Cytomegalovirus-induced pathology in human temporal bones with congenital and acquired infection

OBJECTIVE

Publications on histopathology of human temporal bones with cytomegalovirus (CMV) infection are limited. We aim to determine histopathology of the inner ears and the middle ears in human temporal bones with congenital and acquired CMV infections.

METHODS

Temporal bones from 2 infants with congenital and 2 adults with acquired CMV infection were evaluated by light microscopy.

RESULTS

Two infants with congenital CMV infection showed striking pathological changes in the inner ear. There was a hypervascularization of the stria vascularis in the cochlea of the first infant, but no obvious loss of outer and inner hair cells was seen in the organ of Corti. However, cytomegalic cells and a loss of outer hair cells were found in the cochlea of the second infant. The vestibular organs of both infants showed cytomegalic cells, mostly located on dark cells. There was a loss of type I and type II hair cells in the macula of the saccule and utricle. Loss of hair cells and degeneration of nerve fibers was also seen in the semicircular canals. Both infants with congenital infection showed abundant inflammatory cells and fibrous structures in the middle ear cavity. No evidence of cytomegalic cells and hair cell loss was found in the cochlea or vestibular labyrinth in acquired CMV infection.

CONCLUSIONS

In two infants with congenital CMV infection, the cochlea, vestibule, and middle ear were highly affected. Temporal bones of adult donors with acquired viral infection showed histological findings similar to donors of the same age without ear disease.

Cochleosaccular (Scheibe) dysplasia in dogs: A temporal bone study

The objective of this study was to evaluate any otopathologic changes in temporal bone specimens from dogs with deafness related to cochleosaccular (Scheibe) dysplasia (CSD). We used the canine temporal bone collections of the Otopathology Laboratory at the University of Minnesota and of the Massachusetts Eye and Ear Infirmary at Harvard University in Boston. Our morphometric analysis included measuring the areas of the stria vascularis and the spiral ligament and counting the number of spiral ganglion cells. In addition, we noted the presence of the organ of Corti and cochlear hair cells, assessed the location of Reissner's membrane and the saccular membrane, and counted the number of both Type I and Type II vestibular hair cells in the macule of the saccule and vestibular ganglion cells. In the group of specimens from dogs with cochleosaccular dysplasia, we observed generalized degeneration in the cochlea and a significantly decreased number of Type I and Type II vestibular hair cells and vestibular ganglion cells. As hereditary deafness is presently untreatable with known therapeutic methods, dogs with cochleosaccular dysplasia should not be considered for breeding. Future therapeutic approaches, such as stem cell therapies, should be designed to target all the elements of the cochlea in addition to the saccule as it was found that both are affected in dogs with CSD.

Quantitative assessment of vestibular otopathology in granulomatosis with polyangitis: A temporal bone study

Objective

To investigate the temporal bone histopathology of vasculitis, especially in the vestibular organs, in granulomatosis with polyangitis (GPA).

Methods

Using light and differential interference contrast microscopy, we examined 12 human temporal bones from six deceased GPA patients and 12 histopathologically normal human temporal bones from six deceased age‐matched patients.

Results

In the GPA group, three patients had undergone tympanostomy tube placement. Two of them had suffered mixed hearing loss; one, sensorineural hearing loss; and one, conductive hearing loss. Of the 12 specimens in the GPA group, the granulation tissue invaded the round window niche in seven; cochlear hair cells were not preserved in five. Hemosiderin was deposited in the stria vascularis in eight specimens, in the ampulla or semicircular duct in 10, and in the vestibule in three. The spiral ligament showed severe loss of cellularity in two specimens. In the GPA group, type I vestibular hair cell density was significantly decreased; however, type II vestibular hair cell density did not significantly differ between the GPA group and the control group.

Conclusion

Our histopathologic findings in human temporal bone specimens of GPA patients delineated changes in the tympanic membrane, middle ear cavity, round window membrane, organ of Corti, stria vascularis, spiral ligament, ampulla, semicircular duct, and vestibule. Type I vestibular hair cell density significantly decreased in the GPA group, as compared with the control group.

Level of Evidence

N/A

Secondary Endolymphatic Hydrops

HYPOTHESIS

A review of the most recent literature will provide clinicians with an update of secondary endolymphatic hydrops, aiding in diagnosis and treatment of affected patients.

BACKGROUND

Secondary endolymphatic hydrops is a pathologic finding of the inner ear resulting in episodic vertigo and intermittent hearing loss. It is a finding for which extensive research is being performed.

METHODS

A review of the most recent literature on secondary endolymphatic hydrops was performed using PubMed literature search.

RESULTS

Recent investigation of secondary endolymphatic hydrops has brought attention to traumatic and inflammatory insults as causes for secondary endolymphatic hydrops. Such etiologies, including postsurgical effects of cochlear implantation and endolymphatic sac ablation; otosclerosis and its operative intervention(s); acoustic and mechanical trauma; medications; and systemic inflammatory processes, have been determined as causes of secondary lymphatic hydrops. Histopathological slides for many of the etiologies of secondary endolymphatic hydrops are presented.

CONCLUSION

Through an understanding of the pathophysiology and etiologies of secondary endolymphatic hydrops, clinicians will gain a better understanding of this complex disease process, which will aid in treatment of patients with this disease process.

The evaluation of hormonal and psychological parameters that affect bone mineral density in postmenopausal women

OBJECTIVE

In this study we aimed to investigate the relationships between serum levels of DHEAS, reproductive hormones and low bone mineral density (BMD) in postmenopausal women. We also examined the relationship between psychological status of patients and their BMD results.

PATIENTS AND METHODS

This study included postmenopausal female patients. BMD measurements were performed with dual-energy X-ray absorptiometry (DEXA). Psychological assessments of all cases were performed using the Hamilton Anxiety and Hamilton Depression scales. All patients provided fasting venous blood samples in order to determine serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and DHEAS.

RESULTS

There were 33 cases (45.2%) with normal BMD levels and 40 cases (54.8%) with abnormal BMD levels (osteopenia and osteoporosis). DHEAS levels did not show any statistically significant difference according to BMD results (p = 0.431). The Hamilton Anxiety and Depression scores also did not show statistically significant differences in accordance with the BMD results (p = 0.889 and p = 0.706, respectively).

CONCLUSIONS

According to our results, anxiety, depression and circulating DHEAS levels are not significantly associated with low levels of BMD, particularly at osteopenic levels. So these parameters are not useful for clinical practice in patients with low BMD in the middle-aged postmenopausal women.

A histochemical study of ultraviolet B irradiation and Origanum hypericifolium oil applied to the skin of mice

Ultraviolet (UV) rays cause skin damage. Chronic exposure to UV irradiation causes decreased collagen synthesis, degenerative changes in collagen bundles, accumulation of elastotic material and increased epidermal thickness. Origanum hypericifolium, an endemic Turkish plant, belongs to Lamiaceae family. The main constituents of its oil are monoterpenes including cymene, carvacrol, thymol and γ-terpinene. The effects of undiluted O. hypericifolium oil on UVB irradiated skin of mice were investigated histochemically. Four groups of female BALB/c mice, whose dorsal hair was shaved, were allocated as follows: non-UVB irradiated (Group 1), UVB-irradiated (Group 2), O. hypericifolium oil treated (Group 3), and O. hypericifolium oil treated and UVB irradiated (Group 4). Sections of dorsal skin samples were stained with Mallory's phosphotungstic acid hematoxylin for collagen fibers and Taenzer-Unna orcein for elastic fibers. Sections also were stained with hematoxylin and eosin to measure epidermal thickness. We observed intense staining of collagen and homogeneous, scattered thin elastic fibers in Group 1; scattered and weakly stained collagen and curled, amorphous, accumulate elastic fibers in Group 2; and intense staining of collagen in Groups 3 and 4. Accumulation of elastic fibers in the dermis was unremarkable in Groups 3 and 4. In Groups 3 and 4, O. hypericifolium oil treatment thickened the epidermis. Epidermal thickness was greatest in Group 4. We suggest that O. hypericifolium oil may block UVB induced alterations of collagen and elastic fibers, and increase epidermal thickness.

An objective method to determinme corneal changes during menopause

OBJECTIVE

We hypothesized that menopause has a measurable effect on corneal thickness. The aim of this study was to evaluate central corneal thickness (CCT) differences between women in the premenopausal and postmenopausal period.

METHODS

A prospective, case-control, single-blind study was designed. Two groups were included: Group I (premenopausal period) and Group II (postmenopausal period). Forty women were recruited in each group. The correlation between CCT with age, estradiol (E2) and follicle stimulating hormone (FSH) levels were evaluated.

RESULTS

CCT was significantly decreased in postmenopausal women compared to premenopausal women (521.18 +/- 37.97 microm 561 +/- 42.84 microm, respectively, p < 0.005). Similarly, there was a linear correlation between CCT and serum E2 levels of patients overall (p < 0.01).

CONCLUSION

The data presented in this study suggest that menopause causes corneal changes, which may be documented by central corneal thickness measurement.

Malignant germ cell tumors of the ovary: a review of 41 cases and risk factors for recurrence

OBJECTIVE

To review the outcome of treatment in patients with malignant ovarian germ cell tumors and to define the risk factors for recurrence.

MATERIAL AND METHODS

Forty-one patients with malignant ovarian germ cell tumors were reviewed retrospectively. Survival time and survival rate were obtained. Risk factors such as stage, histological type, and type of operation were evaluated for reccurrence.

RESULTS

Twenty-three (56%) had dysgerminomas, eight (19.5%) had mixed germ cell tumors, three (7.3%) had yolk sac tumors, three (7.3%) had immature teratomas, two (4.8%) had squamous cell carcinoma arising from a mature teratoma, one (2.4%) had embryonal carcinoma and one choriocarcinoma. Most of the cases (73%) were in Stage I. Twenty-nine patients (70.7%) underwent conservative surgery and 12 patients (29.3%) had at least bilateral salpingo-oophorectomy. Thirty patients were operated on optimally with surgical staging and 11 suboptimally. Seven patients (17%) had recurrence after remission. The overall survival time was 187 +/- 8.43 months for all cases, 195 +/- 8.49 for dysgerminoma and 161 +/- 10.96 for non-dysgerminoma cases with a median follow-up time of 98.52 (8-204) months. Non-dysgerminoma histologic type, being operated on suboptimally and radically, and advanced tumor stage have been found to be risk factors for recurrence.

CONCLUSION

Regardless of histologic types and stages the prognosis of germ cell tumors are satisfactory with current therapeutic strategies.

Invasive squamous carcinoma of the vulva in women aged less than 40 years: report of two cases and a third case diagnosed during pregnancy

PURPOSE OF INVESTIGATION

Invasive squamous cell cancer of the vulva (ISCC) is a rare disease in young patients and in pregnant women. The purpose of this paper was to investigate this type of cancer in women less than 40 years old and to present three cases, one which was diagnosed in the third trimester of pregnancy.

METHODS

Three cases of invasive squamous cell cancer in women under age 40 among the retrospectively analyzed 52 vulvar cancer cases diagnosed between 1995-2002 were investigated.

RESULTS

Women aged 25, 39 and 31, respectively, had Stage 1, 2 and 3 ISCC of the vulva. The first two cases had been spared by surgery and radiotherapy. The third patient was diagnosed during the last trimester of pregnancy. Although she was treated by radical surgery and postoperative radiotherapy, she had a recurrence in the inguinal region at 36 months, and died of disease 12 months later.

CONCLUSION

Vulvar ISCC in young women may occur in association with or without predisposing factors. Although HPV-related type is predominant in the literature, keratinizing type of carcinoma may also be seen in this group of patients. Biopsy from suspected lesions is of paramount importance.

Analysis of vaginal recurrences in stage I endometrial adenocarcinoma

OBJECTIVE

To determine the risk of vaginal recurrence in Stage 1 endometrial cancer and treatment morbidity associated with different therapeutic approaches

MATERIAL AND METHODS

Between 1995 and 2005, 341 patients with clinical Stage I endometrial cancer were treated at Istanbul Medical Faculty. One hundred and forty-four women were included in this study as the follow-ups and records were complete. The patients with no myometrial invasion received no further therapy following hysterectomy. When there was superficial myometrial invasion postoperative vaginal vault radiation was used, and if deep myometrial invasion was present, external pelvic radiation was given.

RESULTS

Overall 5-year survival rate for all patients with Stage I disease was 80%. Nine patients (6.25%) developed recurrent disease, three of whom had vaginal recurrences. All three vaginal recurrences were small and diagnosed at routine follow-up exam within 51 months of primary therapy.

CONCLUSION

This selective treatment protocol for patients with Stage I endometrial cancer avoided radiation entirely in 38% of the patients while achieving a very low rate of vaginal recurrence and good overall survival.

Antibacterial activity and chemical composition of Turkish propolis

The antibacterial activities of propolis samples have been examined in vitro, according to the principles accepted for the determination of a similar activity of antibiotics with the use of solid and liquid media. It has been found that propolis extracts showed antibacterial activity through a range of commonly encountered gram positive cocci (S. aureus, beta hem. Streptococus), but had weak activity against gram negative bacteria (E. coli, P. aeruginosa). GC/MS analysis showed that propolis samples contain a variety of chemical compounds including aromatic compounds, fatty acid esters and sesquiterpenes.

A survey of Nosema apis of honey bees (Apis mellifera L.) producing the famous Anzer honey in Turkey

The aim of this study is to find out the ratio of Nosema infected honey bees which are producing the famous Anzer honey that is used for the cure of the illnesses such as farangitis, tonsilitis, ulceration, and scratchs due to the experiences of the people living in Turkey. Honey bee samples were collected from two different regions of Anzer plain in July. Honey bee abdomens were homogenized and 1 ml distilled water was added for each honey bee. Later, 0.1 ml out of this solution was examined by Neubauer slides and the number of Nosema apis spores were counted. The results showed that Nosema apis significantly infected the honey bees although it was summer season. However, the summer season at the Anzer plain, when compared with the Mediterranean climate, is considered to be spring.

Developmental temperature effects on five geographic isolates of the entomopathogenic nematode Steinernema feltiae (Nematoda: Steinernematidae)

The development of five geographic isolates of Steinernema feltiae at 5, 8, 10, 15, 20, 25, and 28 degrees C in wax moth, Galleria mellonella, larvae was examined. The isolates were from Mediterranean (Sinop from Turkey, SN from France, and Monterey from California), subtropical (Rafaela from Argentina), and tropical (MG-14 from Hawaii) regions. All isolates caused 100% mortality of wax moth larvae and developed and produced progeny between 8 and 25 degrees C. At 28 degrees C, mortality was 100%, but no progeny was observed. The highest infective juvenile production was observed at 15 degrees C for all isolates. In general, the tropical isolate, MG-14, had the lowest production of infective juveniles. The time of emergence of the infective juveniles from the host cadaver showed some differences among isolates, with the Sinop isolate having the earliest emergence time from cadavers at 15 degrees C (10 days) and 20 degrees C (8 days). At 25 degrees C, the infective juveniles of the Sinop, SN, and Rafaela isolates emerged from the cadavers from 5 to 7 days. Time of host death by all isolates showed no differences at 8, 10, 15, 20, and 28 degrees C. At 25 degrees C for all isolates (except the MG-14), shorter times to host death were observed. Host death occurred at 12 days at 8 degrees C, 9 to 11 days at 10 degrees C, 4 to 5 days at 15 degrees C, 3 days at 20 degrees C, and 2 days at 25 and 28 degrees C. For penetration efficiency, the Sinop, SN, and Rafaela isolates penetrated their hosts at 5, 8, and 10 degrees C. Penetration of the infective juveniles was consistently high for all isolates at 15, 20, 25, and 28 degrees C, but it was significantly lower for the MG-14 isolate at 15, 25, and 28 degrees C. No progeny production occurred at 28 degrees C, but nematode penetration did occur with the MG-14 isolate having significantly lower penetration than the other isolates. When nematodes were produced at 8, 15, and 23 degrees C in wax moth larvae, all isolates had infective juveniles with longer body lengths at 8 degrees C followed by 15 and 23 degrees C. To further verify body length at the different temperatures, beet armyworm, Spodoptera exigua, larvae and dog-food agar medium were used, respectively, for in vivo and in vitro culture of the Sinop isolate. Infective juvenile body length showed the same trends, with the longest being at 8 degrees C and decreasing in length from 15 to 23 degrees C. The data suggest that quality of food for the nematode and temperature (that is, developmental time) influence the body length of the infective juvenile.

A trial of reducing adhesion formation in a uterine horn model

For the prevention of postoperative adhesion formation, one of the most common causes of infertility, none of the adjuvants had been proven uniformly effective. In this study we evaluated the effectiveness of sodium carboxymethylcellulose (SCMC) and disodium cromoglycate (DSCG) in postoperative adhesion prevention in a rat uterine horn model. Thirty female Sprague-Dawley rats were used. After uterine horn abrasion, in 10 rats 10 ml 0.9% saline, in 10 rats 10 ml of 2% SCMC, and in 10 rats 10 ml DSCG were administered intraperitoneally. Two weeks later, all animals were sacrificed and adhesion formation was assessed. All the pieces of the peritoneum biopsies were stained with Luna's mast cell stain to assess the mast cell degranulation. The mean adhesion scores were 2.1, 2.0 and 1.5 for saline, SCMC and DSCG groups respectively. There were no significant differences among all groups. In the pathologic examination, mast cell degranulation was less in the DSCG group than the other groups.

Arachidonic acid metabolites and colchicine in Behçet's disease (BD)

Vasculitis is accepted to be the basis of Behçet's disease (BD) which is a multisystem disease, and the arachidonic acid(AA) metabolites acting as balancing mediators in the organism are accepted to be responsible for the vasculitis. In this study, we examined the prostaglandin E2 (PGE2) and leukotriene C4 (LTC4) levels of the patients with BD before and after colchicine therapy. We found a statistical decrease in the PGE2 and LTC4 levels after colchicine therapy compared to the previous levels, concluding that colchicine inhibits the inflammation and the polymorphonuclear leukocyte (PML) chemotaxis by inhibiting the cyclooxygenase and lipoxygenase pathways.

[Staphylococcus aureus infection in Apis mellifera L. (honeybees)]

The causative agent of American foulbrood is Bacillus larvae, the causes of the European foulbrood diseases are Streptococcus pluton and Bacillus alvei and the causes of the septicemia are Pseudomonas apiseptica and Escherichia coli in honeybees (Apis mellifera). Apart from the above causative agents in this study, Staphylococcus aureus has been isolated and identified from honeybees (Apis mellifera).

[Microorganisms as potential source of fats]

The production of fat and fatty acids from microorganisms have come up as a problem recently. Since, the fat originated from plants and animals in living world is not enough for the increasing world population. The most important problem was to select the true microorganisms for microbial fat production. Although the fact that bacteria grow fast but due to having small cellular mass production they were not chosen for this purpose, instead, various subspecies of yeast such as Candida, Rhodotorula were studied. These subspecies were generally grown up fast, having a highest cellular mass and giving a mixture of homogeneous fermentation liquor and collected easily by centrifugation.

Atypical mycobacteria in the Niagara Peninsula

From 1960 to 1965, 44,629 cultures were performed on persons attending chest clinics in the Niagara Peninsula.Tubercle bacilli were cultured from 965 biological specimens (2.16%) and atypical mycobacteria from 281 specimens (0.62%).Twelve subjects had more than one variety of atypical mycobacterium in their secretions, suggesting the occurrence of mutation. The administration of antituberculous drugs may have contributed to the emergence of atypical mycobacteria in some instances, but 41 patients had never received antituberculous drugs.Of 113 persons from whom atypical mycobacteria were cultured only two had lung infection primarily due to the atypical mycobacterium isolated.