Comparison of immunogenicity for Sinovac-CoronaVac vaccine vs. natural infection during cancer treatment.

OBJECTIVE: Efficacy of the COVID-19 vaccines in cancer patients, especially during their active treatment, are lacking. Most of the studies in the literature compared the immunity in cancer patients with a cross-sectional cohort or retrospectively. Our study investigated Sinovac-CoronaVac COVID-19 vaccine immunogenicity and compared it with natural COVID-19 disease in cancer patients during their cancer therapy. PATIENTS AND METHODS: A total of 111 patients with cancer and who are on active treatment were included in the study. This is a single-center study and was designed prospectively. Two group of patients were included in the study, natural disease and vaccinated group. RESULTS: A total of 111 patients were included in the study, 34 of whom had natural COVID-19 disease. Antibody levels following the first dose vaccine were 0.4 (0-1.9) U/ml while after the second dose of vaccine were 2.6 (1.0-7.25) U/ml. Immunogenicity levels were 82.4% in the natural disease group and 75.8% in the vaccinated group after the second shot of the vaccine. Immunogenicity rate was significantly higher in non-chemotherapy (receiving immunotehrapy/targeted therapy or biologic agent) group compared to chemotherapy drug (92.9% vs. 63.3%, p=0.004). There was a difference between the antibody levels following the first and second vaccination [median (IQR): 0.3 (0-1.0) and 3.3 (2.0-6.7), p=0.001, respectively]. CONCLUSIONS: The present study revealed that the Sinovac-CoronaVac vaccine showed an acceptable immunogenicity following two shots in cancer patients who were receiving active systemic therapy. On the other hand, natural disease immunogenicity was higher than vaccinated group.

Effect of Lipoic Acid on Serum Paraoxonase-1 and Paraoxonase-3 Protein Levels and Activities in Diabetic Rats.

The aim of the present study was to investigate the effect of streptozotocin-induced diabetes mellitus and lipoic acid treatment on serum paraoxonase-1 and paraoxonase-3 protein levels and paraoxonase, arylesterase and lactonase activities.36 rats were equally and randomly divided into 4 groups as control, lipoic acid, diabetes and diabetes+lipoic acid. To induce diabetes, a single dose of streptozotocin (40 mg/kg) was injected intraperitoneally to diabetes and diabetes+lipoic acid groups. Lipoic acid (10 mg/kg/day) was injected intraperitoneally for 14 days to lipoic acid and diabetes+lipoic acid groups. Serum PON1 and PON3 protein levels were measured by western blotting. Serum paraoxonase, arylesterase and lactonase activities were determined by the measuring initial rate of substrate (paraoxon, phenylacetate and dihydrocoumarin) hydrolysis.Streptozotocin-induced diabetes mellitus caused a significant decrease whereas lipoic acid treatment caused a significant increase in serum PON1 and PON3 protein levels and paraoxonase, arylesterase and lactonase activities. The increase percent of serum PON3 protein was higher than that of serum PON1 protein and the increase percent of serum lactonase activity was higher than that of serum paraoxonase and arylesterase activities in diabetes+lipoic acid group.We can report that, like PON1 protein, PON3 protein and actually its lactonase activity may also have a role as an antioxidant in diabetes mellitus and lipoic acid treatment may be useful for the prevention of the atherosclerotic complications of diabetes by increasing serum PON1 and PON3 protein levels and serum enzyme activities.

Beyond anti-microbial properties: The role of cathelicidin in allergic rhinitis

BACKGROUND: Cathelicidin, an anti-microbial peptide, is a component of the innate immune system. Cathelicidin has anti-microbial, anti-inflammatory and immunoregulatory functions. Knowledge about the role of the innate immune system in the pathogenesis of allergic diseases has expanded in recent years. We measured levels of the LL-37 peptide in the nasal fluids of children with allergic rhinitis (AR) and investigated the possible role of this peptide in the pathogenesis of AR. METHODS: The study population included 46 children who were newly diagnosed with AR and not taking any medication. Thirty-three healthy control subjects were also enrolled. Nasal secretions were collected from the study and control groups using a polyurethane sponge nasal secretion collector, and nasal fluid LL-37 levels were determined using the ELISA method. Results; The levels of LL-37 in the nasal fluid of the AR patients were lower than those of the control group (median of 2.3ng/ml [minimum-maximum, 2.1-3.2] vs. 2.6 ng/ml [2.1-5.4], respectively; p < 0.001), and they were significantly reduced in patients with moderate/severe AR compared with those of patients with mild AR (2.2 ng/ml [2.1-2.4] vs. 2.5 ng/ml [2.1-3.1], respectively; p < 0.001). CONCLUSION: Our results show that children with AR have reduced nasal fluid LL-37 levels compared with healthy controls. Additionally, children with moderate/severe AR have decreased nasal fluid LL-37 levels compared with children with mild AR. These findings highlight the role of cathelicidin in the pathogenesis of AR

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Beyond anti-microbial properties: The role of cathelicidin in allergic rhinitis.

BACKGROUND: Cathelicidin, an anti-microbial peptide, is a component of the innate immune system. Cathelicidin has anti-microbial, anti-inflammatory and immunoregulatory functions. Knowledge about the role of the innate immune system in the pathogenesis of allergic diseases has expanded in recent years. We measured levels of the LL-37 peptide in the nasal fluids of children with allergic rhinitis (AR) and investigated the possible role of this peptide in the pathogenesis of AR. METHODS: The study population included 46 children who were newly diagnosed with AR and not taking any medication. Thirty-three healthy control subjects were also enrolled. Nasal secretions were collected from the study and control groups using a polyurethane sponge nasal secretion collector, and nasal fluid LL-37 levels were determined using the ELISA method. RESULTS: The levels of LL-37 in the nasal fluid of the AR patients were lower than those of the control group (median of 2.3ng/ml [minimum-maximum, 2.1-3.2] vs. 2.6ng/ml [2.1-5.4], respectively; p<0.001), and they were significantly reduced in patients with moderate/severe AR compared with those of patients with mild AR (2.2ng/ml [2.1-2.4] vs. 2.5ng/ml [2.1-3.1], respectively; p<0.001). CONCLUSION: Our results show that children with AR have reduced nasal fluid LL-37 levels compared with healthy controls. Additionally, children with moderate/severe AR have decreased nasal fluid LL-37 levels compared with children with mild AR. These findings highlight the role of cathelicidin in the pathogenesis of AR.

Significance of TNM staging, Demographic and Histologic Features in Predicting the Prognosis of Renal Cell Carcinoma.

BACKGROUND: The aim of this study was to evaluate the prognostic significance of clinical, demographic and detailed histopathological parameters in renal cell carcinoma (RCC). METHODS: A total of 102 patients who underwent partial or radical nephrectomy for a renal mass between 2008 and 2013 were evaluated retrospectively. Fuhrman grade, TNM stage, macroscopic satellite tumor nodule formation, histopathological subtype, renal vein invasion (RVI), necrosis, microvessel invasion (MVI), sarcomatoid differentiation and overall survival (OS) were evaluated to determine prognostic factors. RESULTS: The 102 patients consisted of 73 with clear cell tumor, 15 with papillary tumor, 12 with chromophobe tumor and 2 collecting duct RCC cases. A statistically negative relationship was observed between increasing age and OS when the patients were grouped as above and under 40 years of age. There was no statistical relationship between OS and histopathological subtype, adrenal gland invasion, and lymph node metastasis. The risk of death was 10-fold increased in patients with stage 4 tumor compared to patients with stage 1 tumor. Statistically significant macroscopical parameters for OS were satellite tumor nodule presence, Fuhrman grade, tumor size, renal sinus and perinephric fat invasion, distant metastasis, and RVI. The risk of death was 13-fold higher in cases with sarcomatoid differentiation. There was a strong correlation between the presence of a satellite tumor nodule, necrosis, sarcomatoid differentiation and the tumor stage. A statistically negative correlation was observed between OS and the MVI, sarcomatoid differentiation, and necrosis. CONCLUSION: We found the Fuhrman grade, tumor size, renal sinus and perinephric fat invasion, distant metastasis, RVI, MVI, sarcomatoid differentiation, necrosis and satellite tumor nodule to be all statistically significant parameters for OS. The addition of other variables to the TNM stage and grade may improve the prediction of outcomes for RCC patients.

Adrenal dysfunction in critically ill children.

Cortisol is the major glucocorticoid synthesized by the adrenal cortex and its secretion is under the control of hypothalamic-pituitary axis. There is an increase in corticotrophin-releasing hormone and corticotrophin secretion and a decrease in the negative-feedback effect during critical illness. Adrenal insufficiency (AI) in children with critical illness is defined as an inadequate glucocorticoid response, measured by the peak cortisol or the increment in the cortisol level following exogenous ACTH (corticotrophin) administration. Clinically apparent AI is uncommon in critically ill patients. The incidence of AI in critically ill children varies with the underlying disease, its severity and duration, and multiple different definitions for the diagnosis of AI. Most of the pediatric studies for evaluation of AI during critical illness focused on patients with sepsis or septic shock. In patients with sepsis or septic shock, decreased synthesis or release of corticotrophin-releasing hormone, corticotrophin, and cortisol by cytokines and other circulating mediators released during sepsis are the most likely mechanism of AI. Recent studies in critically ill children reported that the prevalence of AI was not significantly different between septic and nonseptic patients, but it was noteworthy that AI appeared to be common both in septic and nonseptic critically ill children. A multidisplinary approach is necessary to manage to AI in critically ill children. However, no concensus exists among pediatric intensivist and endocrinologysts on diagnosis or treatment of AI in pediatric critical illness.

Cathelicidin and human ß-defensin 2 in bronchoalveolar lavage fluid of children with pulmonary tuberculosis.

BACKGROUND: The antimicrobial peptide cathelicidin LL-37/hCAP-18 and human ß-defensins (hBD) are key factors in innate immune responses of the respiratory tract. OBJECTIVE: To determine LL-37 and hBD-2 concentrations in the bronchoalveolar lavage (BAL) fluid of paediatric patients (aged <16 years) with pulmonary tuberculosis (TB) and to compare these with concentrations in healthy children. METHODS: We measured peptide concentrations using an immunosorbent assay (ELISA). RESULTS Forty TB patients and 40 healthy controls were enrolled in the study (mean age 9.2 ± 4.7 and 8.3 ± 4.2 years, respectively, P = 0.97). The two groups exhibited no statistically significant difference in terms of sex, body mass index, relative weight or 25-hydroxyvitamin D levels. The mean BAL LL-37 level of the TB group was significantly higher than that of the control group (0.95 ± standard deviation [SD] 1.33 vs. 0.35 ± SD 0.51 ng/ml, P = 0.01, t = 2.54). The hBD-2 level was also higher in the TB group; however, the difference was not statistically significant (0.30 ± SD 0.58 vs. 0.14 ± SD 0.30 ng/ml, P = 0.11). There was no correlation between LL-37, hBD-2 and 25-hydroxyvitamin D levels. CONCLUSIONS Our data suggest that LL-37 and hBD-2 may play an important role in TB pathogenesis in children. To our knowledge, this is the first study on BAL LL-37 and hBD-2 concentrations in children with pulmonary TB.

Cardiovascular risk factors, carotid artery intima media thickness, and HSCRP levels in patients with impaired glucose metabolism.

AIM: The aim of this paper was to compare serum high sensitivity C-reactive protein (HsCRP) levels and carotid artery intima-media thickness (CIMT) of patients with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) with that in control subjects. METHODS: Ninety-six subjects with prediabetes, 48 with IFG, of mean age 50.7±11.3 years, and 48 with IGT, of mean age 50.9±12.3 years, were enrolled, along with 44 age-, sex-, and body mass index-matched controls with normal glucose tolerance. Serum HsCRP, lipid profile, insulin levels and the homeostasis model assessment of insulin resistance (HOMA-IR) was evaluated. High-resolution B-mode ultrasonography was performed. RESULTS: Serum HsCRP levels were significantly elevated in pre-diabetic patients when compared with that of control subjects. Median HsCRP values were 3.1 mg/L in IFG group, 3.47 mg/L in IGT group, and 1.5 mg/L in the controls (P<0.001). CIMT was significantly higher in pre-diabetic groups than that in the control group (IFG: 0.612±0.09; IGT: 0.625±0.1; control: 0.517±0.09, P<0.001). CIMT and HsCRP levels were similar in pre-diabetic groups. CIMT values were positively correlated with HsCRP (r=0.793, P=0.000), age (r=0.435, P=0.000), waist-hip ratio (r=0.170, P=0.044), fasting plasma glucose (r=0.302, P=0.000), HOMA-IR (r=0.173, P=0.041), and low-density lipoprotein cholesterol (r=0.168, P=0.047) levels. CONCLUSION: Both IFG and IGT were associated with increased cardiovascular risk as assessed by serum hsCRP levels and CIMT. In contrast to previous studies, risk appears to be the same in the two categories of prediabetes.

MUC1 and bcl-2 expression in preinvasive lesions and adenosquamous carcinoma of the lung.

BACKGROUND: Adenosquamous carcinoma of the lung involves both adenocarcinoma and squamous cell carcinoma, each comprising at least 10% of the tumor. Atypical adenomatous hyperplasia (ADH), bronchiolar columnar cell dysplasia (BCCD), basal cell dysplasia (BCD), columnar cell dysplasia (CCD), bronchial epithelial dysplasia with transitional differentiation (BEDT) and squamous dysplasia (SD) are preinvasive lesions. The aim of this study is to define the preinvasive lesions and evaluate the role of MUC1, bcl-2, and the preinvasive and invasive components of adenosquamous carcinoma. METHODS: A group of 31 patients with adenosquamous carcinoma of the lung were selected. The ratio of squamous to glandular differentiation, the associated preinvasive lesions, the features of peritumoral tissue, the stroma of the tumor, necrosis, perineural and vascular invasion were analyzed. For the immunohistochemical study, blocks containing squamous cell carcinoma, adenocarcinoma and preinvasive lesions were selected. MUC1 and bcl-2 analyses were performed by the immunoperoxidase method using the avidin-biotin complex. RESULTS: Associated preinvasive lesions amd SD, BCCD, BEDT, AAH and CCD were observed in 24, 6, 3, 1 and 6 cases, respectively. Expression for MUC1 was positive in the squamous component of 30 cases, the adenocarcinoma component of 27 cases and in 34 preinvasive lesions. A strong correlation was found between MUC-1 expression in the squamous component and tumor localization (p = 0,01). The positive expression of Bcl-2 in the adenocarcinomatous component was correlated with the presence of preinvasive lesions (p = 0,01). CONCLUSIONS: Squamous dysplasia was the most frequent preinvasive lesion of adenosquamous carcinomas. MUC1 and bcl-2 expression levels were strongly associated with preinvasive lesions in adenosquamous carcinomas.

The protective effects of taurine on experimental acute pancreatitis in a rat model.

The aim of this study was to investigate the protective effects of taurine (Tau) on experimental acute pancreatitis (AP) in a rat model by measuring cytokines and oxidant stress markers. Forty rats were randomly divided into four groups: sham, AP, Tau and AP + Tau. AP was induced with sodium taurocholate. No treatment was given to the AP. All rats were killed 5 days later. Pancreatic tissues of rats and blood samples were obtained. Tau treatment significantly decreased serum amylase activity (p < 0.001), total injury score (p < 0.001), malondialdehyde levels (p < 0.001) and myeloperoxidase (MPO) activity (p < 0.001). There was no significant difference between the Tau and AP + Tau groups in serum and pancreatic tumor necrosis factor-α, interleukin (IL)-1ß and IL-6 levels (p = 1.000). Histopathologic scores in the AP + Tau and Tau groups were significantly lower compared with the AP group (both p < 0.001). These results showed that Tau reduces lipid peroxidation, amylase and MPO activities and the concentrations of proinflammatory cytokines secondary to AP and also increases superoxide dismutase and glutathione peroxidase activities in rats with sodium taurocholate-induced AP. It also has a marked ameliorative effect at histopathologic lesions. With these effects, Tau protects the cells from oxidative damage, reduces inflammation and promotes regression of pancreatic damage.

Bone mineral density and associated parameters in pre-pubertal children with asthma treated with long-term fluticasone propionate.

AIMS: The primary aim of the objective of the study was to determine the effects of long-term treatment with the recommended dose of inhaled fluticasone propionate spray usage on bone mineral status in children with asthma. METHODS: This cross-sectional, case-control study was of 270 pre-pubertal children with asthma, who had used inhaled fluticasone propionate at a mean daily dose of 200 µg (range: 200-350 µg) for at least 5 years. The bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry (DEXA). The results were compared to untreated controls (n=200), who were newly diagnosed children with asthma without any corticosteroid treatment. RESULTS: The 270 study patients (175 males) were aged between 6 and 13 years. The average age (±SEM) was 9.2±0.6 years, and the mean (±SEM) steroid dosage used was 183.3±57.0 µg daily, with 236.5±17.2 g total steroid use during treatment. Between the study and the control groups, no significant difference was observed in BMD (p>0.05). CONCLUSION: The findings suggest that long-term periodical treatment for 5 years with inhaled fluticasone propionate, 100 µg twice daily, in children with asthma revealed no negative effect on bone mineral density by using DEXA.

Is NAFLD an independent risk factor for increased IMT in T2DM?

AIM: Recent data have suggested that the presence of non-alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus may also be linked to increased risk of cardiovascular disease (CVD) independent from metabolic syndrome. Therefore the aim of the study is to compare the CVD risk in diabetic and non diabetic participants and to evaluate whether there is an association betweeen NAFLD and CVD risk. METHODS: Fifty five type 2 diabetic (study group) and 44 nondiabetic patients (control group) were included in the study. Patients were divided into two groups according to degree of hepatosteatosis. Group 1 include grade≥2 hepatosteatosis and group 2 include grade<2 hepatosteatosis patients. RESULTS: As a result, hepatosteatosis rates were found to be similar in diabetic and non-diabetic patients (P=0.07). Mean CIMT was significantly higher in diabetic patients (P=0.01). Mean fasting plasma glucose (FPG) and glucolise hemoglobin (HbA1c) were found to be higher in grade≥2 hepatosteatosis group (P=0.002 and 0.004 respectively). But CIMT was found to be similar between hepatosteatosis groups (P=0.618). CONCLUSION: NAFLD is extremely common in people with type 2 diabetes and is mainly associated with uncontrolled diabetes. CIMT values as cardiovascular risk assessment were found to be significantly higher in diabetic patients regardless degree of hepatosteatosis.

First Report of Phytophthora cryptogea on Potato Tubers in Turkey.

Potato (Solanum tuberosum L.) is an important agricultural crop in Turkey, with 150,000 ha and a production of about 4 million tons per year. There are numerous pathogens that limit potato production. In 2011, a new disease was observed on the potato cultivar Ramos in Erzincan Province in Turkey. Disease symptoms were similar to pink rot. Infected tubers had a rubbery texture and when cut, infected areas were cream colored. When the infected area was exposed to air for 10 min, the color turned to salmon pink and after 15 to 20 min it turned black. A funguslike organism was isolated from diseased tubers on carrot agar. The colonies were uniform and there were no petaloid patterns. Soil extract solution was prepared using 1,000 ml of distilled water and 15 g of field soil according to Jeffers and Aldwinckle (2) and used for sporangia production. Agar discs from 5-day-old colonies were placed in soil extract solution and incubated under continuous fluorescent light at room temperature. Sporangia began forming after 24 h and were abundant after 48 h. Oogonia were not observed on corn meal agar plates supplemented by beta-cytosterol. Sporangia were nonpapillate and noncaducous, mostly ovoid, but some were obpyriform. The mean size of the sporangia was 43 ± 4 × 30 ± 2 µm. The Oomycete was identified as Phytophthora cryptogea Pethybr. & Laff., according to its morphological characters (1). Isolate identity was confirmed by sequence analysis of the ribosomal DNA internal transcribed spacer using primers ITS1 and ITS4. The ITS sequence was a 99% match to P. cryptogea strains (GenBank Accession Nos. AF087475.1, AF228101.1, GU111626.1, AY995400.1, GU111624.1, AY995400.1, and GU111624.1). The isolate from Turkey was deposited in GenBank as Accession No. JQ071495. Pathogenicity tests were conducted on potato tubers (cv. Ramos). Tubers were surface disinfected with 0.5% NaOCl for 5 min., then washed twice with sterile water. When dried, 20 tubers were wounded with a shallow cut made parallel to the surface by a sterile knife. An agar disc from a 1-week-old colony was placed on the artificial wound on each of 10 potatoes. For controls, agar discs without fungal mycelia were placed on the wounds of the other 10 potatoes. Each inoculated and uninoculated potato was incubated for 5 days at 24°C in the dark and in separate plastic cups containing moistened filter paper at the bottom. Tubers were then cut open and examined for disease. Cream colored lesions were first observed; after 10 min lesions turned salmon pink and after 20 min they turned black. Cream colored lesions were not observed inside uninoculated potatoes. To the best of our knowledge, this is the first report of P. cryptogea causing pink rot of potato in Turkey. Pink rot disease of potato is commonly caused by P. erytroseptica, but P. cryptogea can cause similar symptoms (3) and severe tuber rot. This pathogen could cause important losses of potato in Turkey, especially during storage of tubers. References: (1) M. E. Gallegly and C. Hong, Phytophthora: Identifying Species by Morphology and DNA Fingerprints. APS Press, St. Paul, MN, 2008. (2) S. N. Jeffers and H. S. Aldwinckle, Phytopathology 77:1475, 1987. (3) E. C. Rowe and A. F. Schimitthenner, Plant Dis. Rep. 61:807, 1977.

Molecular epidemiology and the clinical significance of Acinetobacter baumannii complex isolated from cerebrospinal fluid in neurosurgical intensive care unit patients.

OBJECTIVE: This study was intended to investigate the clinical significance and molecular epidemiology of Acinetobacter baumannii complex (ABC) isolated from cerebrospinal fluid (CSF) in neurosurgical intensive care unit (NSICU) patients, particularly comparing isolates from healthcare workers' (HCW) hands. METHODS: We retrospectively reviewed the medical records of 30 patients with CSF cultures positive for ABC seen at our NSICU from the date it first opened, January 2007, to September 2010. Pulsed-field gel electrophoresis (PFGE) typing was performed on 68 strains isolated from 32 patients' CSF and 36 HCWs' hands. RESULTS: ABC isolates were considered to be clinically significant in 21 (70.0%) patients but insignificant in the other nine (30.0%) patients. The prolonged (>7 days) use of cephalosporins was more common in patients with clinically significant ABC isolates (p = 0.049). Multiple drug resistance (MDR) was observed in 12 (57.1%) clinically significant isolates. Empirical antimicrobial therapies were not appropriate for nine of these 21 patients (42.8%). Mortality was significantly higher in the clinically significant group than in the clinically insignificant group (18/21 vs. 3/9; p = 0.008). Fifty-three isolates (77.9%) were grouped into 15 clusters, three of which contained possibly related isolates from patients' CSF and staff members' hands. CONCLUSIONS: The fact that ABC isolates grown from CSF cultures do not always exhibit infection and have high multiple antibiotic resistance, including to carbapenems, should be borne in mind when planning treatment for these patients. In addition, HCWs' hands may play a significant role in transmission to patients, and compliance with infection control procedures, especially hand washing, must be enhanced in order to avoid ABC infections.

The incidence of non-proliferative and precancerous lesions of reduction mammoplasty: evaluation of 273 cases.

BACKGROUND: Reduction mammoplasty (RM) is one of the most commonly performed plastic surgery procedures to treat symptomatic macromasty or to correct asymmetry. Occult breast carcinomas were rarely defined in RM specimens. There are few studies aiming to define the incidence of non-proliferative and precancerous lesions. MATERIAL AND METHODS: We evaluated the pathological findings of the RM specimens that have been submitted to our Center for the last 6 years (2005-2011). RESULTS: A total of 273 cases with bilateral RM were enrolled to the study. Of them, 229 cases had pathological changes. Eight cases (2.9%) had atypical ductal/lobular hyperplasia. One case (0.3%) had lobular carcinoma in situ; however, no invasive breast carcinoma was detected. Other pathological findings included fibrocystic changes, fibrosis, adenosis, fibroadenoma (without complex features), mastitis and duct ectasia. CONCLUSIONS: Pathological examination of the RM specimens is quite important to define the lesions precancerous of breast carcinoma. Unknown occult breast lesions could be identified and early interventions may be taken into account.

Pituitary macroadenoma with persisting dense lymphocytic infiltration in a young male patient.

CONTEXT: Lymphocytic anterior hypophysitis in association with a pituitary adenoma was reported previously. In rare instance, inflammatory infiltration was confined to adenoma tissue itself, excluding anterior pituitary. CASE: The patient - a 27-year-old male - presented with visual field defect. Further examination revealed a pituitary mass with suprasellar extension. Hormonal evaluation indicated mild hyperprolactinemia (42 ng/ml, normal < 19). After transsphenoidal resection, a pituitary adenoma showing cytoplasmic immunoreactivity to prolactin was identified. Dense and diffuse lymphocytic infiltration was seen within the tumor. At 15th month, a second transsphenoidal operation was necessary because of rapid development of visual compromise and headache. Excised surgical specimen consistent with previously resected adenoma showed diffuse lymphocytic infiltration composed of B and T cells within the adenoma tissue again. CONCLUSION: Presence of dense, hypophysitis-like lymphocytic infiltration within pituitary adenoma tissue obtained by two consecutive operations may reflect an host-mediated immune reaction to tumor. This rare finding could be challenging in terms of differential diagnosis and follow-up course.

Expression of GSTM4 and GSTT1 in patients with Tinea versicolor, Tinea inguinalis and Tinea pedis infections: a preliminary study.

BACKGROUND: Several skin diseases are believed to be associated with oxidative stress. Defence against reactive oxygen species in the skin involves a variety of antioxidant enzymes, including glutathione-S-transferases (GSTs) catalysing the reaction between reduced glutathione, and a variety of exogenously and endogenously derived electrophilic compounds. The mammalian soluble GSTs are divided into five main classes: alpha (A), mu (M), pi (P), theta (T) and zeta (Z). AIM: To investigate the expression of GSTM4 and GSTT1 in lesional and nonlesional skin of patients with dermatophytoses and Tinea versicolor infection. Methods. Expression of GSTM4 and GSTT1 was assessed by immunohistochemistry for dermatophytoses in 15 patients with T. versicolor, 15 patients with Tinea pedis and 8 patients with Tinea inguinalis, and compared with healthy controls (n = 9). After written consent was signed by each participant, punch biopsies were excised from the centre of the lesional skin sites in patients and from the normal skin sites in controls. The relationships between expression of GSTM4 and GSTT1 isoenzymes and fungal infections were also examined. RESULTS: When the normal and infected tissue of these cases were compared according to their staining intensity, GSTM4 expression was found to be stronger in control epithelium than in the epithelium of patients with T. pedis, T. inguinalis or T. versicolor (P < 0.05). By contrast, expression of GSTT1 was stronger in the epithelium of patients infected with any of the three dermatophytes than in control epithelium (P < 0.05). CONCLUSIONS: There is a significant relationship between presence of T. versicolor, T. inguinalis and T. pedis and expression of GSTM4 and GSTT1.