Treatment and outcomes of patients with metastatic spinal cord compression: a double-center study

OBJECTIVE

Spinal metastases may only affect the bone tissue and result in spinal instability or may additionally result in epidural compression, leading to neurological deficits. Surgery has emerged as a popular method in treating metastatic epidural spinal cord compression (MESCC) due to the advances in surgical techniques and instrumentation. In this study, we evaluated patients with MESCC regarding neurological status, pain status, and survival rates, and presented our experience managing MESCC.

PATIENTS AND METHODS

Clinical and radiographic records of 53 patients diagnosed with MESCC between January 2011 and March 2017 were retrospectively evaluated. The study included patients with a pathological diagnosis of primary cancer, those who complained of spinal metastasis, and those who had indications of MESCC on Magnetic Resonance Imaging (MRI). Bone structure and spinal stability were evaluated using assessed Computed Tomography (CT), and metastatic spread was considered using assessed Positron Emission Tomography (PET) in suitable cases. For each patient, the presence of a tumor compressing the spinal cord, age, gender, preoperative, and postoperative American Spinal Injury Association scores (ASIA), Tokuhashi prognostic score (TPS), affected spinal segment, pathological diagnosis, preoperative, and postoperative Visual Analog Scale (VAS), the status of spinal stability, follow-up period, and complications were evaluated.

RESULTS

Forty-five patients (82.2% of them were women) underwent surgery with a mean age of 58.29 ± 15.14 years. The most frequent type of primary tumor was multiple myeloma (33.9%), followed by lung (24.6%), gastric (7.5%), and prostate (5.7%). The most common site of metastasis was the thoracic region (43.4%), followed by lumbar (24.5%), multiple (24.5%), and cervical (5.7%). The analysis indicated that a significant difference was found between the survival rates of the TPS categories.

CONCLUSIONS

Common symptoms of MESCC include spinal pain and neurological deficit below the level of the injury. Prompt surgical treatment followed by oncological treatment leads to significant neurological recovery, more prolonged survival, pain relief, and improved quality of life in patients with a short survival time. Oncological treatments, including radiotherapy (RT), should be recommended after surgical treatment.

Inhibition of acrolein-induced apoptosis by the antioxidant selenium

In this study, the effects of a potent antioxidant, selenium, on apoptosis induced by acrolein, a cytotoxic and genotoxic environmental pollutant, were investigated by immunohistochemical and electron microscopic methods. One hundred adult male Wistar albino rats were used in the study. The rats were divided into four main groups: control, acrolein, selenium, and acrolein + selenium. The animals in the experimental groups were given 1 mg/kg/day selenium and 4 mg/kg/day acrolein daily for 7 days by gavage. After drug administration, each group was divided into subgroups according to the time they were to be euthanized: 12th hour, 1st, 2nd, 3rd, and 5th day. The rats in each group at the determined time were euthanized and their livers were removed. Routine histological procedures were performed for light and electron microscopy examinations. After applying the Terminal Deoxynucleotidyl Transferase dUTP nick end labeling assay on the liver sections, apoptotic index values were calculated. Comparing the liver sections of the rats in the acrolein group and the control group, acrolein was found to cause a significant increase in the apoptotic index. The apoptotic index values of the acrolein + selenium group decreased compared to the acrolein group. In the electron microscopic examinations, apoptotic findings were observed in the liver tissues of the rats given acrolein, such as chromatin condensation in the nucleus of hepatocytes, dilatations in the perinuclear space, and cytoplasmic vacuolization. These apoptotic findings were not observed in the acrolein + selenium group after the 12th hour. These findings show that selenium may potentially be useful as a protective agent for people exposed to acrolein.

A histopathological and stereological study of the effects of acetylsalicylic acid on doxorubicin-induced hepatotoxicity in mice

Doxorubicin (Dox) is an anthracycline antibiotic with antineoplastic activity. Acetylsalicylic acid (Asa) is recommended for use as a prophylactic for thromboembolism during treatment of cancers. We investigated liver toxicity due to combined use of Dox and Asa in chemotherapy regimens. We used 140 Swiss albino mice divided into four main groups: control, Dox, Asa, and Dox + Asa. Each group was subdivided into seven subgroups based on time of sacrifice, i.e., 6, 12, 24, 48 h and 7, 14, 21 days. Quantitative and histopathological changes in liver were assessed by light microscopy and stereology. The portal triad area of the Dox and Dox + Asa groups was increased significantly compared to controls at 6 h, whereas in the Asa group, the means were similar to controls. Assessment of histopathology indicated an increased time-dependent degeneration and necrosis of liver tissues in mice in the Dox and Dox + Asa groups. The protective effects of Asa were not evident in Dox + Asa group. When Dox and Asa were administered together, degenerative changes were greater than for in the group that was given Dox alone. We found that Asa and Dox combined therapy increased tissue damage.

DEATH DUE TO CARDIAC ANGIOSARCOMA: AUTOPSY CASE REPORT

Background. Primary tumors of the heart are rarely detected at autopsy, especially angiosarcomas which are primary malignant one. Objective. We presented autopsy case of cardic angiosarcoma with morphologic findings. Methods. We described adult man died in emergency service of the hospital. Results. Reported case was 33 year-old-man who was died in emergency service of hospital where he was taken when he was ill after leaving home. According the prosecution documents, and the expressions of family, it was reported that he had a heart disease; his symptoms repeated 3 day ago before he died, he thought to attend the Cardiology Clinic due to his symptoms. At autopsy on macroscopic internal examination, mass with rough surface in the right atrium, hematoma at the posterior of the right atrium, blood in the pericardia, nodular lesions in hemorrhagic appearance in the sections of lung, liver and spleen were detected. In histopathologic examination; in the heart angiosarcioma as primary malign heart tumor and metastatic masses in the liver, spleen and lung were detected. Conclusions. We aimed to discuss cardiac angiosarcoma case with autopsy and histopathologic findings in the aspect of medico legal literature.

Stereological examination of curcumin's effects on hippocampal damage caused by the anti-epileptic drugs phenobarbital and valproic acid in the developing rat brain

The anti-epileptic drugs phenobarbital and valproic acid have an extremely strong negative effect on cognitive processes such as learning and memory in the developing brain. We examined whether or not curcumin has protective effects on neuronal injury caused by these drugs in the developing rat brain. Young male Wistar rats were studied in two groups, a 7 days old and a 14 days old group (35 rats in each). Both groups were then divided into 7 sub-groups as the control, curcumin, dimethylsulfoxide, phenobarbital, valproic acid, phenobarbital + curcumin, and valproic acid + curcumin groups (n = 5 in each group). At 24 h after the intraperitoneal injection of the compounds, the rats were sacrificed, and the hippocampal tissue was subjected to stereological analysis with the optical fractionation method. Total numbers of neurons in the hippocampus of the 7 days old and 14 days old rats were calculated. It was found that treatment with phenobarbital resulted in a loss of 43% of the neurons, and valproic acid induced a loss of 57% of the neurons in the 7 days old rats. Curcumin prevented this loss significantly with only 19% in the phenobarbital group and 41% in the valproic acid group. In the 14 days old rat groups, phenobarbital was found to reduce the number of neurons by 30%, and valproic acid reduced it by 38%. Curcumin treatment limited neuronal loss to 3% in the phenobarbital + curcumin group and 10% in the valproic acid + curcumin group. These data strongly indicate that curcumin is a protective agent and prevents hippocampal neuronal damage induced by phenobarbital and valproic acid treatment.

Relationship of hemoxygenase-1 and prolidase enzyme activity with oxidative stress in papillary thyroid cancer

AIM

Recent studies associate thyroid cancer with oxidative stress. We aim to clarify the relation between papillary thyroid cancer, oxidative stress, hemoxygenase-1, prolidase enzymes and investigate the availability of these enzymes as markers for diagnosis, success of treatment, and follow-up.

METHODS

Thirty-one patients with papillary thyroid carcinoma and 25 healthy control subjects were included in this study. Hemoxygenase-1, prolidase (oxidant stress indicator), malondialdehyde, protein carbonyl, and superoxide dismutase (an indicator of antioxidant defense system) were measured pre-operatively and 30 days after thyroidectomy.

RESULTS

There was a significant decrease in serum levels of malondialdehyde and superoxide dismutase (p <0.001 for both) after thyroidectomy in papillary thyroid carcinoma group. In addition, there was a significant difference in the postoperative serum levels of prolidase, malondialdehyde, protein carbonyl, and superoxide dismutase between papillary thyroid carcinoma and control groups (p =0.024, p <0.001, p =0.002, and p =0.016, respectively) beside significant difference of malondialdehyde, protein carbonyl, hemoxygenase-1, and superoxide dismutase pre-operative serum levels (p <0.001, p =0.003, p =0.006, and p =0.025, respectively).

CONCLUSION

When the unquestionable role of oxidative stress in the pathogenesis of cancer is considered, in the future it is expected to associate parametric changes in the serum of patients caused by oxidative stress to papillary thyroid cancer. Hippokratia 2016, 20(1): 55-59.

The importance of hemosiderin deposition in the infant brain: an autopsy study

BACKGROUND/AIM

Iron is an essential element involved in many metabolic processes. Presence and accumulation of iron in various body systems can result in different outcomes. Its accumulation in the central nervous system (CNS) cannot be detected routinely by application of hematoxylin-eosin staining. Detection of the presence of hemosiderin in the brain and cerebellum by application of Perls' dye is of importance in cases of infant deaths.

MATERIAL AND METHODS

In this study, brain and cerebellar specimens obtained from 52 eligible infants  (aged 0-1 years) autopsied in our institute between the years 2010 and 2013, independent of the cause of death, were analyzed in order to detect possible presence of hemosiderin. Perls' dye was used to detect histopathological staining intensity and distribution of hemosiderin in the brain and cerebellum.

RESULTS

Cases did not differ significantly as for the patients' age and gender (p =0.473), type of the culprit trauma (p =0.414), death/crime scene (p =0.587), and diagnosis groups (p =0.550). In this autopsy study blue colored hemosiderin granulations, stained with Perls' dye were detected in the brain (n: 39, 75%), and cerebellum (n: 35, 67.3%). A weakly negative, but significant correlation was detected between the postmortem interval and intensity values of cerebellar hemosiderin (Spearman's correlation coefficient: -0.381, p =0.024). A statistically significant difference was found between the distribution scores of cerebral hemosiderin in cases with and without trauma history (p =0.03). Median cerebral hemosiderin distribution scores were 2.5 and 2, respectively.

CONCLUSIONS

The detection of a correlation between the presence of cerebral and cerebellar hemosiderin, and postmortem interval in the age group of 0-1 years, should be interpreted as an important finding in the analysis of cerebral iron. The presence of hemosiderin in the CNS may be a significant finding in the elucidation of infant deaths and this procedure should be carried out on a routine basis.Hippokratia 2015; 19 (2):164-171.

Evaluation of potential salivary acetaldehyde production from ethanol in oral cancer patients and healthy subjects

BACKGROUND

Acetaldehyde has been implicated as a major factor in oral carcinogenesis associated with alcohol consumption. In this study, saliva samples from oral cancer patients and healthy individuals were incubated in vitro with ethanol in order to investigate factors which can influence salivary acetaldehyde production.

MATERIALS AND METHODS

A total of 66 individuals (40 males and 26 females, mean age 52 years) participated in the study. Participants were classified into three groups: Group 1 (oral cancer patients [n = 20]); Group 2 (poor dental health status [n = 25]) and Group 3 (good dental health status [n=21]). Every patient chewed a 1g piece of paraffin chewing gum for 1 minute then saliva samples were collected from all individuals. After in vitro incubation of the samples with ethanol, the levels of salivary acetaldehyde production was measured by head space gas chromatography. Kruskal-Wallis and Mann-Whitney tests and Spearman's Correlations analysis were performed for statistical analyses.

RESULTS

The salivary acetaldehyde production was significantly higher (p <0.0001) in both group 1 and group 2 when compared to group 3. However, there was no significant difference between group 1 and group 2. Poor dental health status, infrequent oral hygiene habits and dental visits, smoking and presence of a dental prosthesis were significant parameters for increased levels of salivary acetaldehyde production from alcohol. The evaluation of salivary acetaldehyde production after in vitro incubation with ethanol may be useful for early detection of oral cancer.

CONCLUSION

According to the results of this study, the significantly higher levels of salivary acetaldehyde production in oral cancer patients and individuals with poor dental health status may suggest a possible link between increased salivary acetaldehyde production and oral cancer. Improved oral hygiene can effectively decrease the level of salivary acetaldehyde production in oral cavity. Hippokratia 2014; 18 (3): 269-274.

Cranial injury caused by penetrating non-missile foreign body: an autopsy case

Presented case was 32-year-old male marble worker, who underwent industrial accident at workplace. On gross physical examination; on forehead region round skin wound in 0.9 cm diameter was detected, radiological examination showed the image of metallic object. in the skull cavity. Brain dissection showed obvious brain injury, haemorrahge explaining the pattern of injury caused by the metallic bodys path, from left frontal lobe to the left cerebellar hemisphere was identified. We presented rare case of penetrating injury of the cranial region caused by non-missile foreign body.

KEYWORDS

cranial injury - non-missile foreign body - autopsy.

Unusual head and neck injury in elevator: autopsy study

Industrial injuries related to auto-load-carrying vehicles were not frequently reported in the literature. Presented case was, 31-year-old male furniture worker. Deceased was found in awkward position in furniture workshop. Victim was observed on his knees in front of the elevator, head and neck lodged within openings of the elevator, and head and neck structures compressed-guillotined by the lower platform of the elevator were detected. We presented rare case of head and neck compression by elevator. Key words: head - neck - accidents - elevator - autopsy.

Death due to peripheral vascular injury following blunt trauma

According to the document of death, 34-year-old forester sustained a crush injury to his lower extremity and pelvis as was pinned between the wood log and ground. During autopsy intramuscular bleeding was observed in the left pelvic region the left femoral region femur was detected intact there was no fracture, but there was observed a traumatic transection of the common femoral artery and vein, which was accompanied with massive bleeding in the surrounding soft tissues and muscles. We presented rare case of traumatic transection of the common femoral artery and vein in a patient without an femoral fracture caused by blunt trauma.

KEYWORDS

blunt trauma - peripheral vascular injury - autopsy.

Sudden death due to a rare brain tumor: an autopsy case

Sudden death in persons with intracranial neoplasms is a rare mechanism of death detected in the forensic autopsies. 10 years-old girl was brought to a local clinic death shortly after analgesic therapy for headache. Autopsy findings showed a large, solid cerebellar mass. Histological diagnosis was pilomyxoid astrocytoma, low-grade tumor with features alike to pilocytic astrocytomas. In this case report we present and discuss rare autopsy case of pilomyxoid astrocytoma from medicolegal point of view.

KEYWORDS

sudden death - brain - pilomyxoid astrocytoma - autopsy.

Age-related histopathological changes in the cardiac conducting system in the Turkish population: an evaluation of 202 autopsy cases

BACKGROUND

Histopathological features of the cardiac conducting system (CCS) in the Turkish population have not been investigated previously.

MATERIAL AND METHODS

We examined CCS of 202 autopsy heart specimens dissected between the years 2004 and 2005 in Bursa Forensic Medicine Institution. Of the 202 cases from all age groups, 154 were males and 48 were females.

RESULTS

In our cases, an increase in fibrous and adipose tissue concordant with age, indicating an age-related nature, were detected. Fibrous and fatty tissue infiltration appeared at the age of 35. Fatty infiltration started between the ages 20 and 34 years at the sinoatrial node (SAN). There was no relationship between obesity and fatty tissue infiltration in SAN and atrioventricular node (AVN). In 4 cases calcification and in 19 cases inflammation was observed. Amyloid accumulation was not present. In 7 cases myocardial infarction not involving CCS was seen. In 1 case fibroelastoma was detected.

CONCLUSIONS

In the Turkish population age-related fibrosis and fatty infiltration in CCS appeared at the age of 35 years and increased with age. Fatty infiltration in the SAN started at a younger age than that reported in the literature. In cases where the cause of death could not be determined, we could not detect lethal pathological features. However, we think that examination of the CCS will improve the quality of autopsy diagnosis.

Distribution of HLA antigens in breast cancer

Investigation of various tumor-specific markers has a critical role in early diagnosis and treatment of breast cancer. The aim of the this study is to investigate the Human Leukocyte Antigen (HLA) alleles, the molecules that play an important role in immunity and tumor response of the body, and its relationship with breast cancer. In this prospective clinical study, after obtaining approval from the ethics committee of Istanbul University Experimental Medical Research Institute, 22 female patients who have been hospitalized in Istanbul University Cerrahpasa Faculty of Medicine the Department of General Surgery with a diagnosis of breast cancer were selected. In the control group, there were 22 healthy women who had no relationship and were donor candidates for renal transplantation. After collecting blood in 5 ml tubes with EDTA, HLA A, B and DR groups were measured with SSP method using the GenoVision Olerup SSP (Olerup SSP, Stockholm, Sweden) kit in Istanbul University Cerrahpasa Faculty of Medicine Blood Center Tissue Type Determination Laboratory. In patient and control group, totally 53 alleles; 17 alleles of HLA-A gene, 22 alleles of B gene, 14 alleles of DR gene were detected. A statistically significant relationship was determined between HLA-B55:01 and HLA-DRb1*18:01 alleles and the development of breast cancer (p<0.05). HLA-B13:01 antigen is determined only in the control group. It was concluded that HLA-B13:01 antigen, determined only in the control group, may be protective for breast cancer and HLA-B55:01 and HLA-DRb1*18:01 antigens, determined only in the patient group, may be a risk factor for breast cancer (Tab. 5, Ref. 22).

Protective role of melatonin supplementation against nicotine-induced liver damage in mouse

The present study was carried out to determine histopathological effects of nicotine, one of the most significant components of tobacco, on mouse liver and ameliorative effect of melatonin on liver damage. A total of 140 mature Swiss Albino mice ( Mus musculus) were divided into four experimental groups: control group, nicotine group, melatonin group and nicotine + melatonin group. Each group was further subdivided into seven groups (five mice each) according to the time of killing (12 h and days 1, 3, 5, 7, 14 and 21 after drug administration). In nicotine and nicotine + melatonin groups, 3 mg/kg of nicotine was injected intraperitoneally every day until killing. The nicotine + melatonin group was additionally injected with 10 mg/kg of melatonin after 30 min of nicotine injection. The melatonin group was injected only with 10 mg/kg of melatonin every day until killing. All the treatments were given 2 h before sunset, when melatonin receptors were active. After the last injection, five mice from each group were killed at 12th hour and on days 1, 3, 5, 7, 14 and 21; the livers were removed for histopathological processing by light microscopy. The histopathological results revealed time-dependent degeneration in the livers of mice in nicotine group. Regenerative changes in the nicotine and melatonin groups were observed when compared with nicotine groups.

Spectroscopic reflectometry of mirror surfaces during plasma exposure

An in situ spectroscopic reflectometry system has been built to investigate the evolution of the specular reflectivity spectrum of ITER first mirror samples during plasma exposure. Results are presented for three different types of molybdenum mirror samples that were exposed to deuterium plasma, including single crystalline, nanocrystalline, and polycrystalline molybdenum. The results show good agreement with ex situ measurements of the reflectivity spectrum before and after exposure and extend the results obtained in previous experiments.

Morphometric features of the thyroid gland: a cadaveric study of Turkish people

BACKGROUND

Although racial and ethnic variations in the morphology of anatomical structures are defined well, the size, shape, and weight of the thyroid gland have not previously been reported in Turkish people. This study provides data about the morphometric features of the thyroid gland, thyroid lobes, and pyramidal lobe, and highlights some anatomical variations in people from the Marmara region in Turkey.

MATERIAL AND METHODS

The material for the present study consisted of thyroid glands obtained from 75 male and 15 female adult cadavers aged between 18 and 80 years. A dissection was carried out and the thyroid glands were exposed. The glands were weighed and measured according to the various age groups of the patients.

RESULTS

A pyramidal lobe was found to be present in 57.8% of the cadavers (52/90). During midline dissection of the neck 2 males out of 90 cadavers, giving an incidence of 2.22%, did not show an isthmus. The mean thyroid weight was 26.11 ± 8.14 g. In males it was 26.93 ± 7.96 g while in females it was 21.93 ± 7.98 g.

CONCLUSIONS

This is the first reported morphometric study on cadaveric thyroid glands from Turkey and it highlights individual and ethnic/racial variations. In order to perform safe and effective surgery and for the accurate diagnosis of thyroid disorders, knowledge of normal anatomy and the variations of the thyroid gland are essential.

Black esophagus: a rare autopsy case

The black esophagus is a rare entity of an acute esophageal necrosis described at endoscopy and typical histological properties of a diffuse mucosal necrosis. The presented case was a 17-year-old girl; admitted to the hospital with an abdominal distantion and vomiting, who died soon after admittance. The case was investigated by local prosecutor, as the cause of the death was unknown; a forensic autopsy was mandated and later performed in our department. During autopsy on macroscopic examination an acute esophageal necrosis with black colored esophageal mucosa was detected. In this case report, we aimed to explain the autopsy findings, clinical presentation, histological appearance, risk factors and pathogenesis of the disease from the medico legal point of view (Tab. 1, Fig. 1, Ref. 5).

An analysis of carbon monoxide poisoning cases in Bursa, Turkey

Carbon monoxide (CO) poisoning from coal and gas heaters is a public health concern in Turkey. This study estimated the prevalence, mortality rate and clinical predictors of severity of CO poisoning cases treated at the emergency unit of the Uludağ University Medical School, Bursa from 1996 to 2006. Of 305 patients treated over a 10-year period, only 1 case was recorded as suicide. The CO source was a coal heater in 85.9% of cases. Mean Glasgow coma score (GCS) on admission was 12.8 (SD 0.2) and mean carboxyhaemoglobin level was 21.6% (SD 0.92%). There were statistically significant associations between higher GCS score, older age and higher HbCO level. Better education of the public is vital for the prevention of these injuries.

Allergic myocardial infarction due to hydatid cyst: an autopsy case

Hydatid disease is a parasitic tapeworm infestation. Anaphylactic reactions as a result of cyst perforation generally occur after trauma during a spread of cystic fluid in the intravascular space, which may also initiate anaphylaxis. The reported case was a 17-year-old boy who was admitted to the hospital emergency department with a sudden onset of nausea, vomiting and fainting, resulting in death. The cause of his sudden death was unknown. Autopsy macroscopically revealed hydatid cysts in the liver. In the histopathological examination, hydatid cyst was recognized by scolices and also an inflammatory infiltration composed mainly of mast cells in the myocardium was detected. Sudden death in this case was attributed to allergic myocardial infarction due to intravascular spread of the hydatid cyst content (Fig. 2, Ref. 10).

Blast injury: lessons learned from an autopsy

Blast injury is becoming more common in the non-military population but it is still rare to see such injuries and deaths unrelated to terrorist acts. The exact mechanisms involved in blast injuries are unclear. Civilian physicians and surgeons need to have a basic understanding of the patho-mechanics and physiological effects of blast injuries. We report a case where a 31-year-old male accidentally detonated a diesel storage tank. His autopsy findings provide useful information for those who investigate explosive-related deaths.

Performance of emergency medicine residents in the interpretation of radiographs in patients with trauma

BACKGROUND

Radiographs are vital diagnostic tools that complement physical examination in trauma patients. A study was undertaken to assess the performance of residents in emergency medicine in the interpretation of trauma radiographs.

METHODS

348 radiographs of 100 trauma patients admitted between 1 March and 1 May 2007 were evaluated prospectively. These consisted of 93 cervical spine (C-spine) radiographs, 98 chest radiographs, 94 radiographs of the pelvis and 63 computed tomographic (CT) scans. All radiological material was evaluated separately by five emergency medicine residents and a radiology resident who had completed the first 3 years of training. The same radiographs were then evaluated by a radiologist whose opinion was considered to be the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.

RESULTS

The mean (SE) age of the patients was 29 (2) years (range 2-79). There were no statistically significant differences in terms of pathology detection between the emergency medicine residents and the radiologist. The agreement between the emergency medicine residents and the radiology resident was excellent for radiographs of the pelvis and the lung (kappa (kappa) = 0.928 and 0.863, respectively; p<0.001) and good for C-spine radiographs and CT scans (kappa = 0.789 and 0.773, respectively; p<0.001).

CONCLUSIONS

Accurate interpretation of radiographs by emergency medicine residents who perform the initial radiological and therapeutic interventions on trauma patients is of vital importance. The performance of our residents was found to be satisfactory in this regard.

Histological Changes on Liver Glycogen Storage in Mice (Mus musculus) Caused by Unbalanced Diets

Weight-losing diets have appealed to people who want to lose weight in the short-term. They usually apply high-protein (HP) diets (like Atkin’s, Stillman’s, Scarsdale) which they practice for 2 weeks or so. Unfortunately, these people who have rapid weight loss return to their old habits and quickly regain the weight lost. We have shown in previous work that actually these weight losses have been associated with body fluids, protein and glycogen storage. In our study, we examined the effect of unbalanced diet—related to an HP diet- on liver glycogen storage.

For this study 40 Swiss albino mice consisting of two groups were used. The first group (HPSD) was fed with 25% HP for fifteen days and then were fed standard meals for the remaining 15 days; the other group was fed with standard meals throughout. The two groups were fed their respective diets for 30 days. At the end of 15th, 20th, 25th and 30th days 5 from each group were killed with cervical dislocation. The livers were removed perfused and then fixated.

There were major differences in weight between the first and the fifteenth days. We detected remarkable increase in the weight gain of mice in the remaining 15 days. Glycogen storage was significantly reduced in HPSD (15) stained with PAS. In the others 20th, 25th and 30th days abnormally dense glycogen deposits were observed. Vacuoles in the hepatocyte cytoplasm, brownish deposits within hepatocytes, wide sinusoids, macrovesiculler steatosis structures and hydropic degeneration were observed in PAS and H&E stained HPSD group.

As a result for the HPSD group a significant decrement in glycogen storage at the 15th day and also an accumulation of excessive amounts of glycogen deposits in mice liver was observed in the normal feeding phase.

Ovarian enlargement associated with massive oedema

Massive ovarian oedema is a rare entity described as accumulation of oedema fluid within the ovarian stroma, separating normal follicular structures. Our case was a 27-year-old woman who presented with a large solid pelvic mass after recurrent episodes of self-limited abdominal pain. On physical examination, she had left abdominal tenderness with minimal rebound and guarding. With a diagnosis of malignant ovarian tumor, an exploratory laparotomy was done and a twisted ovarian mass was found which was excised completely. Histopathological evaluation of the mass revealed massive oedema of the ovary. Massive ovarian oedema should be suspected in women at the fertile age range with solid enlargement of the ovary.

Retrospective analysis of 105 cases of uterine sarcoma

16079

Background: Currently there is no randomized study based or widely accepted therapeutic modality in uterine sarcomas which are rare tumors forming a heterogeneous group in respect to their pathologic classification. Methods: In our trial, 105 pts. with uterine sarcoma who were referred to our clinic between years 1995–2003 have been retrospectively researched to evaluate the results in this tumor group. 43.8% had Leiomyosarcoma (LMS), 28.6% had Endometrial Stromal Sarcoma (ESS) and 27.6% had a Malign Mullarian Mixed Tumor (MMMT) while the distribution according to the histological subgroups were found to be 58.8% and 41.2% in low + middle grade tumors combined and in high grade tumors respectively. 76.2% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy (TAH+BSO), 18.1% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy + Lymphadenectomy (TAH+BSO+LND) and 5.7% had a suboptimal surgery as a surgical procedure. 38.1% of the pts. had Radiotherapy (RT), 18.1% had Chemotherapy (CT) and 12.4% had Chemo-radiotherapy (CT+RT) in addition to surgery. Results: The median age of the whole group is 51 (24–87). 55% of our pts. are under 50 years old and 68.5% had an “organ limited disease” ( stages I-II combined). The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival rates at 3 and 5 years are 54.46% and 49.88% ; while the overall survival rates at 3 and 5 years are 54.63% and 51.09% all respectively. The stage is the most important factor effecting on the O.S and 5- year O.S rate is 68.43% in Stage I disease. Conclusions: The aggressive tumor progression pattern and the poor prognosis of uterine sarcomas require adjuvant therapies. The merit of current therapeutic options are still on debate since none of them has proved any specific effects. Planning further multi-center retrospective studies with high number of pts., a more clear description of the prognostic factors and thus the determination of the most appropriate therapeutic option is definitely needed.

No significant financial relationships to disclose.

Sudden death related to anomalous origin of coronary artery and coexisting fenestrated membrane of the sinus coronarius

Coronary artery anomalies that may be an isolated defect or part of complex congenital malformations of the heart are also often associated with a high risk of sudden death. A 19-year-old woman lost consciousness in the night. She was taken to hospital where she was treated. However, she died on the same day. The prosecutor considered the death suspicious, and the victim was taken to the morgue department for further examination and autopsy. On macroscopical examination, both coronary arteries originated from the left aortic sinus with the left one being dominant. The orifice of the sinus coronarius in the right atria was covered with a fenestrated membrane. Demonstration of coronary artery pathologies and associated anomalies in autopsies is vital for the elucidation of sudden death cases related to these lesions and for the development of new treatment approaches. The purposes of this case report are to characterise and identify markers of the coronary artery anomalies and to highlight their medicolegal importance in sudden death cases.

Sudden death due to single coronary artery

Coronary artery anomalies that entail a risk of sudden death are frequently associated with complex cardiac malformations but may occasionally be solitary. A 31-year-old man became ill in the night and lost consciousness. He was taken to a hospital where he was treated. However, he died on the same day. The death was considered to be suspicious and an autopsy was mandated. On macroscopic examination, the heart weighed 410 g. A single coronary artery that originated from the right aortic sinus was found. The coronary artery ostium was 0.8 cm in diameter and had a hole-like shape. Demonstration of coronary artery pathologies in autopsies is vital for the elucidation of sudden death cases related to these lesions and for the development of new treatment approaches. The aims of this case report are to contribute to a better understanding of the coronary artery anomalies and emphasise their medicolegal importance.

Suicidal electrocution using a homemade electrocution device

Electrocutions deaths are mostly accidental, suicidal electrocutions are rarely reported. The records of Forensic Medicine Council of Turkey Bursa Morgue Department reveal second case of suicidal electrocution during the past 20 years. The presented case was a 61 year old man, found by his wife at his home bedroom, using a homemade suicidal electrocution device with bare copper wires. The mechanism of death and autopsy findings in suicidal electrocution is discussed.

Histological changes of liver glycogen storage in mice (Mus musculus) caused by high-protein diets

High Protein diets (HP) have been popular for people who want to lose weight since the 1960s. Even though these diets do not harm healthy people in the short term, there is insufficient data to support their safe use and efficiency over a long period. Because of the fact that the proteins in these diets are mainly from animal sources, it induces a higher intake of total fat, saturated fat and cholesterol. It is proven that high protein diets cause both physical and pathological abnormalities in the body. However, there exist very few studies about the effects of high protein nutrition on liver glycogen storage. For this study 40 Swiss albino mice consisting of two groups were used. The first group was fed with 25% High Protein; the other was fed with standard meal. The two groups were fed with respect to their diets for 30 days. At the end of 15th, 20th, 25th and 30th days 5 from each group were killed with cervical dislocation. The livers were removed after perfusion then fixated. The routine paraffin pursuit was applied before cutting into 5 micrometer sections and staining with H-E, PAS and silver. There were major differences in weight loss between the first and the fifteenth days. Glycogen storage was significantly reduced in HP (15) stained with PAS. Hydropic degeneration and regenerative activity was observed in H-E and silver stained HP group. As a result for the high protein diet group, weight loss at the 15th day and a significant decrement in glycogen storage at the 30th day was observed.