Relevance of lipogenesis and AMPK/Akt/mTOR signaling pathway in endometrial cancer.

OBJECTIVE: New evidence is presented for differences in lipid metabolism between healthy and cancer cells, which has increased considerably in recent years. Alterations in lipid metabolism affect important processes such as cell growth, proliferation, and differentiation. Therefore, the purpose of this study is to determine the gene expression levels of the enzymes which have a function in lipid metabolisms such as fatty acid synthase (FASN), sterol regulatory element-binding protein (SREBP), phosphatidylinositol 3-kinase (PI3K), mammalian target of rapamycin (mTOR), protein kinase B (Akt), and AMP-activating protein kinase (AMPK) in patients with endometrial cancer. PATIENTS AND METHODS: This study included 60 patients diagnosed with endometrial adenocarcinoma which subgrouped as Grade 1 (n = 20), Grade 2 (n = 20), Grade 3 (n = 20). For control group endometrial tissues from 30 individuals subgrouped as control 1 (n = 15) secretory phase and control 2 (n = 15) proliferative phase healthy endometrial tissues. Gene expression analysis was performed using Real-time polymerase chain reaction (RT-PCR). RESULTS: PI3K gene expression levels were decreased in patients with Grade 3 endometrial cancer compared to Grade 1 and 2 (p <0.05). The gene expression levels of Akt and mTOR were decreased in the Grade 3 patients compared to control groups. The gene expression levels of SREBP, FASN, and AMPK were decreased in all patients' groups compared to control groups (p <0.05). CONCLUSIONS: The results suggest that while lipogenesis may show different tissue-specific behaviors related to some pathways, it may have a direct relationship with endometrial cancer.

Histopathological efficiency of amifostine in radiation­induced heart disease in rats.

OBJECTIVE: Amifositine is a phosphorylated thiol that holds its radioprotective actions by several indirect mechanisms. The purpose of this study was to evaluate histopathologically whether amifositine administration prior to irradiation would have a long­term protective effect on heart tissue in an experimental rat model. METHODS: Single dose of 18 Gy radiation and sham radiation exposure were used in related groups. A dose of 200 mg/kg of amifostine was injected intraperitoneally 30 min prior to radiation exposure. Analyses were performed 6 months after irradiation. RESULTS: Vascular damage and vasculitis were significantly decreased in amifositine treatment group. At the same time, significant thickening of the medial layer was accompanied by vascular damage in irradiated groups. The number and severity of myocyte necrosis were diminished with amifostine.Nevertheless, it could not prevent epicardial and myocardial fibrosis. Severe myocardial fibrosis was observed prominently in three regions, particularly on the apex, tips of papillary muscles and in sites adjacent to the atrioventricular valves. The anti-inflammatory effect of amifostine was not seen. CONCLUSION: The development of vascular damage and vasculitis were prevented by the use of amifostine. There was a correlation between vascular damage and fibrosis development. According to histopathological results, amifostine could be used as a protective agent against the side effects of radiotherapy (Tab. 4, Fig. 2, Ref. 22).

Morphology and morphometry of the ulnar head of the pronator teres muscle in relation to median nerve compression at the proximal forearm.

INTRODUCTION: The pronator syndrome is a rare compression neuropathy of the median nerve. Ulnar head of the pronator teres muscle may cause compression at proximal forearm. HYPOTHESIS: Detailed morphologic and morphometric studies on the anatomy of the ulnar head of pronator teres is scarce. MATERIAL AND METHODS: We dissected 112 forearms of fresh cadavers. We evaluated the morphology and morphometry of the ulnar head of pronator teres muscle. RESULTS: The average ulnar head width was 16.3±8.2mm. The median nerve passed anterior to the ulnar head at a distance of 50.4±10.7mm from the interepicondylar line. We classified the morphology of the ulnar head into 5 types. In type 1, the ulnar head was fibromuscular in 60 forearms (53.6%). In type 2, it was muscular in 23 forearms (20.5%). In type 3, it was just a fibrotic band in 18 forearms (16.1%). In type 4, it was absent in 9 forearms (8%). In type 5, the ulnar head had two arches in 2 forearms (1.8%). In 80 forearms (71.5%: types 1, 3, and 5), the ulnar head was either fibromuscular or a fibrotic band. DISCUSSION: Although the pronator syndrome is a rare compression syndrome, the ulnar head of pronator teres is reported as the major cause of entrapment in the majority of the cases. The location of the compression of the median nerve in relation to the ulnar head of pronator teres muscle and the morphology of the ulnar head is important for open or minimally-invasive surgical treatment. TYPE OF STUDY: Sectional study. LEVEL OF EVIDENCE: Basic science study.

Neurogenous hyperplasia in the oesophagus.

Leiomyoma and gastrointestinal stromal tumours take first place among mesenchymal tumours of the oesophagus, where tumours of peripheral nerve origin are rarely seen. Schwann and enterochromaffi n cell proliferation occur in neurogenous hyperplasia, an entity observed in the appendix which has not been reported in the oesophagus in the medical literature. Oesophagogastroscopy of a 58-year-old woman showed linear erosions and nodularity at the gastroesophageal junction. The microscopic examination of biopsies taken from this area revealed proliferation of spindle cells with oval-round nuclei forming focal fascicular arrangement in the lamina propria. These cells stained positive for synaptophysin and S100-protein, while immunohistochemistry for smooth muscle actin and CD117 were negative. The case was diagnosed as neurogenous hyperplasia with these findings. Control endoscopic biopsies showed no evidence of neurogenous hyperplasia. Neurogenous hyperplasia can be considered as a distinct entity which might also be observed in the oesophagus as in the appendix.

The effects of systemic isotretinoin and antibiotic therapy on the microbial floras in patients with acne vulgaris.

BACKGROUND: Although there are several studies about the alteration in skin flora, limited number of reports about changes in the microbial contents and their resistance profile of other body sites in patients treated with isotretinoin for acne vulgaris. OBJECTIVES: The aim of this study was to investigate the effects of systemic isotretinoin and antibiotic therapy on the microbial floras of oropharynx, nose and feces in acne patients. METHODS: Treatment groups of isotretinoin and antibiotics consisting of 20 and 15 patients, respectively were included. Microbiological culture samples were taken at baseline and once a month during 4-6 months of treatment period. RESULTS: Difference in microbial flora throughout the treatment period was detected at least among one of all culture samples of 15 (75%) and 5 (33%) patients in isotretinoin and antibiotic groups. There was statistically significant difference between two groups in means of alteration of the microbial flora (P = 0.013). The difference was definitely observed among nasal cultures (65%) in isotretinoin group and fecal cultures (20%) in the other. Staphylococcus aureus colonization was prominent in the microbial floras of nose and oropharynx and 2 of 14 nasal isolates were detected to be methicilline resistant while Escherichia coli with extended spectrum beta lactamase activity was detected in fecal floras of patients in isotretinoin group. CONCLUSIONS: Systemic isotretinoin and antibiotic treatments in acne patients precisely caused variations in the microbial floras of several sites of the body, while isotretinoin was commonly more responsible than antibiotics. Knowing that alterations in the microbial colonization of the flora regions may preceede infectious disease and bacterial resistance, treatment options and follow-up procedures in acne vulgaris should be carefully determined to reduce the risk of destruction of the microbial flora.

Is the pathological examination of routine tonsillectomy and adenoidectomy specimens necessary? A retrospective study of 559 adenoidectomy and 1132 tonsillectomy specimens and a literature review.

OBJECTIVE: There is still no consensus about the necessity of histopathological analysis of routine tonsillectomy and adenoidectomy specimens. In this study, our goal was to determine the incidence of unexpected pathological findings in routine tonsillectomy and adenoidectomy specimens. The results are discussed in the light of current literature. MATERIALS AND METHODS: The patient data were obtained from the archives of the departments of otorhinolaryngology and pathology. Between November 1992 and July 2006, chronic, recurrent infections or obstructive problems led to bilateral tonsillectomies, adenoidectomies, and adenoidectomies plus tonsillectomies being performed in 435, 502, and 770 patients respectively. Five hundred and fifty-nine of 1272 adenoidectomy specimens and 1132 of 2410 tonsillectomy specimens were sent to the department of pathology for histopathological examination. RESULTS: The histopathological results for all the adenoidectomy specimens reported chronic inflammatory processes. Only one of 1132 tonsillectomy specimens involved granulomatous inflammation, while 1131 were chronic inflammatory processes. CONCLUSION: On the basis of the result of our study and review of the published literature, the microscopic analysis of routine tonsillectomy and/or adenoidectomy specimens may not be necessary, especially in young patients with no clinically suspicious factors for malignancy. However, all patients must be carefully examined for evidence of malignancy before surgery.

Bone wax can cause foreign body granuloma in the medulla oblongata.

Bone wax is commonly used in neurosurgical practice as a haemostatic and sealing agent. It is a safe agent, but may lead to adverse effects such as infection, epistaxsis, allergic reaction or foreign body granuloma. There are very few reported cases of the neurological complications of remnant bone wax in the subdural or subarachnoid space. The authors report the case of a foreign body granuloma infiltration through the medulla oblongata due to remnant bone wax in the subarachnoid space after posterior fossa decompressive surgery.

Neoplastic diseases prevalence in a turkish university hospital.

PURPOSE: The purpose of this study was to register the different cancer cases diagnosed in our hospital with an aim to define the most common and treatable cancer types and help define accurate targets for the allocation of the already limited resources of the Ministry of Health. MATERIALS AND METHODS: We surveyed 12 months of the hospital's pathology records to determine the prevalence of various cancer types. RESULTS: Out of 9720 biopsy and cytology samples, 662 were cancer cases. Breast and gastric cancers were higher and colorectal cancers were lower than the series reported from the United States. Of the pulmonary malignancies, lung cancer in general was not particularly higher in proportion to other cases, something interesting for a country with smoking rates exceeding 60% of the adult population. Squamous cell lung cancer was more common compared to the rates reported in the western world statistics. CONCLUSION: Although biases may exist, as certain cancers are more amenable to surgical intervention and physician groups may have special interest toward a particular cancer, distribution of cancer cases in Turkey is probably similar to the western world.