A New Determinant of Poor Outcome After Spontaneous Subarachnoid Hemorrhage: Blood pH and the Disruption of Glossopharyngeal Nerve-Carotid Body Network: First Experimental Study.

OBJECTIVE: The chemoreceptor network, consisting of the glossopharyngeal nerve and carotid body (GPN-CB), is essential for the regulation of blood pH. Its ischemic insults after subarachnoid hemorrhage (SAH), which may contribute to acidosis, have not been investigated. METHODS: Twenty-three hybrid rabbits were used. They were divided into 3 groups: 5 as a control group, 5 as a sham group, and the remaining 13 as the study group. Injections included 1 cm3 serum saline and 1 cm3 autolog arterial blood into the cisterna magna in the sham and study group, respectively. Blood pH values of all animals were recorded. After 2 weeks, animals were euthanized. The number of normal and degenerated neurons of the carotid bodies (CBs) was counted by stereologic methods and analyzed statistically. RESULTS: Two of 13 rabbits died within the second week. The mean blood pH values were measured as 7.35 ± 0.07 in the control group (n = 5), 7.33 ± 0.06 in the sham group (n = 5), 7.29 ± 0.05 in rabbits with slight acidosis (n = 6), and 7.23 ± 0.02 in rabbits with prominent acidosis (n = 7). In the control group, the average normal neuronal density of the CBs was 6432 ± 790/mm3 and the degenerated neuron density was 11 ± 3/mm3, whereas the degenerated neuronal density in CBs was 35 ± 8/mm3 in the sham group and 1034 ± 112/mm3 in the slight acidosis-developed group (n = 6; P < 0.05). Conversely, degenerated neuron density of CBs was 2134 ± 251/mm3 in the prominent acidosis-developed animals (n = 7; P < 0.005). Interestingly, in the rabbits who died, the degenerated neuron density of the CB was 3160 ± 840/mm3. CONCLUSION: An inverse relationship between neurodegeneration in the CB and pH values secondary to the disruption of the GPN-CB network after SAH was found, which may contribute to developing acidosis.

Genetic alterations in gastric precancerous lesions.

To investigate the occurrence of 17p (p53) loss of heterozygosity (LOH) and increased 4N or aneuploidy in gastric precancerous lesions (GPL), and their association with Helicobacter pylori (H pylori) infection. A total of 78 gastric mucosal biopsy specimens, including 10 normal mucosa and 68 gastric precancerous lesions [chronic atrophic gastritis (CAG, n = 20), intestinal metaplasia (IM, n = 12), low grade dysplasia (LGD, n = 15), and high grade dysplasia (HGD, n = 21)] were studied using PCR and flow cytometry. A modified Giemsa staining technique was used to detect H pylori. The study was performed in Erzurum Numune Hospital between 2007 and 2009. 17p (p53) LOH was observed in (1/20) 5% of CAG, in (2/12) 16% of IM, in (3/15) 20% of LGD and in (11/21) 53% of HGD. There was correlation between prevalence of 17p (p53) LOH and histological type of GPL (P = 0.004). Similarly, increased 4N or aneuploidy was detected in (1/20) 5% of CAG, in (1/12) 8% of IM, in (2/15) 13% of LGD and in (9/21) 43% of HGD. The correlation was found between aneuploidy and histological type of GPL (P = 0.009). However, there was no correlation between presence of H pylori infection in histological type of GPL (P = 0.921). On the other hand, a significant association was found between increased 4N or aneuploidy and 17p (p53) LOH in all of GPL (P = 0.0001). However, there was no statistically significant association between H pylori infection and 17p (p53) LOH or increased 4N/aneuplody in GPL. 17p (p53) LOH and increased 4N or aneuploidy are closely related to the early stages of gastric carcinogenesis.

Epidermodysplasia verruciformis: An early and unusual presentation.

Epidermodysplasia verruciformis is a rare, heritable disease characterized by an unusual susceptibility to infection with specific types of human papillomavirus and a propensity for developing malignant skin tumours. Partial defects in cell-mediated immunity have been demonstrated in this disease. In the present report, a young patient with epidermodysplasia verruciformis who was treated successfully with surgical treatment is described.

Immunohistochemical detection of progesterone receptors and the correlation with Ki-67 labeling indices in paraffin-embedded sections of meningiomas.

Female sex steroids may play a role in the proliferation of meningiomas, which usually have a high level of progesterone receptors (PgRs). We aimed to investigate the presence of PgRs and the Ki-67 labeling index (Ki-67 LI) in meningioma cases (N = 110) in relation to the severity of the disease. We studied PgR immunoreactivities and the Ki-67 LI in paraffin-embedded sections from meningiomas. Immunodetection of PgRs was conducted with peroxidase-antiperoxidase complex. Immunodetection of Ki-67 antigen was achieved by streptavidin-biotinperoxidase complex. Of 110 meningiomas, in 57 (52%) the immunostaining for PgRs was moderately to strongly positive (Group 1), in 23 (20%) weakly positive (Group 2), and in 30 (28%) negative (Group 3). The positive immunostaining rate for the PgR in the benign meningiomas (76%) was significantly higher than that in nonbenign tumors. The positive immunostaining rate for the PgR was significantly higher in women (81%) than men (55%). The results suggested that progesterone may play a role in the growth of meningiomas. Our results confirmed that the immunodetection of the PgR and Ki-67 antigens on the paraffin sections of meningiomas provides a valuable tool for estimating the biological behavior of meningiomas.