High risk HPV in situ hybridization, p16 INK 4A, and survivin expressions in cervical carcinomas and intraepithelial neoplasms: evaluation of prognostic factors.

BACKGROUND: Cervical carcinoma (CC) is one of the most important health problems of adult women in developing countries. CC is the second most common carcinoma of the women worldwide. Efficient screening and early therapeutic programmes are vital because of the higher burden of the disease. MATERIALS AND METHODS: The authors included a total of 53 cases in this study. Distribution of diagnoses among cases was as follows: cervical intraepithelial neoplasm (CIN) (n=44), squamous cell carcinoma (SCC) (n=7), adenocarcinoma in situ (n=1), and condyloma accuminatum (n=l). Presence, density, and nuclear identification form of human papilloma virus (HPV) DNA in relation with host cell DNA were evaluated by in situ hybridization (ISH) and p16 and survivin by immunohistochem- ical methods (IHC). RESULTS: The authors determined that the presence, density, and nuclear identification form of high risk HPV DNA had diagnostic and prognostic importance in CC and CIN (p < 0.05). p16 and survivin also had diagnostic significance. Since p16 and survivin expressions signalled progressive oncogenic events, p16 and survivin were persistent HPV markers (for p16, p < 0.001, for survivin p < 0.01). The authors determined that expressions, density, and prevalence of all three markers showed correlation with increasing CIN grade (for p 16, p < 0.001, for survivin, p < 0.01, for HPV, p = 0.002). The episomal pattern which is the independent visit of Hr HPV DNA to host cell DNA, signalled early HPV infection (p = 0.001). When it is integrated into host cell DNA, especially if HPV DNA signal intensity and prevalence increases, then this signal signifies persistent HPV infection (p = 0.001). CONCLUSION: With the aid of these findings, the authors determined that HPV is infectious in CIN I and proliferative (neoplastic) in CIN II-CIN III lesions.

Cervical cancer coexisting with small lymphocytic lymphoma detected during positron emission tomography/computed tomography simulation: a case report.

BACKGROUND: Positron emission tomography (PET)/computed tomography (CT) simulation in cervical cancer may help radiation oncologists to better define the target volumes. It may also detect extrapelvic lesions and incidental second malignancies, leading to significant changes in treatment management. CASE: A 63-year-old woman who was deemed inoperable due to carcinoma of the cervical stump extending to the parametria and paraaortic lymph nodes detected on MR images presented for extended field radiotherapy. PET/CT simulation revealed an FDG avid mass in the cervical stump, and an enlarged axillary lymphadenopathy showing moderate FDG uptake. The excisional biopsy was consistent with small lymphocytic lymphoma (SLL). CONCLUSION: In our case, PET/CT simulation not only led to changes in treatment management, but also revealed a very rare coexistence of SLL and invasive squamous cell carcinoma of the cervix.

Time-level relationship for nitric oxide and the protective effects of aminoguanidine in experimental spinal cord injury.

BACKGROUND: The secondary injury process following spinal cord trauma has been shown to involve different mechanisms such as excessive release of excitatory amino-acids, and induction of free radical induced lipid peroxidation. In this experimental study, the time-level relationship of the nitric oxide and the neuroprotective effects of aminoguanidine were investigated in a rat spinal cord trauma model. METHODS: The experiments were performed on 63 Wistar albino rats divided into three groups; sham-operated control (Group 1), trauma created control (Group 2) and aminoguanidine group (Group 3). In groups 2 and 3, spinal cord trauma was produced at thoracic level by using weight the drop technique (at a severity of 50 gr-cm). After the trauma, the rats in Group 3, received an intraperitoneal injection of 100 mg/kg aminoquanidine twice a day for 3 days. The effects of the injury and the efficacy of aminoguanidine were determined based on biochemical parameters (lipid peroxidation and nitric oxide levels in tissue), and on light microscopy findings in cord tissue collected at different times post-injury. Biochemical parameters were performed one hour, three and five days after injury. Functional recovery was assessed at 3, and 5 days after cord trauma with the inclined-plane technique and Tarlov's motor grading scale. FINDINGS: Although there was no statistically significant difference at the 1(st) hour, the values of the tissue nitric oxide in trauma created controls were 42% higher on the 3(rd) day and 40% higher on the 5(th) day when compared with those in sham controls. The levels of the tissue lipid peroxidation in trauma created controls were 88% higher at the 1(st) hour and 52.8% higher on the 5(th) day when compared with shame controls, but there was no meaningful difference on the 3(rd) day. In the trauma created control group, the mean motor function scores decreased to 1.16 +/- 0.40 and to 1 +/- 0 on the 3(rd) and 5(th) day, respectively. In this group the mean values of the inclined plane were 39.16 +/- 2.04 on the 3(rd) day and 37.91 +/- 1.02 on the 5(th) day. No statistically significant difference was observed in both tissue lipid peroxidation and nitric oxide levels for all time points between the aminoguanidine group and the sham-operated controls (p>0.01). The motor function scores were observed as 2.16 +/- 0.40 on the 3(rd) day and as 3 +/- 0 on the 5(th) day in aminoguanidine group. These values were significantly higher than the trauma created controls (p<0.01). Aminoguanidin treatment also improved the inclined plane performance of the rats; In this group, the mean values of the inclined plane scores were 44.58 +/- 2.92 and 52.91 +/- 1.88 on the 3(rd) and 5(th) days, respectively. These values were significantly higher than the trauma created controls (p<0.01). INTERPRETATION: This study shows that the nitric oxide level does not increase in the spinal cord tissue during the first hour after the spinal cord trauma. It increases significantly in the spinal cord tissue not only three days but also five days following the trauma. Aminoguanidine treatment, which is started just after the trauma, can prevent both the nitric oxide production and lipid peroxidation in spinal cord tissue and it can improve the functional status of the animals. In this respect, aminoguanidine may have a potential role in the treatment of acute spinal cord injury.

Laparoscopic management of a giant adrenal cyst: case report.

A 22-cm left adrenal cyst in a 30-year-old woman was laparoscopically drained and then excised. The main symptom was dull left-upper-quadrant pain. Operative time was 95 minutes, and the hospital stay was 1 day. The patient returned to normal activity 7 days after surgery. Histology revealed a benign adrenal cyst. At the 3-month follow-up, ultrasonography showed the absence of any cystic recurrence, and adrenal endocrine function was normal. The advantages and disadvantages of this modality for the management of adrenal gland cysts are discussed.