Does the vitamin C level affect postoperative analgesia in patients who undergo orthognathic surgery?

Vitamin C has a critical role in pain management because of its antioxidative, neuroprotective, and anti-nociceptive properties. Oxidative stress caused by surgery increases the requirement for vitamin C. The aim of this study was to evaluate the change in vitamin C level and its effect on postoperative pain in patients undergoing orthognathic surgery. Thirty patients were included in the study. The relationships between the postoperative plasma vitamin C level, duration of surgery, postoperative analgesic consumption, and pain scores (visual analogue scale) were analysed. The difference between the mean pre- and postoperative vitamin C levels was found to be statistically significant (7.5 ± 2.9 mg/l vs 4.9 ± 2.3 mg/l, respectively; P = 0.001). There was no significant relationship between the duration of surgery and the vitamin C level decrease (P > 0.05). There was an inverse correlation between the postoperative vitamin C level and the amount of analgesic requested via patient-controlled analgesia (r = -0.699, P < 0.001). The findings suggest that, in patients who undergo orthognathic surgery, plasma vitamin C levels decrease significantly (34.6%), and an increase in the duration of surgery is not associated with any decrease in the vitamin C levels. A low postoperative plasma vitamin C level was found to be associated with greater postoperative analgesic consumption. In patients with preoperative plasma vitamin C levels ≤ 42 µmol/l, perioperative vitamin C administration may be considered for postoperative pain management.

Clinical role of CD274 (PD-L1) and CD3+ lymphocytes in predicting high risk in advanced colorectal cancer patients receiving neoadjuvant chemotherapy

In cancer research, the mechanism underlying the immune response to a tumour has been of great interest. In this study, we investigated the role of CD274 (programmed cell death-ligand 1 - PD-L1) and CD3+ tumour-infiltrating lymphocytes (TILs) in the prognosis of advanced colorectal cancer (CRC) patients treated with neoadjuvant chemotherapy. We retrospectively examined primary tumour specimens from stage III/IV CRC patients operated on between 2008 and 2018. We found a significant association between these biomarkers and pT stage (PD-L1, p = 0.020; CD3+TILs, p = 0.025), tumour grade (PD-L1, p = 0.005; CD3+TILs, p = 0.004), positive surgical margin (PD-L1, p = 0.001; CD3+TILs, p = 0.001), MSI (PD-L1, p < 0.001; CD3+TILs, p < 0.001), etc. We also discovered that these biomarkers are independent risk factors for MSI (PD-L1, OR = 1.84 [1.27-4.02], p = 0.003; CD3+TILs, OR = 1.92 [1.31-4.35], p = 0.008). Univariate analysis results revealed that patients with high PD-L1, low CD3+TIL, and both showed poor relapse-free survival (RFS) and poor overall survival (OS) (PD-L1: RFS, p = 0.008 and OS, p = 0.001; CD3+TILs: RFS, p = 0.003 and OS, p = 0.005; PD-L1 and CD3+TILs: RFS, p < 0.001 and OS, p < 0.001). The results of the multivariate analysis showed that the combined use of high PD-L1 and low CD3+TILs was a better predictor of poor RFS and OS (PD-L1 and CD3+TILs: RFS, hazard ratio - HR, = 2.85 [95% CI: 1.36-3.84], p < 0.001); OS, HR = 2.74 [1.32-3.71], p < 0.001). We also found a high PD-L1 parameter as another independent overall and relapse-free survival parameter. Our findings suggest that a combination of high PD-L1 and low CD3+TIL can reliably predict poor survival in CRC patients receiving chemotherapy. Therefore, these biomarkers may be promising for the planning and execution of appropriate targeted therapies.

Neuroprotective effects of amantadine for experimental acute carbon monoxide poisoning

OBJECTIVE

Amantadine is known to have a neuroprotective effect in many neurological diseases. This study aims at investigating the neuroprotective effect of amantadine in rats exposed to carbon monoxide (CO) poisoning.

MATERIALS AND METHODS

Rats were maintained under standard experimental laboratory conditions and randomized into 4 different groups of 7 each namely control, amantadine only, CO exposure, and amantadine + CO exposure. For immunohistochemical analysis, tissues taken from the prefrontal and hippocampal regions were taken into formalin and kept for at least one day. Afterward, the tissue was followed and blocked for paraffin blocking. N-Methyl D-Aspartate (NMDA) levels in homogenates were studied by the Enzyme-Linked Immunosorbent Assay (ELISA) method. Superoxide dismutase (SOD) and catalase (CAT) activities in the supernatants were studied with commercial kits. Nitric oxide (NO) and Asymmetric Dimethyl Arginine (ADMA) levels were studied by the ELISA method. Enzyme activity values were calculated by dividing the protein values in the supernatants and normalizing them.

RESULTS

CAT, SOD, NMDA, ADMA, and NO levels were statistically significantly different between the groups (p < 0.05). According to post-hoc pairwise comparison test results, the values of the control and amantadine groups for CAT, SOD, NMDA, ADMA, and NO parameters were significantly higher than that of CO group. Similarly, values in the control and amantadine groups were considerably higher than values for the amantadine + CO group. NMDA values were significantly lower in group amantadine + CO than in CO group (p: 0.049).

CONCLUSIONS

Apoptosis and endothelial damage after CO poisoning is a complex process, and amantadine administration has a limited contribution in preventing this process.

The Effects of Colchicine on the Histopathological Findings of Celiac Disease During Familial Mediterranean Fever Treatment

Familial mediterranean fever (FMF) and Celiac Disease (CD) are both autoinflammatory and autoimmune diseases with common clinical features affecting the gastrointestinal system. Familial mediterranean fever may coexist with CD. Inflammatory cells and cytokines are up-regulated within the intestinal mucosa of patients with CD. In this perspective, lymphocyte infiltration to the lamina propria of the small intestinal mucosa is a critical pathological sign. In the present study, we aimed to find out whether the treatment of an FMF patient with colchicine affects the pathological signs of concomitant developed CD on the same patient. We retrospectively reviewed the medical records of 147 patients with FMF who were followed up in our center between 2015 and 2020. Of the 147 patients with FMF, 3 patients also had CD. In this report, we presented these 3 cases. The findings obtained in this study suggest that pathological findings may be misinterpreted in autoimmune diseases, such as CD, when patients administer anti-inflammatory treatments, such as colchicine.

The impact of bone marrow-derived mesenchymal stem cells on experimental testiculartorsion in rats

BACKGROUND

The aim of this study was to investigate the healing effects of bone marrow-derived mesenchymal stem cells (BMMSCs) on experimental testicular torsion in rats.

METHODS

Three groups consisting of 10 Wistar albino rats were created. In Group I, the left testicle was explored and relocated in the scrotum without any attempt to modify it. In Group II, the left testicle underwent torsion for three h and then was detorsed and relocated. In Group III, in addition to torsion and detorsion, BM-MSCs were administered intratesticularly. The rats were sacrificed on the seventh day, and the healing status of the testicles was investigated with histopathological and biochemical analyses. BM-MSC involvement was investigated by immunofluorescence microscopy. Statistical analysis was performed using SPSS 15.0. A p-value < 0.05 was considered statistically significant for all variables.

RESULTS

Immunofluorescence microscopy showed that BM-MSCs were located around the Leydig cells in Group III. Under light microscopy, the mean Johnsen Score of Group III was significantly higher than that of Group II (p = 0.035). The interleukin-10 (IL-10) level was significantly higher in Group III compared to Group II (p = 0.003). While the malondialdehyde (MDA) values in Group I (the control group) were lower than in the other groups (p = 0.037), the superoxide dismutase (SOD) values were similar (p = 0.158). Although there was no statistically significant difference between Group II and Group III in terms of MDA, it was lower in Group III. Although the tissue SOD levels were higher in Group III than in Group II, the difference was not statistically significant.

DISCUSSION

: This study has demonstrated that BM-MSCs significantly corrected the Johnsen Score and increased anti-inflammatory cytokine levels after testicular torsion. BM-MSCs can be used in testicular torsion as supportive therapy to minimize tissue damage.

The impact of bone marrow-derived mesenchymal stem cells on experimental testicular torsion in rats

BACKGROUND/AIM

The aim of this study was to investigate the healing effects of bone marrow-derived mesenchymal stem cells (BM-MSCs) on experimental testicular torsion in rats.

MATERIALS AND METHODS

Three groups consisting of 10 Wistar albino rats each were created. In Group I, the left testicle was explored and relocated in the scrotum without any attempt to modify it. In Group II, the left testicle underwent torsion for three hours and then was detorsed and relocated. In Group III, in addition to torsion and detorsion, BM-MSCs were administered intratesticularly. The rats were sacrificed on the seventh day, and the healing status of the testicles was investigated with histopathological and biochemical analyses. BM-MSC involvement was investigated by immunofluorescence microscopy. Statistical analysis was performed using SPSS 15.0. A p-value < 0.05 was considered statistically significant for all variables.

RESULTS

Immunofluorescence microscopy showed that BM-MSCs were located around the Leydig cells in Group III. Under light microscopy, the mean Johnsen Score of Group III was significantly higher than that of Group II (p = 0.035). The interleukin-10 (IL-10) level was significantly higher in Group III compared to Group II (p = 0.003). While the malondialdehyde (MDA) values in Group I (the control group) were lower than in the other groups (p = 0.037), the superoxide dismutase (SOD) values were similar (p = 0.158). Although there was no statistically significant difference between Group II and Group III in terms of MDA, it was lower in Group III. Although the tissue SOD levels were higher in Group III than in Group II, the difference was not statistically significant.

Patients with rheumatoid arthritis and osteoarthritis in terms of sex hormone receptors and histopathological comparison of features

Objectives

This study aims to investigate the relationship between estrogen receptors (ERs) and progesterone receptors (PRs) and histopathological findings in synovial tissue in rheumatoid arthritis (RA) and osteoarthritis (OA) patients.

Patients and methods

Synovial tissue samples obtained from synovial surgery from 30 RA (10 males, 20 females) and 92 OA (27 males, 65 females) patients with median age of 59 (range, 50 to 67) years were analyzed retrospectively between January 2010 and January 2019. The relationship between histopathological features and hormone receptor presence was analyzed.

Results

There was a meaningful relationship between histopathological parameters and RA and OA (p=0.01). The sex hormone receptor's presence was significantly higher in females with RA (p=0.01). Additionally, in the RA group, there was a remarkable relationship between ER and focal aggregates of lymphocytes (p=0.01), perivascular infiltrates of lymphocytes (p=0.03), and diffuse infiltrates of lymphocytes (p=0.01). In the OA group, a significant relationship was observed between PR and subchondral inflammation (p=0.01). In multivariate analysis, it was observed that ER was an independent risk factor for focal aggregates of lymphocytes in RA group (odds ratio [OR]=1.51 [1.02-2.25], p=0.04). Besides, PR was found to be an independent risk factor for subchondral inflammation in OA group (OR=3.90 [1.28-11.80], p=0.02).

Conclusion

The presence of the sex hormone receptor in the synovium may change histopathological features and affect the clinical course.

Contribution of Bone Marrow-Derived Mesenchymal Stem Cells to Healing of Pulmonary Contusion-Created Rats

BACKGROUND

The most common thoracic injury in children, resulting in trauma, is pulmonary contusion (PC). Bone marrow-derived mesenchymal stem cells (BM-MSCs) are used in wound healing and many other diseases. This study aims to examine the effects of BM-MSCs on PC healing in rats.

MATERIALS AND METHODS

A total of 45 male Wistar albino rats were used. Four groups were formed. BM-MSCs were labeled with the green fluorescent protein. PC was observed in the control group. In group II, PC occured and left to spontaneous healing. In group III, PC formed and BM-MSCs were given. In group IV, BM-MSCs were given without PC formation. Subjects were sacrificed 1 week later. Whether there was any difference in terms of BM-MSC involvement and lung injury score was investigated. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS), version 17.0, software (SPSS Inc., Chicago, IL), and p value of <0.05 was considered statistically significant.

RESULTS

BM-MSCs were collected much more in the lungs in group III than in group IV. Group III had a lower lung injury score value than group II.

CONCLUSION

The greater involvement of the BM-MSCs in the injury site, and further reductions in lung injury score suggest that BM-MSCs are contributing to the healing of the injury. The use of BM-MSCs in risky patients with diffuse PC may be an alternative treatment to conventional methods.

PD-1 and PD-L2 expression predict relapse risk and poor survival in patients with stage III colorectal cancer

BACKGROUND

Immune responses have long been an area of interest in cancer research. In this study, the effects of programmed cell death-1 (PD-1) and its ligand (PD-L2) on the prognosis of colorectal cancer (CRC) were investigated.

METHODS

Primary tumour specimens of stage III CRC patients operated between 2002 and 2013 were assessed for PD-1 and PD-L2 expression and various clinicopathological and prognostic factors.

RESULTS

We observed a significant relationship between poor prognostic factors and PD-1/PD-L2 expression. These biomarkers were also found to serve as independent risk factors for LIR and MSI. In univariate analysis, relapse-free survival (RFS) and overall survival (OS) rates were found to be poor in PD-1 and PD-L2 positive patients. In multivariate analysis, these biomarkers were found to serve as independent poor prognostic factors for RFS and OS.

CONCLUSIONS

Our data indicate that PD-1 and PD-L2 may serve as independent prognostic survival parameters for CRC patients and may be employed for the design of targeted therapies.

Determination of ecologically sensitive areas in Denizli province using geographic information systems (GIS) and analytical hierarchy process (AHP)

Ecological sensitivity is defined as the ecosystem's reaction to environmental change caused by internal and external factors. The degree of ecological sensitivity varies in spatial dimension depending on the natural and cultural features. Ecological sensitivity analysis is based on basis of mapping these differences. As a result of the analysis, an important data that can be a base for spatial plans at different scales is provided. In accordance with this aim, Denizli province was selected for the study area in this research. The factors affecting sensitivity were determined by the literature survey, which was conducted by considering the characteristics of the study area. In this context, elevation, slope, aspect, the proximity to water surface, land cover, and vegetation coverage were evaluated as natural factors, and the proximity to primary traffic roads and residential areas as cultural factors. Each factor was spatially grouped by means of geographic information systems (GIS) according to the degree of impact on ecological sensitivity. Scale 1 (lowest ecological sensitivity) to 5 (highest ecological sensitivity) was used for the spatial grouping. A analytical hierarchy process (AHP) was applied to weight the factors. The overlay method was used in line with the weighted scores in order to determine the composite ecological sensitivity. As a result of the study, the area of 286.26 sq km (2.37%) as highly and more sensitive, 5267.47 sq km (43.50%) as moderately sensitive, and 6554.56 sq km (54.13%) as mildly and less sensitive was determined. In line with the results, suggestions for protection-utilization balance were developed.

The Proportion of Tumour-Stroma in Metastatic Lymph Nodes is An Accurately Prognostic Indicator of Poor Survival for Advanced-Stage Colon Cancers

The importance of tumour microenvironment in tumour behaviour has now become clearer. This study aimed to determine the prognostic effect of the proportion of tumour-stroma (PTS) in metastatic lymph nodes of advanced-stage colon cancers (CCs). We investigated PTS in positive lymph nodes of stage III-IV CC patients who underwent surgical treatment between 2004 and 2014. We used a standard approach in methodology. PTS was significantly associated with prognostic factors in the metastatic lymph nodes (perineural invasion [p = 0.031], lymphatic invasion [p = 0.032], invasive margin [p = 0.043], advanced pT [p = 0.020], and margin involvement [p = 0.034]). In addition, the correlations between PTS estimates (R = 0.704 to 0.617, p < 0.001), the reproducibility of the research (Κappa = 0.72-0.68) and the usefulness of the cut-off value (ROC: 50.33%; AUC = 0.752 [0.667-0.857]) were successful. In univariate analysis, 5-year survival was poor for RFS (p < 0.001), OS (p = 0.001) and LR (p = 0.013) in high PTS patients. Multivariate analysis confirmed that high PTS was an independent worse parameter for RFS (HR = 1.32, 95% CI: 1.17-2.55, p = 0.001) and OS (HR = 1.37, 95% CI: 1.25-1 - 2.56, p = 0.009). In this study, we showed that high PTS in metastatic lymph nodes was a successful prognostic marker for advanced-stage CCs. Also, the standard approach we used for the methodology was successful.

Using of the synthetic dural graft as described in bogota bag technique to decrease the adhesions in decompressive craniectomy

AIM

The aim of this study was to create an alternative synthetic dural graft using a parenteral solution bag made of polyvinyl chloride/polypropylene (PVC/PP).

MATERIAL AND METHODS

Twenty-two albino rats were divided into the Sham, DC and BAG groups. Except for the Sham group animals, the right parietal bone of the rats was totally drilled in a diameter of 1.0 x 0.5 mm. Then, the PVC/PP BAG was layered over the craniectomized bone of the BAG group animals. Thirty days later, all animals were sacrificed, and inflammatory processes consisting of polymorphonuclear cell infiltration, inflammation, edema, hyperemia, lymphocytosis, histiocytosis, vascular proliferation, and fibrosis were graded at the craniectomy site.

RESULTS

The grade values of inflammation, edema, histiocytosis, and fibrosis were found different among the groups (p 0.017). It was observed that placing a synthetic graft to the surgical site undergoing craniectomy could prevent fibrotic adhesions that might occur between the brain tissue and scalp in the chronic period. Furthermore, it was considered that this synthetic material did not increase inflammatory processes secondary to surgery at the surgical site and did not produce a foreign body reaction, toxicity, or infection.

CONCLUSION

As a result of this study, it was argued that the synthetic material used in this study could be compatible with dermal and neural tissues and reduce adhesions at the craniectomy field. Therefore, it was considered that this material could be used as an alternative synthetic dural graft in decompressive craniectomy in human subjects after detailed toxicity studies.

Tumour budding in preoperative biopsy specimens is a useful prognostic index for identifying high-risk patients in early-stage (pN0) colon cancer

Background/aim

Tumour budding (BD) is considered a valuable prognostic factor in colon cancer (CC), but its use in daily practice is uncertain. We investigated the prognostic effect of BD using preoperative biopsy specimens in a fairly homogeneous population.

Materials and methods

Eighty-two (pN0) CC patients who underwent surgery after preoperative biopsy between 1997 and 2013 were included in the study. Model A (using the ‘deeply invasive blocks & hot-spot area & invasive margin) and method 1 (using the ‘20× objective & immunohistochemistry staining & quantitive counting’) were used as standard methods.

Results

High BD was significantly associated with poor prognostic factors (lymphatic invasion [P = 0.008], perineural invasion [P = 0.041], advanced pT [P = 0.015], invasive margin [P = 0.008], and margin involvement [P = 0.019]). Moreover, correlations between different BD estimates (r = 0.613–0.696), reproducibility of study (Κappa = 0.68–0.73), and usefulness of cut-off value (area of under ROC = 0.746 [0.663–0.829]) were well. In univariate analysis, 5-year survival was poor in patients with high BD (relaps-free survival [RFS]: 71 %, P < 0.001; overall survival [OS]: 73 %, P = 0.004, local recurrence [LR]: 18 %, P = 0.032). Multivariate analyses confirmed that high BD is an independent worse survival parameter for RFS (Hazard ratio [HR]: 1.53 [1.14–2.80], P = 0.015), OS (HR: 1.44 [1.17–2.75], P = 0.032, and LR (HR: 1.59 [1.05–2.76], P = 0.045).

Conclusion

Our data show that BD provides valuable prognostic information for early-stage (pN0) CC in preoperative biopsy specimens and that adding BD to current risk classification may contribute to better patient selection.

Tumour Budding and Tumour Stroma Ratio are Reliable Predictors for Death and Recurrence in Elderly Stage I Colon Cancer Patients

AIM

Tumour budding (BD) and Tumour stroma ratio (TSR) are considered valuable survival parameters for colon cancer (CC), but it is still unclear whether these parameters predict a poor prognosis. This study aimed to determine the survival effect of TB and TSR in elderly stage I CC patients.

METHODS

We evaluated these parameters in eighty-eight stage I CC patients who underwent surgical treatment alone between 1998 and 2015. The relationship between these parameters and age was investigated. Model A was used for methodology.

RESULTS

In elderly patients (≥68), these parameters obtained more successful results for following analysis: relationship between prognostic factors [lymphatic invasion (BD, p = 0.003; TSR, p = 0.003), perineural invasion (BD, p = 0.016; TSR, p = 0.004), tumour deposites (BD, p = 0.005; TSR, p = 0.033), MSI (BD, p=0.031; TSR, p=0.012), etc.], correlation of estimates (BD, r=0.724; TSR, r=0.703), and reproducibility of study (BD [Kappa (ĸ)]=0.53-0.75; TSR (ĸ) =0.56-0.71). Also, the cut-off values were useful for BD (area of under ROC (AUC)=0.816 [0.707-0.925]) and TSR (AUC=0.810 [0.697-0.924]). In univariate analysis, in elderly patients, these parameters had a poor 5-year survival for RFS (p<0.001[BD], p=0.001[TSR]), OS (p<0.001[BD], p=0.005[TSR]), and LR (p=0.008[BD], p=0.034[TSR]). Multivariate analysis confirmed that these parameters are independent worse predictors for RFS (BD: 1.42[HR], p=0.002; TSR: 1.50[HR], p=0.001), OS (BD: 1.38[HR], p=0.014; TSR: 1.42[HR], p=0.005), and LR (BD: 1.61[HR], p=0.034) in elderly patients.

CONCLUSIONS

Our results confirm that BD and TSR are reliable indexes for poor survival in elderly stage I CC patients. We recommend using model A for successful results and standardization.

A comparison of efficacies of holmium YAG laser, and pneumatic lithotripsy in the endoscopic treatment of ureteral stones

OBJECTIVE

We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones.

MATERIAL AND METHODS

A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients' files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography.

RESULTS

Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p=0.00).

CONCLUSION

Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL.

Participatory evaluation of monitoring and modeling of sustainable land management technologies in areas prone to land degradation

Examples of sustainable land management (SLM) exist throughout the world. In many cases, SLM has largely evolved through local traditional practices and incremental experimentation rather than being adopted on the basis of scientific evidence. This means that SLM technologies are often only adopted across small areas. The DESIRE (DESertIfication mitigation and REmediation of degraded land) project combined local traditional knowledge on SLM with empirical evaluation of SLM technologies. The purpose of this was to evaluate and select options for dissemination in 16 sites across 12 countries. It involved (i) an initial workshop to evaluate stakeholder priorities (reported elsewhere), (ii) field trials/empirical modeling, and then, (iii) further stakeholder evaluation workshops. This paper focuses on workshops in which stakeholders evaluated the performance of SLM technologies based on the scientific monitoring and modeling results from 15 study sites. It analyses workshop outcomes to evaluate how scientific results affected stakeholders' perceptions of local SLM technologies. It also assessed the potential of this participatory approach in facilitating wider acceptance and implementation of SLM. In several sites, stakeholder preferences for SLM technologies changed as a consequence of empirical measurements and modeling assessments of each technology. Two workshop examples are presented in depth to: (a) explore the scientific results that triggered stakeholders to change their views; and (b) discuss stakeholders' suggestions on how the adoption of SLM technologies could be up-scaled. The overall multi-stakeholder participatory approach taken is then evaluated. It is concluded that to facilitate broad-scale adoption of SLM technologies, de-contextualized, scientific generalisations must be given local context; scientific findings must be viewed alongside traditional beliefs and both scrutinized with equal rigor; and the knowledge of all kinds of experts must be recognised and considered in decision-making about SLM, whether it has been formally codified or not. The approach presented in this paper provided this opportunity and received positive feedback from stakeholders.

Paratesticular sarcomas: A report of seven cases

Primary tumors of the paratesticular region are rare, with paratesticular sarcomas constituting a major proportion of these tumors, particularly in the elderly. The paratesticular region consists of mesothelial, various epithelial and mesenchymal cells and may therefore give rise to a number of tumors with various behaviors. Defining the association between the paratesticular mass and the testicle, and differentiation between benign and malignant masses using radiology is challenging, therefore the mass is usually considered to be malignant and radical orchiectomy with high ligation is performed. The present study reports the cases of seven patients with tumors of the paratesticular region and presents the clinical and significant histological features of the tumors. In total, two patients suffered from dedifferentiated liposarcoma (DDLS), two exhibited leiomyosarcoma, two exhibited low-grade fibromyxoid sarcoma and one case of undifferentiated pleomorphic sarcoma was identified. Radical orchiectomy with high ligation was performed in five cases; simple orchiectomy was performed in one case and excisional biopsy was performed in the remaining case. A leiomyosarcomatous and epithelial membrane antigen (EMA) positive whorl pattern was observed during microscopy in the two DDLS cases. Additionally, one of the low-grade fibromyxoid sarcoma patients exhibited pleomorphism and mitosis in focal areas. To the best of our knowledge, the present study is the second time low-grade fibromyxoid sarcoma cases with paratesticular localization have been reported in the literature. Of the seven cases, four patients succumbed to the disease, one patient is living with the disorder and the two cases of DDLS are living without the disease. Paratesticular sarcomas are often aggressive and a multidisciplinary approach is required for the diagnosis and treatment of these tumors.

Hydatid cyst of the abdominal aorta and bilateral common iliac arteries. A case report

Hydatid disease, a parasitic infestation, is endemic in live-stock raising countries where the custom of feeding offal to dogs prevails. Though infestation of any part of the human body can occur, arterial involvement is a rare affliction. We report here the first case in which abdominal aorta and bilateral iliac arteries were totally occluded with intraluminal cysts.

Echocardiography and magnetic resonance imaging of sinus of Valsalva aneurysm with rupture into the ventricle

A 53 year-old man with rupture of sinus of Valsalva aneurysm into the right ventricle diagnosed by two dimensional echocardiography (2DE), magnetic resonance imaging (MRI), and catheterisation study is reported in this paper. Despite the fact that its incidence is low, early diagnosis is very important in this illness because of the possibility of complete cure with surgery. In this study it was shown that MRI as well as 2DE is an excellent diagnostic method for this illness. The diagnosis was also confirmed with surgery in this patient.

Relationship between histologic grading and serum prostate specific antigen in prostatic carcinoma

Prostate specific antigen (PSA) is the most important tumour marker which, used routinely, proved to have a positive correlation with tumour volume and pathological stage. To evaluate the relationship between serum PSA and histologic grading of prostatic carcinoma, preoperative PSA determinations were made in 25 patients with prostatic cancer. Biopsy materials were evaluated and the Gleason scores were adjusted for histologic grading. The higher values of PSA were proportional to the Gleason scores of the primary prostatic biopsy.

Congenital lobar emphysema. A case report

One infant, age 19 days, with congenital lobar emphysema whose main symptoms included dyspnea, cyanosis and severe infant Respiratory Distress Syndrome, was presented in this paper. The most reliable diagnostic tool was chest x-ray films with anteroposterior and lateral views. As additional diagnostic method, thorax computerized tomography was also used. The affected lobe was the left upper lobe. Resection of the affected lobe was performed with good results.

Thromboangiitis obliterans (Buerger's disease) in women (a reevaluation)

Thromboangiitis obliterans (TAO) is an occlusive vascular disease traditionally known to be almost exclusive to young male smokers. The disease was considered to be extremely rare in women, seen only as isolated, novel case reports in the literature. In the past decade, however, a dramatic increase in the incidence of female TAO has been observed. In this paper the authors report 7 cases of clinically and angiographically verified female TAO. The world literature in regard to the diagnostic criteria, changing incidence, and etiology is reviewed. They conclude that the increased use of tobacco among young women in the past two to three decades is responsible for this dramatic change.

Primary muscular hydatid cyst causing arterial insufficiency: case report and literature review

Hydatid disease, though known to occur in most organs and areas of the body, is extremely rare in skeletal muscle. In this article the authors present a case of a primary muscular hydatid cyst, originating from the adductor muscle group, causing obstruction of the femoral artery and vein.

Fistulous communication of aortic sinuses into the cardiac chambers. Fifteen years surgical experience and a report of 23 patients

Over the past 15 years 23 patients, aged 14-50, with aortic sinus-cardiac chamber fistulous communication have been operated upon. All were symptomatic and had angiographic evaluation before surgery. The last 5 were diagnosed by two-dimensional echocardiography. The origin of the fistula was the right aortic sinus in 22 and the non-coronary sinus in 1. The involved cardiac chamber was the right ventricle in 18, right atrium in 3 and left ventricle in 2. Associated lesions were ventricular septal defect (VSD) in 9, ventricular septal defect + atrial septal defect (VSD + ASD) in 1, ventricular septal defect + pulmonary stenosis (VSD + PS) in 1, atrial septal defect (ASD) in 3 and congenital aortic stenosis (AS) in 1. At surgery both the aorta and involved cardiac chamber were opened. No recurrence was encountered when the fistula was repaired using teflon felts on both ends. Three patients, 2 of whom had been operated upon before the use of cardioplegic arrest, died (13%).