Evaluation of concordance between loop electrosurgical excisional procedure and cervical colposcopic biopsy results

Objective: To evaluate the results of loop electrosurgical excisional procedures (LEEP) with colposcopic biopsy results of patients who presented to our hospital for vaginal smears. Material and Methods: The LEEP reports of patients who presented to our gynecology clinic between January 2015 and December 2020 were retrospectively evaluated. The data were obtained from electronic patient records and the department of medical pathology archives. Results: A total of 579 patients were evaluated with a mean age of 38.05±6.17 years. Colposcopy-guided biopsy was not taken from 102 patients. The results of the remaining 477 (82.4%) patients were: no dysplasia (n=12; 2.1%), Cervical intraepithelial neoplasia-I (CIN-I) (n=99; 17.1%), CIN-II (n=111; 19.2%), CIN-III (n=248; 42.8%), and cancer (n=7; 1.2%). Completed excision was performed in 87.0% of the patients using LEEP, the lesion was positive at the surgical margins in 10.9%, and the lesion could not be completely excised in 2.1%. The complication rate after LEEP was 3.1% including pelvic pain (n=5; 0.9%) and bleeding (n=13; 2%). The histopathologic results of LEEP were: benign (n=50; 8.6%), CIN-I (n=110; 19.0%), CIN-II (n=89; 15.4%), CIN-III (n=280; 48.4%), cancer (n=7; 1.2%), and metaplasia (n=37; 6.4%). The concordance between colposcopic biopsy and LEEP results was 85.9% for CIN-I, 71.2% for CIN-II, 98.4% for CIN-III, and 85.7% for cancer diagnoses. Conclusion: LEEP is a simple minimally invasive method used in the treatment of CIN, with low persistence, recurrence, and complication rates and increased human papillomavirus clearance in most patients. Our results support the consistency of cervical colposcopic biopsy and LEEP results.

Comparison of the effects of methylprednisolone, hyperbaric oxygen and hesperidin + diosmin on the facial nerve injury: an experimental animal model.

BACKGROUND: Necessity of new and alternative treatments in traumatic facial nerve injury. AIMS/OBJECTIVE: In this experimental study, we aimed to evaluate the histopathologic and functional effects of methylprednisolone, hyperbaric oxygen and hesperidin + diosmin treatments on traumatic facial nerve regeneration in rats. METHODS: After facial nerve injury, five groups were formed with eight rats in each group: Group 1 (negative control), 2 (operation), 3 (corticosteroid), 4 (hyperbaric oxygen), 5 (hesperidin + diosmin). Blink reflex of rats evaluated a day after the operation and at the first, second and third weeks. Facial nerve samples from sacrificed animals were examined under a light microscope. RESULTS: According to our results, in group 4; axonal degeneration and vascular congestion were significantly lower than group 2 and 3, and myelin sheath thickness was significantly higher than group 3. In group 5; axonal degeneration was significantly lower than group 2 and vascular congestion was significantly lower than group 2 and 3. In terms of functional recovery; there was no statistically significant difference between the groups. CONCLUSIONS AND SIGNIFICANCE: It has been shown that both hyperbaric oxygen and hesperidin + diosmin treatments have positive effects on facial nerve regeneration. Both treatments may be good alternatives for ameliorating traumatic nerve injury, but these treatment modalities need to be further explored.

Diagnostic Yield of Transabdominal Ultrasound-Guided Core Needle Method in Biopsies of Pancreatic Lesions.

ABSTRACT: In this study, it was aimed to contribute to the selection of the method to perform pancreatic lesion biopsies.Data of patients, who had undergone a percutaneous biopsy because of pancreatic masses in our institution in the period between January 2015 and November 2019, were evaluated retrospectively. The percutaneous biopsy method, the type of needle used in the procedure, and periprocedural complications were listed. Pathology and cytology reports in the archive were reviewed, and biopsy results were divided into 3 groups as benign, malignant, and inadequate. Of 308 patients included in the study, the diagnostic accuracy was verified in 124 patients through the assessment of surgical outcomes, results of biopsies from metastatic lesions, or follow-up findings. The verified results were classified as true-positives and true-negatives.Of a total of 308 patients included in the study, 23 underwent a fine-needle aspiration biopsy (FNAB) and 285 underwent a core needle biopsy (CNB). No statistical differences were observed in sample acquisition success and complications between the groups.Of the lesions with a confirmed pathological diagnosis, 67.74% were malignant and 32.26% were benign. The diagnosis was correct in 107 of 112 CNB patients (95.54%) and 9 of 12 FNAB patients (75.00%). When the success of the 2 methods was compared, it was found that outcomes of CNB were statistically more successful compared with those of FNAB.A transabdominal ultrasound-guided percutaneous CNB is a safe method with a high diagnostic yield to perform a biopsy of the pancreas.

The role of collagen type I/III ratio in the etiology of sacrococcygeal pilonidal.

OBJECTIVE: The purpose of this study is to investigate whether there was a difference between the midline skin and the healthy skin in the lateral by means of total amount of collagen and Type I/III ratio which was the indicator of the collagen structure. MATERIAL AND METHODS: Fifty patients with pilonidal sinus disease were enrolled. Samples were prepared from the midline skin of the sinus where the holes were located and lateral skin of the resected material. RESULTS: It was determined that the lateral line had significantly more collagen intensity and a higher collagen Type I/III ratio (p < 0.001). CONCLUSIONS: One of the reasons why hair mostly pricks into the midline in the intergluteal sulcus in pilonidal sinus disease is the fact that the amount of total collagen and collagen Type I/III ratio of the midline are lower than those of the lateral tissue. Complications are more common in cases with low Type I/III ratio and low total collagen rates.

OBJETIVO: El propósito de este estudio es investigar si existía diferencia entre la piel de la línea media y la piel sana en el lateral por medio de la cantidad total de colágeno y la relación Tipo I/III que era el indicador de la estructura del colágeno. MATERIAL Y MÉTODOS: Se inscribieron 50 pacientes con enfermedad del seno pilonidal. Se prepararon muestras de la piel de la línea media del seno donde se ubicaron los orificios y de la piel lateral del material resecado. RESULTADOS: Se determinó que la línea lateral tenía significativamente más intensidad de colágeno y una mayor relación de colágeno Tipo I/III (p < 0.001). CONCLUSIONES: Una de las razones por las que el cabello se pincha principalmente en la línea media en el surco interglúteo en la enfermedad del seno pilonidal es el hecho de que la cantidad de colágeno total y la relación de colágeno tipo I/III de la línea media son menores que las del tejido lateral. Las complicaciones son más comunes en los casos con una proporción baja de Tipo I/III y tasas bajas de colágeno total.

Association of Fluorodeoxyglucose Positron Emission Tomography Radiomics Features with Clinicopathological Factors and Prognosis in Lung Squamous Cell Cancer.

Aim: To evaluate the role of fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) radiomics features (RFs) for predicting clinicopathological factors (CPFs) and prognosis in patients with resected lung squamous cell cancer (LSCC). Material and Methods: Patients with early-stage (stage I-III) LSCC who underwent 18F-FDG PET/CT before surgical resection between August 2012 and February 2020 were analyzed. Patients who received neoadjuvant chemotherapy or radiotherapy were excluded from the study. The maximum standard uptake value (SUVmax) and RFs were extracted from PET images for primary tumors. The diagnostic performances of PET parameters in groups of tumor differentiation, stage, and mediastinal lymph node metastasis (MLNM) status were evaluated. The study endpoints were overall survival (OS) and progression-free survival (PFS). Univariate and multivariate analyses were performed with RFs, SUVmax, and CPFs to find independent predictors of PFS and OS. Results: A total of 77 patients (5 female, 72 male) were included in the study. SUVmax and GLCM entropy were independently associated with tumor differentiation. The only parameter with significant diagnostic performance for MLNM was GLZLM-SLZGE. Tumor diameter and NGLDM busyness were independently associated with the stage. MLNM and tumor differentiation were found to be independent predictors of PFS. NGLDM contrast and MLNM were independently associated with OS. Conclusion: Using radiomic features in addition to CPFs to predict disease recurrence and shorter overall survival can guide precision medicine in patients with LSCC.

Correlation of [18F]FDG PET activity with expressions of Ki-67 in non-small-cell lung cancer.

BACKGROUND: Lung carcinoma is the most commonly diagnosed cancer throughout the world and is the leading cause of cancer-related deaths. Non-small cell lung cancer (NSCLC) accounts for up to 80% of newly diagnosed lung cancer cases. This study aimed to investigate the relationship between Ki-67 proliferation index (PI) and the maximum standardized uptake value (SUVmax) obtained from [18F]FDG PET/CT in NSCLCs and whether prognosis was predicted with SUVmax values. MATERIAL AND METHODS: This retrospective study included biopsy and resection materials of 41 patients, who were examined in the pathology laboratory of Konya Training and Research Hospital between January 2010 and December 2019, and diagnosed with NSCLC, and whose [18F]FDG PET/CT images were present. RESULTS: There was no significant difference between histopathological subtypes in terms of age (p = 0.077), Ki-67 PI (p = 0.454), and SUVmax (p = 0.143). No correlation was observed between Ki-67 PI and SUVmax values obtained from [18F]FDG PET/CT (p = 0.338, r = 0.153). There was no significant correlation between Ki-67 PI and tumor diameter (p = 0.531). The SUVmax value was found to be lower (12.78 ± 6.14) in tumors measuring ≤ 2.5 in diameter and higher (18.46 ± 7.81) in tumors measuring > 2.5 cm (p = 0.027). Metastases not proven histopathologically but detected in [18F]FDG PET/CT were found to have no significant correlation with Ki-67 and SUVmax values (p = 0.881, p = 0.837). CONCLUSIONS: This study showed that there was no significant relationship between Ki-67 PI and SUVmax value obtained from [18F]FDG PET/CT in NSCLC tumors.

Relationship between histomorphological findings and platelet activation in psoriasis.

BACKGROUND: Elevated platelet count (PC), mean platelet volume (MPV), and Platelet Mass Index (PMI) are reported in patients with psoriasis, while platelet activation is associated with psoriasis severity. Available studies examining the relationship between platelet activation markers and psoriasis have mostly focused on psoriasis area severity index. To the best of our knowledge, there is no study examining the relationship between histopathological features of a single psoriatic plaque and platelet activation. The present study examined the relationship between histomorphological findings obtained by morphometric analysis and psoriasis patients' PC, MPV, and PMI values. MATERIALS AND METHODS: Morphometric analysis was performed on hematoxylin and eosin-stained preparations of skin biopsies to measure minimum suprapapillary epidermis thickness (SPETmin ) and maximum epidermal thickness (ETmax ), maximum suprapapillary keratosis thickness (SPKTmax ), and maximum keratosis thickness (KTmax ). The relationship between PC, MPV, PMI, and morphometric skin biopsy outcomes was evaluated. RESULTS: While an inverse correlation was found between SPETmin and PC and PMI in cases with psoriasis (p values = 0.015 and 0.005, r values = -0.238 and -0.271, respectively), no significant correlation was found between SPETmin and MPV (p value = 0.600, r value = -. 052). On the contrary, no significant correlation was found between SPKTmax, ETmax, and KTmax values and platelet parameters. CONCLUSION: We assume that an increased risk of platelet activation-related diseases is expected in psoriasis patients displaying histopathological findings of suprapapillary thinning due to increased platelet activation; therefore, it may be beneficial to monitor these patients in terms of such risks.

Evaluation of P57, P53 and Ki67 Expression in Meningiomas.

OBJECTIVE: We conducted this study with the aim of predicting the biological behavior of meningiomas, and determining the benefits of associating histological subtype and grade with the expression of proliferative markers and tumor suppressor proteins. METHODS: The study included 29 patients with primary intracranial and intraspinal meningioma diagnosed in the pathology laboratory of Konya City Hospital between January 2014 and December 2020. Clinicopathological characteristics of the patients including parameters such as age and gender were obtained from the hospital records. Histopathological findings were obtained by re-evaluating the preparations stained with Hematoxylin-Eosin, which were extracted from the archive, and by evaluating new sections obtained from paraffin blocks of patients stained with Ki67, p53, and p57 immunohistochemical stains. RESULTS: A moderate correlation was found between tumor size and Ki67 proliferation index (PI) (p=0.003, r=0.530). There was no significant difference between grade I and grade II tumors in terms of p53 (p=0.184) and p57 (p=0.487) expressions. There were higher levels of Ki67 PI in grade II tumors. The histological subtypes of the tumor had no significant difference with Ki67 PI (p=0.018), p53 (p=0.662), and p57 (p=0.368) expressions. CONCLUSION: In order to obtain more definitive results, there is a need for studies, which are conducted with a greater number of patients and in multiple centers, and in which a long prospective follow-up is planned. The combination of histological, surgical, and imaging markers could make a more sensitive tool for predicting recurrence, and this could also be tested in future studies.

Tumefactive fibroinflammatory lesion: A rare cause of chest pain.

Tumefactive fibroinflammatory lesion (TFIL) is a rare idiopathic disease. These lesions clinically mimic malignant neoplasms, but they are characterized by benign histology while they cause local destruction. Its etiology is unknown, but it is thought to be an exaggerated immune response resulting from chronic infections. They are commonly seen in the head and neck area. Similar clinical and histologic findings are also present in IgG4-related disease. Here, it was aimed to present a 75-year-old male patient with chronic diseases including coronary artery disease and obesity. He was admitted to the thoracic surgery outpatient clinic with symptoms of chest pain, dyspnea, and swelling in the anterior chest wall. Imaging methods revealed a mass, which affected bone structures and showed increased 18-fluorodeoxyglucose (FDG) uptake, in the anterior of the left hemithorax. Surgical excision was performed because he met the clinical criteria of malignancy. No malignancy finding was identified in the histopathologic examination of the samples collected from the mass. In light of immunohistochemical and histopathologic findings, he was diagnosed as having TFIL. Treatment options for these lesions include steroids, surgery, and radiotherapy. They are persistent lesions associated with a high recurrence rate. We wanted to present this case because it is possible to recognize this rarely encountered lesion and increase awareness of the existence of such an entity.

Increased expression of ASRGL1 in invasive ductal carcinoma and its association with estrogen-progesterone receptor status of tumors.

AIMS: Human asparaginase-like protein 1 (ASRGL1) is closely related to tumor growth. ASRGL1 can significantly promote cell proliferation and suppress apoptosis. To date, high levels of expression of ASRGL1 have been reported in various tumors, but the function of ASRGL1 in carcinogenesis is still not well understood. In this study, we aimed to immunohistochemically investigate the expression of ASRGL1 in non-neoplastic breast tissue and invasive ductal carcinoma. METHODS AND RESULTS: ASRGL1 was evaluated immunohistochemically in 148 invasive ductal carcinomas and 105 nonneoplastic breast tissue samples to assess the impact on breast cancer development and its association with clinicopathologic features. ASRGL1 was observed positive in 63 (42.6%) and negative in 85 (57.4%) invasive ductal carcinoma. In nonneoplastic breast tissue, 24 (22.9%) cases were ASRGL1 positive and 81 (77.1%) were negative. A significant difference was observed between invasive ductal carcinoma and nonneoplastic breast tissue in terms of ASRGL1 expression, and ASRGL1 expression was increased in invasive ductal carcinoma (P = .001). Most estrogen receptor-negative tumors and progesterone receptor-negative tumors were also negative with ASRGL1 and the difference was significant (P = .006 and P = .001, respectively). The correlation between the ASRGL1 expression of the tumors and event-free survival or overall survival was not significant (P>.05). CONCLUSIONS: ASRGL1 may play a role in increasing cell proliferation and breast cancer development. ASRGL-1 expression in breast cancer closely correlates with the hormone receptor status of the tumor. In breast cancer, ASRGL-1 expression does not contribute to predicting tumor behavior.

Predictive value of preoperative neutrophil-to-lymphocyte ratio while detecting bowel resection in hernia with intestinal incarceration.

BACKGROUND: The aim of this study was to evaluate the relationship between preoperative hematological inflammatory markers of the patients who underwent a surgery for incarcerated hernia and intestinal resection requirement. METHODS: The data of 102 patients who underwent a surgery for incarcerated hernia were retrospectively evaluated. Whole blood cell counts were preoperatively measured, and operation types and pathology results were recorded. The patients with intestinal resections were compared with those without any resection in terms of leukocyte number, neutrophil rate, red cell distribution width (RDW), platelet distribution width, neutrophil-to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV). RESULTS: Eighty-one patients were operated for incarcerated groin hernia, 17 for incarcerated umbilical hernia, and 4 for incarcerated incisional hernia. Twenty-six patients (25%) had intestinal resections; in 4 of them, intestinal perforation was detected. In patients with intestinal resections,the neutrophil rate, PDW, NLR, and PLR values were significantly higher than those in the patients without any resections. CONCLUSION: High NLR rates, certainly with clinical correlation, can be used as a biomarker to predict intestinal necrosis and the need for intestinal resection in patients who will undergo surgery for incarcerated hernia, particularlyin situations with lacking radiological imaging methods.

Assessment of Endometrial Sampling and Histopathological Results: Analysis of 4,247 Cases.

OBJECTIVE: This study aimed to investigate the relationship between indications and histopathological results in patients undergoing endometrial sampling. MATERIALS AND METHODS: Data of 4,247 patients undergoing endometrial sampling due to non-obstetric gynecological causes between January 2010 and October 2016 were retrospectively evaluated using the archives of the Gynecology and Obstetrics Clinic of Konya Training and Research Hospital. RESULTS: The mean age of patients was 46.8 ± 8.22 years; the most common indication was menometrorrhagia/menorrhagia (70.66%), and the least common indication was cervical polyp (1.34%). The most common histopathological result was proliferative-secretory endometrium (63.62%); simple hyperplasia with atypia (0.56%) was determined to be the least common result. Endometrial cancer was observed more frequently in the post-menopausal bleeding and increased endometrial thickness group (23.11%). Of patients in whom biopsy was performed, 52.18% had undergone hysterectomy, as a result of which proliferative-secretory endometrium was most commonly (59.52%) and simple hyperplasia with atypia least commonly found as the histopathological diagnosis. CONCLUSION: Although sampling should be performed following endometrial evaluation in patients with post-menopausal bleeding or increased endometrial thickness, according to the results of our study, routine endometrial biopsy should not be preferred in the other indications.

Resolution of Cutaneous Sarcoidosis Following Topical Application of Ganoderma lucidum (Reishi Mushroom).

Ganoderma lucidum (reishi mushroom) has been used in traditional Chinese and Japanese medicine as a herbal remedy for over 2000 years. Studies have shown that G. lucidum has anti-allergic, anti-oxidant, anti-tumor, anti-viral, and anti-inflammatory properties. A review of the literature revealed that there were no studies examining the use of G. lucidum for the treatment of skin diseases. Here, we report the case of a 44-year-old male patient who used soap enriched with G. lucidum and goat's milk for 3 days in treating annular cutaneous sarcoidosis. The patient showed almost complete regression of the lesions.

Unilateral nevoid telangiectesia: report of two pediatric cases.

Unilateral nevoid telangiectasia (UNT) is characterized by the dermatomal distribution of telangiectasia, which are distributed unilaterally and frequently found in C3-C4 or the trigeminal dermatomal areas. It may be congenital or acquired and has a 2:1 female: male ratio. Several theories where developed in order to explain its etiopathogenesis. The most widely accepted is the one which establishes its probable association with an increase in estrogen levels. Its incidence is unknown, although it's probably subdiagnosed and more frequent than previously recognized. We present two pediatric cases of UNT followed at our instution during the past year.

Cyst of the canal of nuck in pediatric patients.

BACKGROUND: Cyst of the canal of Nuck is a rare cause of inguinal swelling in female infants and children. AIM: The purpose of this study is to discuss the clinical, radiological, and histopathological findings, differential diagnosis, and surgical treatment of this disease in the light of our experience. MATERIALS AND METHODS: This study was conducted in six children who were operated on with cyst of the canal of Nuck at the pediatric surgery clinic in July 1998-March 2013. All information was collected from patient's files and computer records retrospectively. RESULTS: Patients were between the ages of 1 and 12 years. Size of the cysts has varied between 23 mm and 55.2 mm. In all cases, cyst was on the right side. In physical examination while five cases had palpable, well-circumscribed, mobile and painless mass, in one case the mass was immobile. In one patient, the mass was reducible; in the other 5 patients the mass was non-reducible. First patient was operated immediately with the early diagnosis of incarcerated inguinal hernia, the second one was operated under elective conditions with early diagnosis of inguinal hernia and it was diagnosed during operation, and in the last 4 patients pre-operative true diagnosis was possible. CONCLUSIONS: As clinical findings of the cyst of the canal of Nuck are variable, pre-operative true diagnosis can only be related to increasing experience.

Localized actinic nasal porokeratosis: a case report.

Porokeratisis is a specific keratinization disorder. The presence of cornoid lamella is histologically characteristic of the disorder. This report describes a 23-year-old male patient with multiple porokeratotic lesions with bilateral symmetric localization on the ala of the nose, which may be a rare variant of porokeratosis.

Vascular endothelial growth factor expression and neovascularization in non--small cell lung carcinoma.

The prognostic significance of microvascular density (MVD) and vascular endothelial growth factor (VEGF) expression were investigated in 15 patients with adenocarcinoma (AC) and 15 patients with squamous cell carcinoma (SCC). Immunohistochemically, VEGF and factor VIII were applied. The average microvessel counts were given as MVD, and VEGF expression was given as VEGF percentage area and VEGF staining degree. Higher values of MVD were obtained in patients with AC (11.47 +/- 3.48) when compared with patients with SCC (7.47 +/- 2.50; P = .001) and also in patients at early stages of disease (10.77 +/- 3.24) when compared with patients at advanced stages (8.47 +/- 3.64; P = .050). A significant correlation was shown between MVD and VEGF percentage area (P = .006) and between VEGF percentage area and VEGF staining degree (P = .000). No significant difference was found in VEGF percentage area between patients with SCC and AC and between patients at early and advanced stages. In conclusion, VEGF or MVD should not be regarded as a solitary prognostic factor but should be supported by other prognostic factors.

Cluster analysis of p-glycoprotein, c-erb-B2 and P53 in relation to tumor histology strongly indicates prognosis in patients with operable non-small cell lung cancer.

BACKGROUND: Various biomarkers have prognostic value in non-small cell lung cancer (NSCLC). We aimed to identify the roles of P53, c-erb- B2 and p-glycoprotein (pgp) as prognostic factors, independently or in conjunction with each other, in operable NSCLC. MATERIAL/METHODS: Seventy operable NSCLC cases were retrospectively evaluated for P53, c-erb-B2 and pgp expression patterns by immunohistochemistry. An unsupervised hierarchical cluster analysis of the 3 biomarkers was conducted. Univariate and multivariate survival analyses were made in relation to cluster affiliation. RESULTS: Cluster analysis yielded two distinct subgroups; group A of high biomarker expressors (n=26, 37%), and group B (n=44, 63%) of low expressors. Cluster affiliation with regard to tumor histology (interaction term) was independently associated with Recurrence- free survival (RFS) and Overall survival (OAS) with a Hazard Ratio (HR) of 5.88, P=0.003, and HR=4.68, P=0.012, respectively. The median OAS times for cluster A and B in the squamous cell carcinoma subgroup were 328 and 596 days, whereas the corresponding figures in the non-squamous cell carcinoma subgroup were non-measurable and 298 days. CONCLUSIONS: In operable NSCLC there may be different relationships of P53, c-erb-B2 and pgp with patient outcome for different tumor histologies. The prognostic utility of cluster affiliation with regard to these biomarkers, and in relation to tumor histology, deserves further testing.