The role of the adhesion molecule Nectin-4 in the pathogenesis of endometriosis.

OBJECTIVE: Nectins are immunoglobulin-like adhesion molecules, and they play important role in cell proliferation and tumor metastasis. The objective in this study was to compare the expression of Nectin-4 in normal endometrium and in ectopic endometriotic tissues. MATERIALS AND METHODS: Nectin-4 expression was investigated in ovarian endometriosis (n = 20), peritoneal endometriosis (n = 20), endometrium of endometriosis (n = 20), and in a control group (having no endometriosis) (n = 20) by immunohistochemical method. RESULTS: Nectin-4 expression, when compared with control group, was higher in endometriotic lesions of patients having ovarian endometriosis and peritoneal endometriosis (p = 0.003 and p = 0.009, respectively). This difference was significant in the endometrium of patients having endometriosis (p = 0.011). CONCLUSION: The authors believe that Nectin-4 molecule may contribute to the pathogenesis of endometriosis. For this reason, the use of medicines developed against this molecule in the treatment of endometriosis may be useful.

Influence of intracoronary shunt on myocardial ischemic injury during off-pump coronary artery bypass surgery.

AIM: The aim of the study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery in patients with isolated left anterior descending coronary artery lesion. METHODS: Forty patients undergoing off-pump coronary artery bypass using the left internal mammary artery to bypass the left anterior descending coronary artery were randomly assigned to have the bypass performed with intracoronary shunt or by occlusive snaring. Potential damage from the shunt or from snaring was monitored by clinical follow-up, monitoring of cardiac enzymes (cardiac troponin I, CK, CK-MB), electrocardiography, and echocardiography before and 24 h. after the surgery. Left ventricular myocardial biopsies were performed during surgery for histopathological analysis. RESULTS: None of the patients in this study died during or after the surgery. Duration of the anastomosis was significantly longer in the shunt group. No significant difference concerning the preoperative and postoperative CK levels between groups. The preoperative CK-MB levels of the groups were not significantly different, whereas postoperative levels was significantly lower in the shunt group. The preoperative troponin I levels of the groups were not significantly different, whereas postoperative levels was significantly higher in the snare group. Myocardial edema was significantly less in shunt group compared with snare group. There were no electrocardiographic abnormalities, severe CK-MB elevation, or hemodynamic deterioration after the operation in both groups. CONCLUSION: Intracoronary shunt may have beneficial effects due to the reduction of postoperative troponin I levels and myocardial edema during grafting of the left anterior descending coronary artery. However, further trials need to be performed for the documentation of their impacts precisely.

Metastasis from breast carcinoma to endometrial polyp.

Metastasis of a breast carcinoma to an endometrial polyp is extremely rare, with only ten cases having been reported in the literature up to now. We present the case of a 60-year-old woman with invasive ductal carcinoma who complained of vaginal bleeding. She underwent hysteroscopy with biopsy. Microscopic examination revealed an endometrial polyp which contained foci of adenocarcinoma. The morphologic features of the tumor were identical to the original breast carcinoma.

Correlation of endothelial nitric oxide synthase and vascular endothelial growth factor expression with malignancy in patients with astrocytic tumors.

PURPOSE: Many characteristics of malignant brain tumors (increased vascular permeability, vasodilatation, neovascularisation and free radical injury to the tumor and adjacent normal tissues) are believed to be mediated by nitric oxide (NO) synthetized by endothelial NO synthase (eNOS). Overexpression of vascular endothelial growth factor (VEGF) is associated with several central nervous system (CNS) diseases and tumors. Our aim was to study immunohistochemically the coexpression of eNOS and VEGF in astrocytic tumors and to analyse their possible correlation with tumor grade, angiogenesis and proliferation index. MATERIALS AND METHODS: Sections from 120 randomly selected patients with supratentorial astrocytic tumors [38 glioblastomas (GB), 22 anaplastic astrocytomas (AA) and 20 low-grade astrocytomas (LA)], also including oligodendrogliomas (n=20) and mixed oligoastrocytomas (n=20), were immunostained with monoclonal antibodies for eNOS and VEGF using the avidin-biotin method. The proliferative potential was assessed as the MIB-1 staining index for tumor cells. RESULTS: There was positive correlation between eNOS and VEGF expressions and histological grade (p<0.05) in terms of intensity and extent of immunoreactivity distribution. Oligodendrogliomas showed significantly less VEGF and eNOS immunoreactivity compared to pure astrocytomas (p<0.05). CONCLUSION: Overexpressions of eNOS and VEGF in astrocytic tumors were significantly correlated with histological grade, proliferative potential and malignant transformation. The expression of VEGF in a necrotic and ischemic tumor such as GB is more intense and diffuse than low-grade astrocytomas. These findings suggest that eNOS overexpression in tumor vasculature would be precipitated by transformation into an angiogenic phenotype in the process of neovascularisation in astrocytic tumors.