat pituitary tumors in patients with Carney complex may not exhibit the same phenotype.