Serum cytokine profiles of Khorasan veterans 23 years after sulfur mustard exposure.

Sulfur mustard (SM) is an incapacitating chemical warfare agent that was used against Iranian soldiers during the period from 1983 to 1988. We have investigated serum cytokines profiles of Khorasan veterans who were exposed to SM >23 years earlier. Forty-four male Iranian veterans who had >40% disabilities due to delayed complications of SM poisoning and had disabilities were investigated. A total of 30 healthy male volunteers (relatives of the veterans) were selected as the control group. Cytokine levels were measured in the serum of case and control subjects using commercial ELISA kits. Hematologic parameters (white/red blood cell counts, hemoglobin levels, immune cell differentials) were also performed on blood samples from the study subjects. The results indicated that serum levels of ICAM-1 were significantly higher in the samples from SM-exposed veterans (772.8 [± 15.1] ng/ml [p=0.014] vs. control values of 710.2 [± 20.0] ng/ml). On the other hand, serum IL-1ß, IL-8 levels and TNFα, were significantly lower for the veterans than the controls (IL-1ß: 3.8 [± 0.1] vs. 4.3 [± 0.2] pg/ml, p=0.037; IL-8: 21.0 [± 6.1] vs. 84.6 [± 20.3] pg/ml, p=0.002; TNFα: 4.5 [± 0.1] vs. 5.5 [± 0.1] pg/ml, p=0.027). Levels of other assayed cytokines, e.g., IL-2, -4, -5, -6, -10, and -12, IFNγ, TNFß, and sVCAM-1 were not significantly different between the study populations. None of the assayed hematologic parameters appeared to differ as well. It seems possible that dysfunctions could have been induced in the innate immune functions of the SM-exposed veterans as a result of these changes in cytokine expression and that these, in turn, may have contributed to the increased incidence of a myriad of diseases that have been documented in these veterans, including cancers. Future studies must focus on examining the significance of these changes in circulating cytokines and their potential contribution to the development of different diseases in veterans exposed to SM.

Gastrointestinal stromal tumors in fine-needle aspiration biopsies.

Gastrointestinal stromal tumors (GISTs), although rare, are the most common mesenchymal neoplasms of the gastrointestinal tract. Their potential for malignancy underscores the significance of identifying them through cytomorphologic findings and pertinent immunohistochemical markers. GISTs can emerge anywhere along the gastrointestinal tract with a predilection for the stomach. The clinical manifestations vary from nonspecific abdominal symptoms to incidental discovery during diagnostic interventions for unrelated signs and symptoms. Cytologically, GIST aspirates contain spindle or epithelioid cells with immunoreactivity for CD117/c-KIT, DOG-1, and CD34. Molecularly, KIT or PDGFRA mutations are prevalent, guiding targeted therapy with tyrosine kinase inhibitors. Distinct subtypes like succinate dehydrogenase-deficient GISTs pose challenges, often affecting younger individuals and displaying unique features. Histologically, GISTs are graded by mitotic rates, aiding prognostication. Distinguishing GISTs from similar entities is pivotal, necessitating attention to their immunostaining patterns for making an accurate diagnosis and molecular alterations for effectively planning treatment. Common differential diagnoses include leiomyoma, schwannoma, and solitary fibrous tumor. This article presents a classic GIST case and showcases relatively simple diagnostic clues for identifying similar lesions that may occur in diverse locations.

Mercury contamination of fish and shrimp samples available in markets of Mashhad, Iran.

Fish and shrimp are common healthy sources of protein to a large percentage of the world's population. Hence, it is vital to evaluate the content of possible contamination of these marine-foods. Six species of fishes and two species of shrimps were collected from the local markets of Mashhad, Iran. The mercury (Hg) concentration of samples was determined by atomic absorption spectrophotometry using a mercuric hydride system (MHS 10). High concentration of total Hg was found in Clupeonella cultriventris caspia (0.93 ± 0.14 µg/g) while the lowest level was detected in Penaeus indicus (0.37 ± 0.03 µg/g). Mean Hg levels in fish and shrimp samples were 0.77 ± 0.08 µg/g and 0.51 ± 0.05 µg/g, respectively. Farmed species (except for P. indicus) and all samples from Persian Gulf and the Caspian Sea had mean mercury concentrations above 0.5 µg/g, which is the maximum standard level recommended by Joint FAO/WHO/Expert Committee on Food Additives (JECFA). All samples had also mean Hg concentrations that exceeded EPA's established safety level of 0.3 µg/g. A little more extensive analysis of data showed that weekly intake of mercury for the proportion of the Iranian population consuming Hg contaminated fish and shrimp is not predicted to exceed the respective provisional tolerable weekly intakes recommended by JECFA. However, the Iranian health and environmental authorities should monitor Hg contamination of the fishes and shrimps before marketing.

Primary Malignant Melanoma of the Genitourinary System: A Systemic Review and Report of Eight Cases.

Malignant melanoma (MM) of mucosal membranes (excluding anus and head-neck) is a rare but aggressive disease with poor outcomes. The knowledge of this tumor's development, etiology, and management is scarce, mainly due to the low case numbers. We presented eight cases and performed a comprehensive literature review on mucosal MM (between 1970 and 2020). We identified 47 manuscripts on 55 patients with primary mucosal MM (limited to urothelium and vagina) and reviewed demographics, tumor specifications (morphology, stage, etc.), management, and survival. We identified 10 manuscripts discussing treatment in 1595 mucosal and non-mucosal MM and extracted the data regarding the non-surgical treatment modalities of mucosal MM patients. In 63 cases, 48 tumors primarily occurred in the urothelium (urethra: 47, bladder: 1) and 15 in the vagina. Molecular studies in a subset of cases revealed alterations in c-KIT, NRAS, BRAF (non-V600E and V600E), TP53, and NF1. Fifty-three patients underwent surgery (with additional chemotherapy, immunotherapy, and radiotherapy in 19, eight, and eight patients, respectively). The outcome was available in 52 cases, showing 21 deaths, 10 without recurrence, two alive with disease, and five lost to follow-up. Shared genetic signatures in mucosal and skin MM suggest a similar development mechanism; however, unlike skin MM, there are less BRAF mutations and more PI3K/AKT/mTOR pathway alterations in mucosal MM. Prolonged chemotherapy (i.e., methotrexate) and immune-modulating agents (i.e., natalizumab) may be risk factors. The stage at diagnosis and proper surgical extirpation are keys to the prognosis and survival of patients.