A Different Perspective on Macroscopic Sampling of Cholecystectomy Specimens

BACKGROUND: Because there may be interdepartmental differences in macroscopic sampling of cholecystectomy specimens, we aimed to investigate differences between the longitudinal sampling technique and our classical sampling technique in cholecystectomy specimens in which there was no obvious malignancy. METHODS: Six hundred eight cholecystectomy specimens that were collected between 2011 and 2012 were included in this study. The first group included 273 specimens for which one sample was taken from each of the fundus, body, and neck regions (our classical technique). The second group included 335 specimens for which samples taken from the neck region and lengthwise from the fundus toward the neck were placed together in one cassette (longitudinal sampling). The Pearson chi-square, Fisher exact, and ANOVA tests were used and differences were considered significant at p<.05. RESULTS: In the statistical analysis, although gallbladders in the first group were bigger, the average length of the samples taken in the second group was greater. Inflammatory cells, pyloric metaplasia, intestinal metaplasia, low grade dysplasia, and invasive carcinoma were seen more often in the second group. CONCLUSIONS: In our study, the use of a longitudinal sampling technique enabled us to examine a longer mucosa and to detect more mucosal lesions than did our classical technique. Thus, longitudinal sampling can be an effective technique in detecting preinvasive lesions.

Evaluation of insulin resistance by the homeostasis model assessment in female patients with primary sjogren's syndrome

To evaluate insulin resistance in Primary Sjogren's Syndrome [pSS] using homeostasis model assessment [HOMA] method Cross-sectional study conducted between January 2006 and December 2008 Ege University Faculty of Medicine, Izmir, Turkey Thirty-five female patients with pSSful filling the US-European Consensus Criteria. A brief clinical history, demographic, anthropometric, clinical and laboratory profileswererecorded HOMA-IR and serum lipid levels Mean level of HOMA-IR was 1.8 +/- 0.7 in patients with pSS. Mean levels of plasma fasting glucose and insulin were 90.6 +/- 7.1 mg/dl, 7.8 +/- 2.5 micro U/l, respectively. A statistically significant difference was detected between ANA positivity and HOMA-IR values [p=0.016]. Four patients with pSS had high HOMA values [>2.7] and all these patients had ANA positivity. A statistically significant positive correlation was detected between HOMA-IR values and HDL-C levels [R=0,450 p=0.009]. However, a statistically significant difference was detected between extraglandular involvement and LDL-C [p=0.01] and total cholesterol levels [p=0.01]. Patients who had no extraglandular involvement had higher levels of total cholesterol and LDL-C levels. Lower triglyceride levels were seen in patients with anti-La antibodies [p=0.01] but not other antibodies [p>0.05]. Patients with ANA positivity and pSS had lower LDL-C levels [p=0.009]. Autoimmune mechanisms may play a role in insulin resistance in pSS. Metabolic alterations should be taken into account in their management