The Role of Sublobar Resection in T1 N0 Non-Small-Cell Pulmonary Carcinoma.

OBJECTIVES: In this study, we aimed to investigate the effect of resection type on survival in patients with stage IA non-small-cell lung cancer (NSCLC) and other factors affecting the prognosis. MATERIALS AND METHODS: Between January 2005 and December 2016, we retrospectively screened 269 patients who were resected and were having T1N0M0 non-small-cell pulmonary carcinoma. The survival time after surgery was obtained from the National Population Registration System (MERNIS) system. Patients were classified according to the extent of resection. Additionally, age, sex, smoking, concomitant disease, histological type, pathological stage (T1a-T1b-T1c), and the presence of postoperative complications were evaluated to determine whether they are prognostic factors or not. RESULTS: A lobectomy was performed in 257 cases (95.5%), and a sublobar resection was performed in 12 patients (4.5%). The 5-year survival was 62.5% for lobectomies and 73.3% for sublobar resections. Although 5-year survival was better in patients with a limited resection, it was not statistically significant (p=0.301). Histopathological evaluation revealed that 130 patients (48.3%) had adenocarcinoma, 113 (42.0%) had squamous cell carcinoma, and 26 (9.7%) had the other types. The 5-year survival rate was 69.9% in patients with adenocarcinoma and 53.2% in squamous cell carcinoma, and this was statistically significant (p=0.036). The overall 5- and 10-year survival rates in all patients were 65.0% and 47.2%, respectively. CONCLUSION: Although lobectomy is the standard type of resection in the early stage of lung cancer cases in the Thoracic Surgery Department of Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital patients who underwent sublobar resection were found to be having partially better survival, but it was not statistically significant. Owing to the small number of cases, we think that sublobar resections should be prospectively investigated with more extensive series in patients with T1 NSCLC.

Lymphoblastic Involvement of the Bone Marrow as a Cause of Superscan Appearance in 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography.

The 18F-fluorodeoxylucose (FDG) positron emission tomography (PET) is the gold standard imaging modality in the staging of lymphoma. The superscan appearance in the FDG PET/computerized tomography (CT) imaging might be because of benign diseases or malignant infiltrations. This case report presents lymphomatous blastic infiltration as a cause of superscan appearance in 18F-FDG PET/CT.

F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Images of Severe Primary Lung Lymphoma.

Primary lung lymphoma is one of the rarest forms of lymphoma and pulmonary space-occupying lesions. This case report represents the F-18 fluorodeoxyglucose positron emission tomography/computed tomography images of the most severe form of the primary pulmonary lymphoma reported in the literature.

Does cyclin E and p57kip2 expression have prognostic and survival value in colorectal adenocarcinoma?

INTRODUCTION: Colorectal cancer is still one of the main causes of cancer death in the world. There is a continous need for novel biomarkers for diagnose, treatment modalities and follow-up. Cyclin E and p57KIP2 as the positive and negative regulators of cell cycle seem to be an important target for investigations. MATERIALS AND METHODS: In a retrospective setting, primary colorectal adenocarcinoma cases examined in Mustafa Kemal University, School of Medicine, Pathology Department between 2008-2015 were reviewed. Immunohistochemical expressions of cyclin E and p57KIP2 in 80 pairs of colorectal carcinoma and adjacent normal mucosal tissues were evaluated and the findings were compared with clinicopathological parameters and survival time. RESULTS: There were no statistically significant difference between two groups both in cyclin E and p57KIP2 stained tissues (P>0.05). There were 40 (50%) patients in high-expression group and 40 (50%) patients in low-expression group for cyclin E. p57KIP2 was negative in 55 (68.75%) patients and positive in 25 (31.75%) patients. There were no statistically significant relation between p57KIP2 and cyclin E expressions with clinicopathologic parameters defined as age, gender, lymphovascular invasion, perineural invasion, depth of invasion, nodal involvement, emergency in operation, perforation before operation and overall survival except that there was significant relation between p57KIP2 expression and histological grade (P=0.012). CONCLUSIONS: Immunohistochemical studies of cyclin E and p57KIP2 should be performed with larger series of patients supported by more detailed technical research methods to be candidates as predictive markers for treatment modalities and prognostic factors.

Protective Effects of Intralipid and Caffeic Acid Phenethyl Ester on Nephrotoxicity Caused by Dichlorvos in Rats.

The protective effects of Caffeic Acid Phenethyl Ester (CAPE) and intralipid (IL) on nephrotoxicity caused by acute Dichlorvos (D) toxicity were investigated in this study. Forty-eight Wistar Albino rats were divided into 7 groups as follows: Control, D, CAPE, intralipid, D + CAPE, D + IL, and D + CAPE + IL. When compared to D group, the oxidative stress index (OSI) values were significantly lower in Control, CAPE, and D + IL + CAPE groups. When compared to D + IL + CAPE group, the TOS and OSI values were significantly higher in D group (P < 0.05). When mitotic cell counts were assessed in the renal tissues, it was found that mitotic cell count was significantly higher in the D group while it was lower in the D + CAPE, D + IL, and D + IL + CAPE groups when compared to the control group (P < 0.05). Also, immune reactivity showed increased apoptosis in D group and low profile of apoptosis in the D + CAPE group when compared to the Control group. The apoptosis level was significantly lower in D + IL + CAPE compared to D group (P < 0.05) in the kidneys. As a result, we concluded that Dichlorvos can be used either alone or in combination with CAPE and IL as supportive therapy or as facilitator for the therapeutic effect of the routine treatment in the patients presenting with pesticide poisoning.

miR-204-5p expression in colorectal cancer: an autophagy-associated gene.

MicroRNAs (miRNAs) are important factors during tumorigenesis by affecting posttranscriptional gene expression. miRNA 204 (miR-204) is a miRNA frequently investigated in different types of cancers. According to literature, autophagy has dual roles in cancer, acting as both a tumor suppressor and cell survival agent. Also, the current data suggests that autophagy is activated in human colorectal cancer cells and enhances the aggressiveness of human colorectal cancer cells. So, our aim is to investigate potential effect of miR-204-5p on colorectal cancer by associating its expression with autophagy-related targets of miR-204-5p. This is the first miRNA study conducted on patients with colorectal cancer and healthy subjects and also to search the relation of miR-204-5p with clinicopathological factors and survival. Sixty-six patients with colorectal cancer and healthy subjects without any known chronic disease were enrolled into our study. Total miRNA was isolated from paraffin-embedded tissues of all patients' cancerous and normal tissues, and healthy subjects. cDNAs were obtained from this miRNAs by reverse transcriptase method, and miR-204-5p relative expression levels were detected by qRT-PCR method. Patients were divided into two groups according to median relative expression levels of miR-204-5p, as low- and high-expression group. Relation of miR-204-5p with clinicopathological factors and overall survival was also investigated. Medians of miR-204-5p relative expression levels in cancerous and normal tissues of patients were found as 0.00235 and 0.00376, respectively. The difference between two groups was not statistically significant (p = 0.11). Nonetheless, median of miR-204-5p relative expression levels in healthy subjects were found as 0.00135, and the difference between patient with cancer and healthy subjects and between normal tissues of patients and healthy subjects were statistically significant (p = 0.021 and p = 0.0005, respectively). There were 32 patients (48.5 %) showing high expression and 34 patients (51.5 %) showing low expression according to miR-204-5p relative expression levels. There were no statistically significant relation between clinicopathologic features and miR-204-5p relative expression levels. We also investigated the relation between miR-204-5p relative expression levels and overall survival, and no statistically significant relation was found between them (p = 0.462). The absence of any significant difference between tumor and non-tumor samples, low sample size, and performance at just one center are the limitations of our study. In opposition to literature, miR-204-5p is overexpressed in colorectal cancer patients as compared with healthy subjects and this situation is not associated with clinicopathological factors and overall survival. This may be explained by the fact that miR-204-5p increases in colorectal cancer cases in order to inhibit increased activity of LC3B-II in autophagy and Bcl2 against apoptosis posttranscriptionally and to take role as tumor suppressor.

The expressions of AMACR and iNOS in prostate adenocarcinomas.

BACKGROUND AND OBJECTIVE: Prostate cancer is the second leading cause of death in men. The localized disease often responds to conventional therapies like androgen ablation via castration and/or administration of chemical inhibitors but advanced disease resistant to any curative therapies is still challenge for investigators. There are increasing efforts to enhance the possibility of finding positive and sensitive immune markers for diagnosing and treating prostate cancer. The aim of this study was to investigate the expression patterns of AMACR and iNOS in prostate adenocarcinomas with different histopathologic grade. METHODOLOGY: We applied immunohistochemical markers; AMACR and iNOS. Formalin-fixed parafin embedded tissues of 64 prostate needle biopsy specimens diagnosed as prostate adenocarcinoma between 2005-2010 years were included in the study. RESULTS: AMACR expression were found in 58 (90.6%) and iNOS expression in 54 (84.4%) of 64 prostate adenocarcinomas. No significant relationship of AMACR and iNOS was obtained (p>0.05). There was no significant correlation of histopathologic grade of the tumors with AMACR and iNOS expression (p>0.05). CONCLUSIONS: The expression of AMACR and iNOS might be important diagnostic immune markers for prostate adenocarcinomas especially in needle biopsies where the quantity and quality of tissue are limited.

Do histopathologic findings improve by increasing the sample size in cholecystectomies?

BACKGROUND: Gallbladder diseases present with cholelithiasis in a wide spectrum of adenomas and cancers. Two or three specimens are sampled in cholecystectomies in routine pathology practice. The aim of this study was to investigate the increase in frequency of histologic alterations in cholecystectomies, particularly precancerous lesions, by increasing the sample size to understand the carcinoma pathway. METHODS: Cholecystectomies of 432 patients with pathology records and materials from two medical centers were collected, and two groups were created. Initial data with two or three samples were allocated to Group 1 and the new six samples with the initial ones were allocated to Group 2. Hematoxylin and eosin (HandE) sections were examined for histopathologic alterations, and periodic acid-Schiff (PAS) Alcian blue (pH 2.5) and high iron diamine (pH 2.5) stains were used to signify the mucin profile in case of metaplasias. For the comparison of findings, non-parametric tests, McNemar's tests, chi-squared tests and Fisher's exact test were performed. RESULTS: Of the 432 patients, 308 (71.3%) patients were female and 124 (28.7%) patients were male. The mean age of patients was 47.9±14.6 years. Cholesterolosis was observed in 95 (22%) patients in Group 1 and 108 (25%) patients in Group 2. Gallstones were detected in 255 (59%) of the cholecystectomies. There was a significant difference between Group 1 and Group 2 by increasing the sample size when we compared cholesterolosis, metaplasia and polyps (P<0.05). Cholecystitis and dysplasia rates were the same in both of the groups. There was no cancer determined. CONCLUSION: Increasing the sample size in cholecystectomies increased the diagnosis of some histologic alterations, but further studies with a larger number of samples over a longer period time might increase the ability to determine precancerous lesions and concomitants.

The protective effect of ebselen on radiocontrast-induced nephrotoxicity.

AIM: Radiocontrast-induced nephropathy has become one of the most important causes of renal acute failure. The most effective management of reducing the incidence of contrast nephropathy is to understand and prevent its causes. We aimed to investigate the protective role of ebselen against radiocontrast-induced nephrotoxicity in terms of tissue oxidant/antioxidant parameters and light microscopy in rats. METHODS: Albino Wistar rats were randomly separated into four groups. The Group 1 rats were treated with sodium chloride as the control group, Group 2 with radiocontrast, Group 3 with radiocontrast plus ebselen, and Group 4 with ebselen alone. After 24 h, the animals over the experimental period were euthanized and blood samples were analyzed for blood urea nitrogen (BUN) and serum creatinine (Cr) levels. Kidney sections were analyzed for malondialdehyde (MDA) levels and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities, as well as histopathological changes. RESULTS: In the radiocontrast group, BUN, MDA, and GSH-Px levels increased while SOD activity decreased compared with the control group. These decays were improved by ebselen administration in the radiocontrast group. Significant histological deteriorations were observed in the radiocontrast group. We noted improvement in the histologic findings with ebselen administration. CONCLUSION: These results indicate that ebselen might produce a protective mechanism against radiocontrast-induced nephrotoxicity.

Evaluation of fetal autopsy findings in the Hatay region: 274 cases.

OBJECTIVE: The aim of this study was to present the incidence of fetal anomalies in our region of Hatay, Turkey in order to determine the efficiency of prenatal diagnosis through fetal autopsy, and to compare our statistical data with other national and international studies. MATERIAL AND METHOD: This study was conducted on 274 fetuses from terminated pregnancies due to abnormal prenatal findings and intrauterine deaths from 2005 to September 2010. Fetuses were evaluated through postmortem examination, external measurements, X-rays, Magnetic Resonance Images, Multislice Computerized Tomography and photographs. The autopsy was completed by the histological examination of each organ. RESULTS: Autopsy was conducted on 274 fetuses. A fetal anomaly was detected in 160 (58.39%) cases. The central nervous system contained the most frequent structural defects (79 cases, 49.38%), followed by malformations in the musculoskeletal system in 36 cases (22.5%). The most frequent multiple system anomalies were central nervous system defect and bilateral adrenal agenesis, musculoskeletal system malformations and urinary system defects. Fetal autopsy provided additional findings in 43 cases (26.88%). CONCLUSION: Fetal autopsy is a very important procedure and an integral part of the general prenatal management. New findings through this method may suggest invaluable data for parents about potential risks in future pregnancies.

A case of asymptomatic riedel thyroiditis with follicular adenoma in a patient with a multinodular goiter: an unusual association.

BACKGROUND: Riedel's thyroiditis (RT) is a rare inflammatory disease that results in fibrosis of the thyroid gland and invasion to the surrounding structures of the neck. Follicular adenoma (FA) of the thyroid is the most common benign neoplasm of the gland. PATIENT FINDINGS: A 42-year-old woman was referred to the outpatient clinic due to a multinodular goiter and thyroiditis. The patient was euthyroid and thyroid function tests were within normal limits. Thyroid antibodies (thyroid peroxidase antibody and thyroglobulin antibody) were high. Thyroid ultrasonography showed multiple iso-hypoechoic nodules and thyroiditis. Fine-needle aspiration cytology was performed, and it was consistent with 'suspicious for a follicular neoplasm' according to the Bethesda system. Due to the clinical findings, which included weight loss and sweating, and the cytological results indicative of a follicular neoplasm, the patient underwent a total thyroidectomy. The histopathological diagnosis was RT associated with FA. The patient was started on thyroid hormone (thyroxine) replacement therapy after surgery and was evaluated for additional fibrosis related to RT. CONCLUSIONS: To our knowledge, this is the first case of RT associated with FA in an asymptomatic patient with a multinodular goiter and high thyroid antibodies reported in the literature.

Retrospective analysis of basal cell carcinoma.

BACKGROUND: Basal cell carcinomas (BCCs) are the most prevalent cancer type among white-skinned populations worldwide. AIMS: To analyze the gender and age-related incidence of basal cell carcinoma (BCC) histopathologic subtypes, to classify BCCs according to their anatomical location, invasion depth, and size, and to determine the relationship between BCC subtypes and margin of surgical excision. METHODS: All BCCs analysed in our center between 2005 and 2010 were studied retrospectively. The samples, which were totally excised, were included on the basis of histopathological diagnosis of BCC, and confirmed by two pathologists. Patient data included sex, age at diagnosis, tumor location, histological subtypes, invasion depth, and size. RESULTS: We recorded 197 BCCs obtained from 181 white patients (80 females, 101 males). The mean age among males was 64.11, and 59.33 among females. Of the cases, 45.17% were nodular, 22.33% were mixed, and 15.22 were infiltrative type. 91.84% of the cases were located on the head and neck, 3.04% were on the limbs, and 1.52 % were on the trunk. In 32 cases, the margin of surgical excision was positive (17.7%): nodular 12%, infiltrative 43.3%, mixed 20.6%, micronodular 10%, and superfacial multicentric 5.5%. Of these total 32 cases, 34.4% were located on the eyes region, 28.1% were found on the nose, and 15.6% were on the ears. Invasion depth of tumors varied from 0.5 to 22.125 mm. CONCLUSIONS: The results of our study exhibit differences in anatomical distribution, sex and mean age, invasion depth, and size of BCC subtypes. The recurrence rate for incompletely excised tumors varies according to the location and type of the tumor. Infiltrative tumors are more likely to recur and have positive margin of surgical excision. The highest positive margin of surgical excision is in infiltrative BCC. Tumors at difficult-to-treat sites and large and/or deeply invasive tumors are more liable to recur.

[Unusual localization of echinococcosis in Cukurova (134 cases)]. / Cukurova Yöresinde Seyrek Yerlesimli Ekinokokkozis (134 olgu ).

Echinococcosis is a parasitic disease frequently occurring in societies where agriculture and raising animals are common. In Turkey, it is more commonly observed in eastern and middle Anatolia and in Marmara and Trakya regions. While there is a high rate of occurrence in the liver and lungs, Echinococcosis can occasionally be present in other tissues and organs. In this study which was carried out in the Cukurova region, we found 962 echinococcosis cases in a ten year period. Of these, 134 (13.9%) were located outside the liver and the lung. Our aim was to determine the rate of unusual location of echinococcosis cases in our region and draw attention to the issue.

Gastric infection by Strongyloides stercoralis: a case report.

Strongyloides stercoralis is an intestinal nematode with a complex life cycle that involves colonizing and reproducing in the upper small intestinal mucosa. In a healthy host, the parasite usually does not cause any symptoms. We report a gastric infection case of S. stercoralis. A 72-year-old Turkish man was admitted to the Department of General Surgery with complaints of epigastric pain, nausea and vomiting for five days. Upper gastrointestinal endoscopy evidenced a diffuse infiltrate in the stomach, causing decreased distensibility. Microscopically, superficial chronic inflammation with hyperplastic reactive changes and damaged surface was observed. Histopathological examination of the gastric mucosa showed numerous cross-sections of adult worms, eggs and rhabditiform larvae of S. stercoralis developing in the gastric crypts.

Glomus tumor of the hip. An unusual location.

Glomus tumors are usually benign neoplasms that occur in the dermis or subcutaneous tissues of the extremities. They occur very rarely in the hip. We report a patient with severe pain and tenderness in the left hip, especially on palpation, and in the sitting position. On physical examination, there was a soft palpable subcutaneous mass and severe tenderness in the left hip. Ultrasound revealed a hypervascular subdermal mass that was 1.2 cm in diameter, which was subsequently totally excised under local anesthesia. The histopathologic diagnosis was a glomus tumor. The patient has been symptom-free for 3 months of follow-up.

[Problem of cystic echinococcoss in Hatay]. / Hatay Ili'nde Kistik Ekinokokkozis Sorunu.

Echinococcosis is a zoonotic infection caused by Echinococcus granulosus and E. multilocularis. It continues to be a serious public health problem in many countries including Turkey. In Hatay, no previous study has been carried out; therefore, in this study, in order to determine its prevalence and to attract scientific attention to this issue, we have retrospectively evaluated cases of cystic echinococcosis in human patients presenting at the pathology laboratory of the Mustafa Kemal University, Faculty of Medicine, Research Hospital, as well as Antakya and Iskenderun State Hospitals. We have identified a total of 26 cases, of which 18 were in female patients (69.23%) and 8 in male patients (30.76%). The highest rate of cystic echinococcosis was found in the liver (57.6%), and lungs (19.23%). It was also found in the peritoneal region, spleen, cervical region, muscle, and an incision scar. In addition, the presence of cystic echinococcosis was investigated in 35,812 cattle slaughtered in Antakya slaughterhouse and 5,448 (3.23%) were found to have cystic echinococcosis.

Evaluation of effects of memantine on cerebral ischemia in rats.

OBJECTIVE: To evaluate the effects of memantine on infarct size in cerebral ischemia and on neurological outcome after temporary middle cerebral artery occlusion (MCAO) and reperfusion in rats. METHODS: In this study, performed between 2002-2004 in Dicle University School of Medicine, Diyarbakir, Turkey, 30 adult Sprague-Dawley rats were used. Cerebral ischemia was constituted by the intraluminal filament method with a 4-0 nylon suture. Reperfusion was started after 2 hours of MCAO. The rats were randomly divided into 2 groups as control and memantine. Saline 0.9% (0.5 ml/kg) and memantine (30 mg/kg) were administered via nasogastric intubations. Three coronal slices of 2 mm thickness were obtained from cerebrum, cerebellum, and brain stem, and were stained with a 2% solution of triphenyltetrazolium chloride. Transparent sheets were placed over each section and the areas of the brain and infarct were measured. RESULTS: Forty-five slices from each group (total 90) were obtained. Percent of ischemic area (%) in cerebrum, cerebellum, and brain stem level in memantine was lower than those of the control group (p<0.0001). In addition, we determined an improvement in neurological score at 24th and 72nd hours in the rats that have been given memantine. The memantine group showed significantly better recovery than the control group (p<0.0001). CONCLUSION: We concluded that memantine may decrease ischemic area in experimental cerebral ischemia in rats and it seems that memantine may be beneficial in cerebral ischemia.

Microbiologic and histologic assessment of intentional bacterial contamination of bone grafts.

PURPOSE: The purpose of this study was to investigate methods of removing pathogenic micro-organisms from bone grafts that have been contaminated during surgery. MATERIALS AND METHODS: Femora were removed from Sprague-Dawley rats and were divided into sections and contaminated in solutions of the bacteria Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Contaminated bone specimens in each group were immersed in various solutions for specified periods so their antibacterial effects could be evaluated. After these procedures were performed, bone specimens were cultured in nutrient media. Bone structure was evaluated, and the appropriate decontamination method was selected. RESULTS: Solutions such as povidone-iodine, neomycin, cephazolin sodium, and rifamycin were found to be effective decontaminants. These solutions did not damage the bone structure. Among these solutions, only rifamycin was effective against all bacteria used in this study to contaminate bone grafts. CONCLUSIONS: Rifamycin seems to be the most suitable agent for the elimination of contamination introduced into bone grafts during surgery.