The effects of Teucrium polium on ionizing radiation-induced intestinal damage in rats.

BACKGROUND AND STUDY AIMS: Oxidative stress plays an important role in development of intestinal injury after abdomino-pelvic radiation therapy. Teucrium polium (TP) is a medicinal plant which has antioxidant and anti-inflammatory properties. The aim of this study was to investigate the effect of TP on radiation-induced intestinal oxidative damage in rats. MATERIALS AND METHODS: Group 1 (n = 8), the control group; Group 2 (n = 8), the RAD (radiation) group in which each rat received a single whole-body 800 cGy radiation performed with a LINAC ; Group 3 (n = 8), the RAD + TP group in which rats were exposed to radiation as in Group 2, followed by intragastric administration of 0.5 g/kg/daily TP extract for 7 consecutive days; and Group 4 (n = 8), the TP group, rats received only intragastric TP for 7 days. RESULTS: Radiation led to intestinal damage, which was accompanied by an increase in intestinal thiobarbituric-acid-reactive substances (TBARS) and myeloperoxidase (MPO) levels, and a decrease in reduced glutathione (GSH) levels. Although TP significantly decreased intestinal MPO levels and inflammation scores, it neither reverted intestinal TBARS and GSH levels nor ameliorated other histological parameters of the disease. CONCLUSIONS: Our results suggest that TP reduces inflammation but does not ameliorate the increased oxidative stress conditions in radiation-induced intestinal damage in rats.

Longstanding skin ulcers due to Mycobacterium tuberculosis in a healthy man.

Cutaneous tuberculosis, a rare form of extrapulmonary tuberculosis, has a wide variety of clinical presentations and continues to be one of the most important dermatological diseases in developing countries.The sites of predilection are neck, supraclavicular region, axilla, and groin. Single or multiple cutaneous and subcutaneous nodules first appear and breakdown later resulting in undermined ulcers with a purulent discharge, sinuses, and disfiguring scars. We report a multifocal case of scrofuloderma in a 47-year-old immunocompetent man treated successfully with four antituberculotic drugs, albeit lately due to the loss of awareness to the disease.

Combating endometriosis by blocking proteasome and nuclear factor-kappaB pathways.

BACKGROUND: The objective of this study is to investigate the effect of pyrrolidine dithiocarbamate [PDTC; a nuclear factor-kappaB (NF-kappaB) inhibitor] and bortezomib (Velcade; a proteasome inhibitor) on the development of experimental endometriotic implants in rats. METHODS: Endometriosis was surgically induced in 30 rats using the method of Vernon and Wilson. Three weeks later the viability and volume of the implants were recorded and classified. Afterwards, rats were put into three groups with equal numbers. The groups were labelled as the control, the PDTC and the bortezomib groups. Seven days after treatment, a third laparotomy was done and the volume of implants was measured again. The animals were then sacrificed, and the implants were stained with Ki67, proliferating cell nuclear antigen (PCNA), CD34, CD31 and Masson's trichrome histochemical staining. RESULTS: In 80% of the implanted rats, vesicles at the suture region were observed, and the rats graded according to average vesicle diameter (D) as: Grade 1 (no vesicle, 20% of rats), Grade 2 (D < 2 mm, 33.3% of rats), Grade 3 (2 mm 4.5 mm, 26.7% of rats) and Grade 4 (D > 4.5 mm, 20% of rats). After treatment with PDTC or bortezomib, these percentages were decreased for Grades 3 and 4, and increased in Grade 1. The post-treatment implant volumes were decreased in the PDTC and bortezomib groups (P < 0.002 and P < 0.001), and slightly increased in the control group (P = 0.279). In the PDTC and bortezomib groups, CD34, CD31, PCNA and Ki67 expression levels were similar but were significantly reduced compared with the control group. CONCLUSIONS: PDTC and bortezomib may represent a novel therapeutic strategy for treatment of endometriosis.

Atypical reactive ovarian surface epithelium, a pitfall in pathologic assessment.

A 21-year-old parous woman was operated on due to a torsioned huge hemorrhagic benign ovarian mass. A wedge biopsy of the contralateral ovary revealed endophytic superficial cell clusters with atypical features raising suspicion of malignancy. Detailed pathologic and clinical workup proved these foci as reactive ovarian surface epithelium contrary to various initial interpretations as metastatic, deciduoid, or histiocytic by expert pathologists.

Effects of caffeic acid phenethyl ester and epidermal growth factor on the development of caustic esophageal stricture in rats.

BACKGROUND/PURPOSE: An experimental study was performed to modify the healing response in caustic esophageal burns to prevent stricture development. Two different agents with different modes of actions, caffeic acid phenethyl ester (CAPE) and epidermal growth factor (EGF), were studied. CAPE has antiinflammatory, immunomodulatory, antioxidant, and antimitotic properties. EGF has known properties in supporting wound healing and in protecting esophagus from injuries. METHODS: The model described by Gehanno and its modification by Liu was used to create standard esophageal burns with 50% NaOH. The study was performed with 76 rats in 4 main groups (sham, CAPE, EGF, and control) and 2 subgroups in each for 5 and 28 days of observation. Efficacy of treatment was assessed in 28-day subgroups by measuring weight gain, contrast esophagograms on day 27, histologic evaluation by measuring stenosis index (wall thickness/lumen diameter), and collagen deposition, and biochemically by determining tissue hydroxy proline (OHP) content. RESULTS: In the end of the study, increase rates of mean body weights of the animals in the 28-day subgroups were as follows: sham, 30%; CAPE, 23%; EGF, 22%; and control, 14%. Although all the animals in subgroups significantly gained weight, the mean weight gain was significantly low in controls when compared with sham, CAPE, and EGF groups (P <.05). Contrast esophagograms on day 27 showed no stenosis in the sham, mild stenosis in CAPE and EGF, and severe stenosis with proximal dilatation in controls. Stenosis indices of the subgroups were as follows: sham, 0.29; CAPE, 0.41; EGF, 0.41; control, 0.84. Index was significantly higher in controls (P <.05). Collagen accumulation scores in the esophageal wall were as follows: Sham, 0.0; CAPE, 0.87; EGF, 0.30; control, 2.70. Scores also were significantly higher in controls (P <.05). Tissue (OHP) levels were as follows (mg/g dry tissue): Sham, 1.48; CAPE, 1.53; EGF, 1.90; control, 4.01. Production of OHP was significantly higher in controls. CONCLUSIONS: The results of the parameters in the study indicate that administration of CAPE and EGF has beneficial effects in the prevention of caustic esophageal strictures. Those effects of CAPE may occur through its antiinflammatory, immunomodulatory, and antioxidant properties, and EGF may occur through its induced proliferative properties on the esophagus.

Echinococcal hydatid cyst at the right ventricle outlet with leakage to the pulmonary artery outflow causing follicular airway disease and sudden death.

Postmortem examination of a 35-year-old parous woman who died suddenly revealed a hydatid cyst mass located at the right ventricular outlet, with a grossly discernible defect opening to the pulmonary outflow tract. Pulmonary hemorrhage, follicular bronchitis, and bronchiolitis also were present, with severe acute purulent exudation in the airways. Hydatid cyst complications must be kept in mind when dealing with sudden deterioration and death in patients who are residents of regions where echinococcosis is endemic.

Paroxysmal Nocturnal Haemoglobinuria in the Differential Diagnosis of Unresponsive Iron Deficiency Anemia: A Case Report.

A 16-year-old male patient who was on oral iron treatment for iron deficiency anemia for the last one year was seen at the Haematology clinic with complaints of weakness, pallor, and jaundice. A complete blood count revealed Hb of 4.2 mmol/L, Hct of 0.14, and MCV of 76 fl. A blood smear showed 50% neutrophils, 40% lymphocytes, and 10% monocytes with anisocytosis, poikilocytosis, polichromasia in erythrocytes and normoblasts. Reticulocyte count was under 1%. There was a slight erythroid hyperplasia in the bone marrow aspiration. Biochemical examinations showed total bilirubin of 3.9 mg/dL, indirect bilirubin of 3.4 mg/dL, and lactate dehydrogenase (LDH) of 6085 U/L (220-450). In re-evaluating the history of the patient, he was seen to be complaining of dark discoloration of morning urine. Perl's reaction was found to be positive for hemosiderin in the urine sediment. Because Ham's test was positive, the levels of CD55, 58, and 59 proteins on erythrocyte membranes were found to be lower. The patient was started 32 mg of methylprednisolone and his anaemia was improved by the 14th day of treatment. When evaluating iron deficiency anemia resistant to iron supplementation, PNH should be kept in mind.

Adenosquamous carcinoma of the prostate.

We present an unusual variant of prostatic adenocarcinoma with obvious squamous differentiation. The squamous component is represented by cells that contain vesicular or hyperchromatic nuclei and large acidophilic cytoplasm. We could demonstrate immunohistochemically the presence of prostate specific antigen (PSA) and glial fibrillary acidic protein (GFAP) in these tumour cells. Either in adenocarcinomatous or malignant squamous components, the prostatic epithelial cells showed the two markers, namely PSA, GFAP, which may reflect the multidirectional differentiation of these cells from a pluripotent origin.

Cells in various benign and malignant conditions of the human prostate express different antigenic phenotypes.

Prostatic epithelium basically consists of secretory-luminal, basal and endocrine-paracrine cells. Immunohistochemical procedures are frequently used for showing the cells reflecting different differentiations. In this study, 40 prostatic tissue specimens submitted to the Department of Pathology of Inönü University, Research Hospital, between 1991 and 1996 were examined. Half of the cases were diagnosed as cancer and the other half had various benign lesions. Of the cases 22.5% (n = 9) were needle biopsy material whereas the remainder, 47.5% (n = 19), were from prostatectomy and 30% (n = 12) were transurethral resection of the prostate (TURP) specimens. High molecular weight anti-cytokeratin antibodies (HMW anti-cytokeratin) stained basal cells both in all normal prostatic tissue and benign prostatic lesions, but in the majority of cancers (70%, n = 14) negative immunoreactivity was seen. Nevertheless, in some of the cancer cases (30%, n = 6) basal cell anti-cytokeratin staining was shown. Negative immunoreactivity with HMW anti-cytokeratin is important in distinguishing between malignant and benign lesions, whereas positive staining is not every time in favour of benign lesions. With the usage of prostate specific antigen (PSA) it was seen that all of the malignant and benign prostatic lesions stained positively. Basal cells in hyperplastic glands were not stained with this stain. Irregular, and in some areas, intense (PSA) immunoreactivity is present in precancerous and malignant lesions. Endocrine cells, which are represented with Chromogranin-A (Chr-A) immunoreactivity and reflecting neuroendocrine differentiation, are present in 75% (n = 15) of benign lesions and in 50% (n = 10) of cancer cases. It was thought that the lesser number of these cells in neoplastic lesions in comparison to the non-tumoral lesions is correlated with the disorder of mechanism that regulates the cell growth. Both in neoplastic and non-tumoral tissues the prostatic epithelial cells showed the three markers, namely HMW anti-cytokeratin, PSA, and Chr-A, which may reflect the multidirectional differentiation of these cells from a pluripotent origin.

Effect of CO2 laser on spinal epidural fibrosis.

In this study the effect of CO2 laser on spinal epidural fibrosis was examined in 24 guinea pigs which were divided into two groups. The first group was the control group, the second one the CO2 laser group. All animals had laminectomies at 3 levels. Re-exploration was performed three months after the laminectomy. In the second group the same procedure was performed but at the end of the re-exploration, CO2 laser irradiation of the epidural fibrotic tissue was done. The wounds in both groups were closed again. Four months later all animals were sacrificed. For verification and quantification of scar formation (postoperative fibrosis) light microscopic examinations and determination of hydroxyproline were done, using Bergman's spectrophotometric method. The differences which were observed between the two groups were statistically significant (U : 134, P < 0.05). This study demonstrates the reducing effect of CO2 laser irradiation on epidural scar formation. The findings encourage its use as an alternative method of prevention of epidural fibrosis after spinal surgery.

Cervical pregnancy: can age and parity be predisposing factors?

A fifty-year old woman, gravida 17, para 17, presented with profuse vaginal bleeding following curettage in another hospital. At emergency laparotomy total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed because of intractable hemorrhage. Histopathologic examination revealed endocervical placentation and adenomyosis uteri. The case is presented due to its rarity and possible predisposing factors are discussed.

Renal pelvic tumour diagnosed incidentally after traumatic rupture of hydronephrotic kidney.

A 27-year-old man was found to have a low grade transitional cell tumour of the renal pelvis at pathological examination of his traumatically ruptured kidney. The kidney was also hydronephrotic due to urolithiasis of long duration. The medicolegal aspects of the case are evaluated.

A case of cardiac hydatid cyst localized in the lungs bilaterally and on anterior wall of right ventricle.

A 23-year-old man had been coughing with hemoptysis, and had received tuberculostatic medication for four months without any benefit. Upon referral, two-dimensional echocardiography showed a cystic mass located in the anterior right-ventricular wall, without any protrusion into the ventricular cavity. CT examination revealed three cysts in the lung fields bilaterally, additionally a multilocular cystic image in the right-ventricular wall was observed. All components of hydatid cysts in the heart and lungs were removed in the same session by median sternotomy. Extracorporeal bypass was used in this operation.