Hypoxia causes important changes of extracellular matrix biomarkers and ADAMTS proteinases in the adriamycin-induced renal fibrosis model.

AIM: Renal fibrosis is a common cause of renal dysfunction with chronic kidney diseases. This process is characterized by excessive production of extracellular matrix (ECM) or inhibition of ECM degradation. A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) proteinases, which are widely presented in mammals, have very critical roles in ECM remodelling. We aimed to study the role of ADAMTS proteinases and some of the ECM markers in the pathogenesis of renal fibrosis and to investigate the effects of hypoxia on these biomarkers. METHODS: In addition to the control group, Adriamycin (ADR) treated rats were divided into four groups as ADR, sham and two hypoxia groups. Renal nephropathy was assessed biochemical assays, pathological and immunohistochemical staining methods. The expression of ADAMTSs and mRNA were determined using Western blotting and real-time PCR, respectively. RESULTS: Renal dysfuntion and tissue damage in favour of ECM accumulation and renal fibrosis were observed in the ADR group. This was approved by remarkable changes in the expression of ADAMTS such as increased ADAMTS-1, -12 and -15. In addition, it was found that hypoxia and duration of hypoxia enhanced markers of tubulointerstitial fibrosis in the rat kidney tissues. Also, expression differences especially in ADAMTS-1, -6 and -15 were observed in the hypoxia groups. The variable and different expression patterns of ADAMTS proteinases in the ADR-induced renal fibrosis suggest that ADAMTS family members are involved in the development and progression of fibrosis. CONCLUSION: The expression changes of ADAMTS proteinases in kidney and association with hypoxia have potential clues to contribute to the early diagnosis and treatment options of renal fibrosis.

Cutaneous metastasis in prostate cancer: Two cases with similar clinical findings.

Cutaneous metastasis of prostate cancer is rare. Lesions in this type of skin metastasis are usually seen as suprapubic nodules. Here, we presented two cases with skin metastases of prostate cancer characterized by grouped cutaneous and subcutaneous nodules.

Isolated Schwannoma of the Upper Eyelid Margin in a 50-year-old Male.

Schwannomas (neurilemmomas) are benign neurogenic tumours of peripheral nerves. They originate from Schwann cells, which form the neural sheath. Although Schwannomas and neurofibromas are the most common primary peripheral nerve tumours, Schwannomas are rarely observed in ophthalmic areas. When they occur, ocular Schwannomas are usually located in the orbit, uveal tract and conjunctiva. Isolated eyelid Schwannomas are reported infrequently. Herein, we describe a case of eyelid Schwannoma in a 50-year-old man. The diagnosis of Schwannoma was made after the eyelid mass was removed by excisional biopsy, so this entity should be included in the differential diagnosis of eyelid margin tumours.

Isolated intrapulmonary Castleman's disease: a case report, review of the literature.

Castleman's disease (CD), also known as angiofollicular lymph node hyperplasia, is an uncommon, lymphoproliferative disorder of unknown etiology, mostly involving the mediastinum. Parenchymal lung involvement of the disease is extremely rare. Intrapulmonary CD has been reported in seven cases in the English literature. We describe an asymptomatic 28-year-old woman with lesion in the chest X-ray. Computed tomography (CT) of the chest confirmed a 5.5 × 5 cm well-defined, lobulated mass in the hilum of the right upper lobe. She underwent surgical resection for diagnosis and treatment. Pathologic examination showed hyaline vascular type (Castleman's disease) lymph node hyperplasia. CD rarely arises from the intrapulmonary lymph nodes. In these patients, preoperative diagnosis is difficult and invasive attempts may be required.

N-Acetyl cysteine and erdosteine treatment in acetaminophen-induced liver damage.

OBJECTIVE: This study is aimed to investigate the efficacy of erdosteine usage in acetaminophen-induced liver damage and to compare it with N-acetyl cysteine (NAC) in the treatment and prevention of liver toxicity due to overdose of acetaminophen. METHODS: The rats were separated into the following six groups of seven rats each: control group; acetaminophen (1 g/kg, orally); acetaminophen (1 g/kg, orally) + erdosteine (150 mg/kg/day, orally); acetaminophen (1 g/kg, orally) + NAC (140 mg/kg loading dose, followed by 70 mg/kg, orally); NAC (140 mg/kg loading dose, followed by 70 mg/kg, orally); erdosteine (150 mg/kg/kg, orally), subsequently. In all the groups, potential liver injuries were evaluated using biochemical and hematological analyses, oxidant-antioxidant parameters and histopathological parameters. RESULTS: In acetaminophen-treated group, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total oxidant status (TOS) in the blood, prothrombin time (PT) and international normalized ratio (INR) were significantly increased when compared with controls. However, total antioxidant capacity (TAC) and glutathione (GSH) levels were decreased in group treated with acetaminophen, when compared with control group. Levels of AST, ALT and TOS, PT and INR were decreased in groups treated with NAC and erdosteine after acetaminophen administration, but the levels of TAC and GSH were increased. Histopathological improvements were observed in the groups treated with NAC and erdosteine after acetaminophen administration. CONCLUSION: The present study demonstrated that, in the prevention of liver damage induced by acetaminophen intoxication, an early treatment with a single dose of erdosteine was beneficial instead of NAC administration.

Dermoid cyst of the pancreas: a report of an unusual case and a review of the literature.

Pancreatic dermoid cysts are a rare entity. Preoperative diagnosis is difficult. The diagnosis is generally taking intraoperative. A 20-year-old female presented with epigastric pain without nausea, vomiting, diarrhea, fever, jaundice, and weight loss of one-month duration. Ultrasonography and computed tomography showed a smooth borders, solid, hyperechoic tumor within midline abdomen, without any connection to the stomach or spleen. At surgery, the entire mass was excised off of the head and inferior part of pancreas. Histopathologic evaluation revealed the rare diagnosis of a dermoid cyst. The diagnosis is difficult preoperatively in evaluating cystic pancreatic lesions by imaging. Therefore, we want to summarize the literature on this rare entity knowledge.

Effect of melatonin on kidney cold ischemic preservation injury.

Melatonin is a potent free radical scavenger of reactive oxygen species, nitric oxide synthase inhibitor and a well-known antioxidant secreted from pineal gland. This hormone has been reported to protect tissue from oxidative damage. In this study, we aim to investigate the effect of melatonin on kidney cold ischemia time when added to preservation solution. Thirty male Wistar albino rats were divided equally into three groups; Ringer Lactate (RL) solution, University of Wisconsin (UW) solution with and without melatonin. The serum Lactate Dehydrogenase (LDH) activities of the preservation solutions at 2(nd), 24(th), 36(th), and 48(th) hours were determined. Tissue malondialdehyde (MDA) levels were also measured and a histological examination was performed at 48(th) hour. Melatonin that added to preservation solution prevented enzyme elevation and decreased lipid peroxidation in preservation solution when compared to the control group (p<0.05). The histological examination revealed that UW solution containing melatonin significantly prevented the kidney from pathological injury (p<0.05). Melatonin added to preservation solutions such as UW solution seemed to protect the tissue preserved effectively from cold ischemic injury for up to 48 hour.

The hemostatic effect of calcium alginate in experimental splenic injury model.

BACKGROUND: We evaluated the effect of calcium alginate as a hemostatic agent in a splenic injury model. METHODS: Experimental rats (Wistar albino) were divided into four groups. Group I: Laparotomy was not performed. Group II: After laparotomy, the abdomen was closed without any splenic injury. Group III: After laparotomy, splenic injury about 0.5 cm in depth and 0.3 cm in length was created by standard Rochester pean forceps. Physiological serum treated gauze dressing, about 2x2 cm in size, was applied to the injured splenic tissue for 3 minutes. Group IV: After laparotomy, standard splenic injury about 0.5 cm in length and 0.3 cm in depth was created. Calcium alginate wound dressing, 1x1 cm in size, was applied to the splenic wound. In all groups, blood samples for bleeding time and hemogram were taken. Peroperative blood loss, pre- and post-operative hemoglobin and hematocrit values were calculated. RESULTS: Comparing hematocrit values and peroperative bleeding in Groups III and IV, Group IV had a lower decline in hematocrit values and lower peroperative bleeding. CONCLUSION: Calcium alginate has hemostatic capacity. It may be used in splenic injuries, especially for Grades I and II.

Expression of AEG-1 and p53 and their clinicopathological significance in malignant lesions of renal cell carcinomas: a microarray study.

The aim of this study was to investigate the relationship of AEG-1 and p53 with the prognostic parameters of renal cell carcinoma (RCC). In this study, 50 paraffin blocks were histopathologically diagnosed at the Department of Pathology of the Medical Hospital of Duzce University, between 2005 and 2011. The cases consisted of 24 clear cell (CC) and 26 non-clear cell (NCC) RCC subtypes as follows: 24 (48%) clear cell RCC, 12 (24%) papillary RCC, 4 (8%) multilocular cystic RCC and 10 (20%) chromophobe RCC; none had sarcomatoid changes. By immunohistochemical analysis we investigated AEG-1 and p53 expression in carcinomas of the kidney, and by statistical analysis determined their relationship with clinicopathological parameters. Significant relationships were found between increasing tumor diameter and the increase of p53 (p = 0.028). In addition, p53 was significantly related to renal sinus invasion (p = 0.05) and Fuhrman grade (p = 0.026). There was a significant relationship between increased AEG-1 staining scores and CC and NCC carcinoma subtypes (p = 0.032), tumor capsule invasion (p = 0.01) and lymphovascular invasion (p = 0.015). There was also a significant correlation between tumor size and capsule and lymphovascular invasion (p = 0.02). We concluded that high AEG-1 and p53 expression correlates with the prognostic parameters in RCC patients, and in addition may be associated with tumor progression.

Neuroprotective effects of olanzapine in N-methyl-D-aspartate-induced retinal injury.

PURPOSE: The aim of this study was to investigate the neuroprotective effect of olanzapine (OLA), an atypical antipsychotic drug, on N-methyl-d-aspartate (NMDA)-induced retinal injury. METHODS: Retinal neuronal ischemia was induced by NMDA in Wistar rats. OLA was administered intraperitoneally in 2 different dosages: 2 and 12 mg/kg. At the end of 2 weeks of OLA treatment, 1 eye of each animal was enucleated for histopathologic examination. We also measured malondialdehyde (MDA) levels in retinal homogenates as a marker of ischemic injury. RESULTS: The retinal ganglion cell (RGC) count was significantly higher in cases where we used OLA 2 mg/kg or OLA 12 mg/kg compared to the control group (P=0.0032 and P=0.0005, respectively). We also found that MDA was significantly reduced by OLA 2 mg/kg or OLA 12 mg/kg compared to the control group (P=0.0001 and P=0.0001, respectively). There was no statistically significant difference between OLA 2 mg/kg or OLA 12 mg/kg groups in terms of RGC count and MDA levels (P>0.05 for all). CONCLUSION: Our data showed that OLA preserved RGCs from NMDA-induced retinal injury; thus, it may have potential neuroprotective effects.

Leiomyoma of the urinary bladder in asymptomatic women.

Most bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare. Leiomyomas account for less than 0.43% of all bladder tumors. Genitourinary leiomyomata may arise in any anatomic structure containing smooth muscle. They have been reported to involve single or multiple organs. Since they may also mimic malignant lesions, they should always be considered in the differential diagnosis of any pelvic mass, with a possibility of being asymptomatic and discovered incidentally by radiographic imaging. We, herein, report a case illustrating clinical and pathological features in particular immunohistochemistry, and discuss its etiology and differential diagnosis.

Intussusception of the appendix induced by sessile serrated adenoma: a case report.

Intussusception of the appendix vermiformis is a rare condition. It occurs mainly in infants and children. Here, we report an intussusception case that occurred in a 65-year-old male presenting with repeated periumbilical pain, nausea, vomiting and febrile sensation. The appendix was seen to be intussuscepted at laparoscopy. The invaginated segment was reducted and simple appendicectomy was carried out. Histopathologic examination revealed a sessile serrated adenoma at the wall of the appendix, suggesting it as the cause of the intussusception.

Can influenza H1N1 vaccination lead to the membranous glomerulonephritis?

In 2009 winter, Influenza A (H1N1) monovalent split virus vaccine was used prevalently in the whole world as a result of the pandemic caused by Influenza (H1N1) virus. The vaccine's adverse effects were observed closely and vaccination has been found as safe in most studies. But some reports about immune response related diseases after influenza vaccinations are remarkable. The close relationship between membranous glomerulonephritis and antigens is known, particularly in seconder forms which occur after viral infections and vaccinations. So this case report is about a 56-year-old man, who developed membranous glomerulonephritis 23 days after the vaccination against Influenza A (H1N1) virus.

Myxoma of the renal sinus: case report and literature review.

Myxoma is a rare mesenchymal tumor and it is mainly seen in heart and skin. Renal myxoma is extremely rare. To date, eleven cases of kidney myxomas have been reported in the literature. One of them is myxoma of the renal sinus. Our case was an 82-year-old man admitted to our hospital symptoms related to the urinary tract obstruction. Abdominal computerized tomography revealed a solid, hypodense mass 9 cm in diameter infiltrating the renal parenchyma in the renal pelvis. The patient underwent nephrectomy. The resected kidney contained gelatinous tumor with indistinct borders. The tumor was composed of slender, bland, spindle-shaped cells with large amounts of mucoid material. Tumor cells were positively stained with vimentin, focally stained positive for smooth muscle actin and had negative reactivity for S-100 protein, epithelial membrane antigen and pancytokeratin. Herein we report the second case of renal myxoma arising from the renal sinus.

Posttraumatic giant proliferating trichilemmal cysts on the parietal region of the scalp.

Proliferating trichilemmal (pilar) cysts, also known as pilar tumors, are most commonly found on the scalp of elderly women. Proliferating trichilemmal cysts are rare, slowly growing, lobular masses inherited autosomal dominantly and localized on scalps, and believed to arise due to a complication of a trauma and inflammation, and 5-10% of people are reported to be effected. Herein, we present the case of a 70-year-old woman with a 23-year history of multiple enlarging scalp masses. Clinically, squamous cell carcinoma was considered in the differential diagnosis, and the lesion was totally excised. Our case emphasizes the necessity for detailed clinical and pathological correlation for differential diagnosis.