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Hakki U Ozok,1 Okan Ekim,2 Hakan Saltas,3 Ata T Arikok,4 Orkun Babacan,5 Levent Sagnak,1 Hikmet Topaloglu,1 Hamit Ersoy11Department of Urology, 3Department of Microbiology, 4Department of Pathology, Diskapi Yildirim Beyazit Training and Research Hospital, Ministry of Health, Ankara, Turkey; 2Department of Anatomy, 5Department of Microbiology, Ankara University Faculty of Veterinary Medicine, Ankara, TurkeyPurpose: There is currently an emerging need for developing improved approaches for preventing urinary tract infections (UTIs) occurring during diagnostic or interventional procedures of the lower urinary tract. We aimed to establish a rat model to assess the use of transurethral antibiotic administration and to provide evidence that this could be used as a preventive therapy.Methods: Animals received fosfomycin trometamol (FOF) either urethrally or orally prior to the procedure. A third group was generated as treatment controls and did not receive any medication. Urethral dilation was conducted to recapitulate an interventional procedure prior to intravesical Escherichia coli administration in all three groups. Finally, sham-operated animals were introduced as a fourth group which did not receive antibiotics or E. coli. Colony counts of urine and tissue cultures for the identification of E. coli and histopathological examinations of the bladder and prostate were conducted.Results: Evaluation of infection intensities in cultures as well as histopathological examination of the bladder and prostate demonstrated a preventative role of transurethral FOF administration. In terms of efficiency, local administration of FOF was similar to oral administration.Conclusions: These results suggest that transurethral antibiotic administration is a promising alternative for preventing UTIs occurring during diagnostic or interventional procedures of the lower urinary tract.Keywords: cystitis, fosfomycin, infection, prostatitis, urinary tract

Failed Back Surgery Syndrome (FBSS) refers to a subset of patients who have new or persistent pain after spinal surgery for back or leg pain. Epidural fibrosis (EF) is a common cause of FBSS. Many agents aiming to prevent EF have been tested. However, hemostatic agents are readily available at hospitals, easy to reach and frequently used. For these reasons, oxidized regenerated cellulose, polysaccharide hemostat, hemostatic thrombin-gelatin matrix and chitosan linear polymer were evaluated for their effects on epidural fibrosis on rats after laminectomy. 40 Sprague–Dawley rats were randomly divided into 5 equal groups including the control group where only the laminectomy was performed. The other 4 groups received hemostatic agents after laminectomy. The rats were euthanized 45 days later and were assessed by a blinded observer to grade the fibrosis level. The study revealed that oxidized regenerated cellulose, polysaccharide hemostat and hemostatic thrombin-gelatin matrix lowered the epidural fibrosis grade which was statistically significant (p < 0.001). Although chitosan linear polymer created fibrosis similar to the control group it was not proven to be statistically significant (p = 0.8999). However, when compared with other hemostatic agents it resulted in a higher fibrosis grade (p < 0.001). The results obtained from this experimental study revealed that Pahacel, Sealfoam and Surgiflo, were effective in reducing epidural fibrosis after laminectomy in rats. [ABSTRACT FROM AUTHOR]

Sepsis is one of the most serious problems in intensive care units due to its high morbidity and mortality. Objective of the study to compare the healing effects of Activated Protein C and Tri-Iodothyronine in the late period of experimental sepsis. Twenty-four Wistar Albino male rats were divided into 4 groups, including the control group, septic group, Activated Protein C (APC), and Tri-Iodothyronine (T3) treatment groups. Leukocyte, thrombocyte, IL-1, IL-6, TNF-a, and antithrombin-III levels were investigated. Histopathological evaluation was performed by taking the liver, lung and intestinal tissue samples. The APC and T3 replacement groups were compared with the septic rat group, and it was observed that they preserved thrombocyte levels and antithrombin III levels, suppressed interleukin levels, and limited the effects of inflammatory responses in the liver, intestine and lung tissue. Leukocyte levels were found to be significantly higher in the T3 replacement group than in the septic group, while there was no significant difference between the APC group and the septic group. Our study showed that both activated protein C and Tri-iodothyronine can be effective in the host's response to infection in the late period of sepsis, alone and in a single dose. [ABSTRACT FROM AUTHOR]

Background: According to sick lobe theory, one or more lobes of the breast are more prone to the development of carcinoma. However, the implications of this theory in breast magnetic resonance imaging (MRI) are unknown. Purpose: To evaluate the MRI appearance of mass type (multifocal and multicentric diseases) and non-mass type (nonmass enhancements) sick lobe patterns, together with the histopathology results. Material and Methods: MRI reports of 2015 patients in two tertiary breast imaging centers between June 2012 and June 2018 were retrospectively reviewed for multifocal-multicentric diseases and segmental, linear, and regional enhancements. A total of 113 patients were included. The specimens obtained by thick needle, vacuum, excisional biopsy/lumpectomy or mastectomy after breast MRI scans were pathologically assessed. The pathologic results were categorized as invasive carcinoma, precursor, and benign proliferative lesions according to the 2012 World Health Organization Classification of Tumors. Results: The percentage of underlying benign and precursor invasive lesions was significantly different in patients with mass and non-mass MRI patterns. While the pathology results of mass type patterns were premalignant and malignant in all cases, nearly half of the underlying histologies were benign proliferative subtypes in patients with non-mass type patterns. Conclusion: In this study, the mass and non-mass patterns derived from sick lobe theory were related to different risks of malignancy in the pathological examinations. [ABSTRACT FROM AUTHOR]

Introduction: Tetracosactide is an engineered peptide that applies the same biological impacts as the endogenous adrenocorticotropic hormone. Previous studies indicated that tetracosactide has anti-inflammatory, antioxidant and neurotrophic activity. In this study, we hypothesized that tetracosactide may have protective effects in spinal cord ischemia-reperfusion injury.Material and Methods: Rabbits were randomized into the accompanying four groups of eight animals each: group 1 (control), group 2 (ischemia), group 3 (methylprednisolone) and group 4 (tetracosactide). In the control group, just a laparotomy was performed. In the various groups, the spinal cord ischemia model was made by the impediment of the aorta only caudal to the renal vein. Neurological assessment was conducted with the Tarlov scoring system. Levels of myeloperoxidase, malondialdehyde and catalase were analyzed, similar to the activities of xanthine oxidase and caspase-3. Histopathological and ultrastructural assessments were additionally performed.Results: After ischemia-reperfusion injury, increments were found in the tissue myeloperoxidase levels (p < 0.001), malondialdehyde levels (p < 0.001), xanthine oxidase action (p < 0.001) and caspase-3 movement (p < 0.001). Conversely, both serum and tissue catalase levels were diminished (p < 0.001 for both). After the administration of tetracosactide, declines were seen in the tissue myeloperoxidase levels (p < 0.001), malondialdehyde levels (p = 0.003), xanthine oxidase action (p < 0.001) and caspase-3 movement (p < 0.001). Conversely, both the serum and tissue catalase levels were expanded (p < 0.001). Besides, tetracosactide treatment indicated enhanced results related to the histopathological scores (p < 0.001), the ultra-structural score (p = 0.008) and the Tarlov scores (p < 0.001).Conclusions: The findings showed for the first time that tetracosactide shows significant neuroprotective activity against ischemia-reperfusion injury of the spinal cord. [ABSTRACT FROM AUTHOR]

Context:Pterygium is the fibrovascular growth of the limbal conjunctiva over cornea. This proliferative nature might have a pathogenesis associated with tight junction proteins. Objective: To investigate the tight junction protein claudin-1 expressions in pterygium with respect to normal conjunctiva. Materials and methods: This retrospective study included 28 patients who underwent pterygium surgery with autograft. Claudin-1 expressions were immunohistochemically evaluated in normal and lesional conjunctiva of the same eye. Immunohistochemical evaluation was done with regard of both the intensity and the extent of staining. The distribution of the immunohistochemical scores in pterygium and normal conjunctiva has been compared with using McNemar test. Results: The mean age of the patients was 52.2 ± 11.2 years and male/female ratio was 8/20. Among 28 samples of normal conjunctiva 25 (89.2%) demonstrated a strong immunohistochemical expression with claudin-1 whereas this rate was 10.8% for pterygium samples. Statistical analysis revealed a significant decrease in claudin-1 expressions in pterygium with respect to normal conjunctiva (p < 0.001). Discussion and conclusions: The loss of claudin-1 appears to be involved in the pathogenesis of pterygium and the future studies will elucidate the exact role of tight junction proteins in the invasive and recurrent nature of pterygium. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we tried to determine whether darbepoetin-α would protect the brain from oxidative stress and apoptosis in a rat traumatic brain injury model.Material and Methods: The animals were randomized into four groups; group 1 (sham), group 2 (trauma), group 3 (darbepoetin α), group 4 (methylprednisolone). In the sham group only the skin incision was performed. In all the other groups, a moderate traumatic brain injury modelwas applied.Results: Following trauma both glutathione peroxidase, superoxide dismutase levels decreased (p < 0.001 for both); darbepoetin-α increased the activity of both antioxidant enzymes (p = 0.001 and p < 0.001 respectively). Trauma caused significant elevation in the nitric oxide synthetase and xanthine oxidase levels (p < 0.001 for both). Administration of darbepoetin-α significantly decreased the levels of nitric oxide synthetase and xanthine oxidase (p < 0.001 for both). Also, trauma caused significant elevation in the nitric oxide levels (p < 0.001); darbepoetin-α administration caused statistically significant reduction in the nitric oxide levels (p < 0.001). On the other hand, malondialdehyde levels were increased following trauma (p < 0.001), and darbepoetin α significantly reduced the malondialdehyde levels (p < 0.001). Due to the elevated apoptotic activity following the injury, caspase-3 activity increased significantly. Darbepoetin-α treatment significantly inhibited apoptosis by lowering the caspase-3 activity (p < 0.001). In the darbepoetin group, histopathological score was lower than the trauma group (p = 0.016).Conclusions: In this study, darbepoetin-α was shown to be at least as effective as methylprednisolone in protecting brain from oxidative stress, lipid peroxidation and apoptosis. [ABSTRACT FROM AUTHOR]

Background: Tumor necrosis factor-α is the key inflammatory cytokine in psoriasis vulgaris triggering abnormal differentiation and proliferation of keratinocytes. Etanercept as an antitumor necrosis factor-α agent is widely used for the treatment of psoriasis vulgaris. Objectives: To find out whether etanercept has an apoptotic effect on psoriatic keratinocytes. Methods: Biopsies from 13 untreated chronic plaque psoriasis patients and 10 control subjects were examined in the study. Immunohistochemical staining for Ki-67 and the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick-end labeling (TUNEL) method for the detection of apoptosis were performed. Ki-67 and TUNEL indices were calculated. Results: The mean Ki-67 index of patients before treatment (34.20 ± 10.30) was significantly higher than that of the control subjects (8.30 ± 2.20) and of the treated patients (9.50 ± 2.50); however, it did not differ between the treated patients and control subjects ( p < 0.001, p = 0.001 and p = 0.208, respectively). Although the mean TUNEL index of patients before treatment (0.23 ± 0.44) was significantly lower than the controls (1.1 ± 0.99), it did not significantly differ after etanercept therapy (0.46 ± 0.66) ( p = 0.030 and p = 0.083, respectively). The mean TUNEL indices of treated patients and control subjects were not different ( p = 0.131). Conclusion: Etanercept decreased epidermal thickness successfully without inducing apoptosis of psoriatic keratinocytes. [ABSTRACT FROM AUTHOR]

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Some skin lesions may accompany malignancies. Acanthosis nigricans, one such lesion, is a paraneoplastic dermatosis characterized by hyperpigmented and velvety verrucose plaques observed as symetric eruptions. With this report, we aim to present a rare case of concomitant lung cancer and acanthosis nigricans. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. A 65-year-old patient who had hyperpigmented, hypertrophic and symmetric verrucose lesions at the flexor surfaces of the lower and upper extremities, face, palms and the axillary region. Thoracic computed tomography demonstrated a hypodense mass lesion with a dimension of 5×5.5 cm at the center of basal segment bronchi of the left pulmonary lobe. Fiberoptic bronchoscopy showed that the access to the lower left lobe was almost completely obstructed by the endobronchial lesion. The result of the histopathologic examination of the endobronchial tissue biopsy was reported as non-small cell (adenocarcinoma) lung cancer. Result of the histopathologic analysis of the punch biopsy of the skin lesions was reported as acanthosis nigricans .There are no pathognomonic dermatological findings for lung cancer. In conclusion, there are skin lesions that accompany lung cancer and we believe that these should be considered for differential diagnosis.

Sepsis is one of the most serious problems in intensive care units due to its high morbidity and mortality. Objective of the study to compare the healing effects of Activated Protein C and Tri-Iodothyronine in the late period of experimental sepsis. Twenty-four Wistar Albino male rats were divided into 4 groups, including the control group, septic group, Activated Protein C (APC), and Tri-Iodothyronine (T3) treatment groups. Leukocyte, thrombocyte, IL-1, IL-6, TNF-α, and antithrombin-III levels were investigated. Histopathological evaluation was performed by taking the liver, lung and intestinal tissue samples. The APC and T3 replacement groups were compared with the septic rat group, and it was observed that they preserved thrombocyte levels and antithrombin III levels, suppressed interleukin levels, and limited the effects of inflammatory responses in the liver, intestine and lung tissue. Leukocyte levels were found to be significantly higher in the T3 replacement group than in the septic group, while there was no significant difference between the APC group and the septic group. Our study showed that both activated protein C and Tri-iodothyronine can be effective in the host's response to infection in the late period of sepsis, alone and in a single dose. [Med-Science 2022; 11(1.000): 259-66]

Necrotizing fasciitis (NF) is an aggressive, necrotic, life-threatening infection of the soft tissues. The delay on treatment is generally accompanied by almost 90 % lethality according to the development of septic shock and its associated complications. Primary Necrotizing Fasciitis of the Breast (PNFB) is seen extremely rare. To date, breast necrotizing fasciitis have been reported only as a limited number of case reports in the literature. PNFB is commonly misdiagnosed as cellulitis, mastitis, abscess or inflammatory breast cancer. Although PNFB is a very rapid and aggressive disease, which can be fatal. Delayed cases were unfortunately resulted in mortality due to several consequential reasons. Therefore, careful and detailed evaluation of all cases irrespective of age, especially those with risk factors and comorbidities, could be life saving in respect of early diagnosis and timely treatment. Our aim is to to present the analysis and treatment modalities of five primarily seen PFNB, in this case series. [ABSTRACT FROM AUTHOR]

Schwannomas are well capsulated, benign, and slowly growing tumors which originate from Schwann cells of peripheral nerve sheath. The incidence of schwannomas in the axillary region is not common. This rarity causes misdiagnosis at the radiological evaluation. In this case we present the imaging and histopathological findings of a cystic schwannoma located in the axillary fossa of a 47-year-old female patient mimicking complex cyst, lymphadenopathy or hydatid cyst in radiological evaluation. Although lymphadenopathy, lymphatic malformation, lipoma, cyst, hidradenitis suppurativa or dermato?broma are the most frequent lesions to be considered, peripheral nerve sheath should also be kept in mind in the differential diagnosis of axillary masses. [ABSTRACT FROM AUTHOR]

Summary: Objective: It is aimed to define the existence of pseudocapsular structure on renal tumours, illuminate the relation between pseudocapsular invasion and Fuhrman grade histological type that are among histopathologic prognostic risk factors and determine the relation between surgical margin positivity and existence of pseudocapsular invasion. Sequential partial nephrectomy series and relevant pathological preparations were retrospectively reviewed in order to evaluate these issues. Methods: The study includes 123 patients diagnosed with T1 renal tumour and treated with partial nephrectomy in between January 2007 and June 2016. Benign angiomyolipoma was excluded due to complete non-existence of pseudocapsule. 99 T1 patients diagnosed with renal cell cancer whose pathological slides can be duly analysed were included in the study. Clinical and pathological details were evaluated for all patients. Existence of pseudocapsule was revealed for all patients. Pseudocapsule invasion was classified by existence of expansive and infiltrative type and non-existence of pseudocapsule invasion. The groups have been assessed by their histopathologic characteristics. Results: Compared to the group in which pseudocapsular invasion was not detected, clear-cell histological subtype was observed more frequently in a statistically significant way in the group with expansive pseudocapsular invasion and infiltrative pseudocapsular invasion respectively (p = 0.017 and p

Aim: To investigate the effects of cerebrolysin on inflammation, oxidative stress, apoptosis, and neurologic recovery in the setting of an experimental rabbit model of spinal cord ischemia/reperfusion injury (SCIRI)., Material and Methods: Rabbits were randomly divided into five groups: control, ischemia, vehicle, methylprednisolone (30 mg/kg), and cerebrolysin (5 ml/kg) group. The rabbits in the control group underwent only laparotomy; the other groups underwent spinal cord ischemia and reperfusion injury for 20 minutes. Neurologic examination after 24 hours was based on the Modified Tarlov scale. Myeloperoxidase activities, catalase and malondialdehyde levels, and caspase-3 concentrations were determined in serum and tissue samples. Serum xanthine oxidase levels were studied and histopathological and ultrastructural changes were examined., Results: After SCIRI, serum and tissue myeloperoxidase activities, malondialdehyde levels, caspase-3 concentrations, and serum xanthine oxidase activities were increased (p < 0.01?0.001). Catalase levels were significantly diminished (p < 0.001). Cerebrolysin treatment correlated with reduced myeloperoxidase and xanthine oxidase activities, malondialdehyde levels and caspase-3 concentrations; and with increased catalase levels (p < 0.001, for all). The cerebrolysin group showed improved histopathological, ultrastructural, and neurological outcomes., Conclusion: For the first time in the literature, the current study reports anti-inflammatory, antioxidant, antiapoptotic, and neuroprotective effects of cerebrolysin in a SCIRI rabbit model.

Aim: To investigate the effects of an anti-ischemic agent, mildronate, on subarachnoid hemorrhage-induced vasospasm., Material and Methods: Rabbits were randomly divided into four groups: control, subarachnoid hemorrhage (SAH), vehicle, and mildronate (n=8 animals per group). In the treatment group, 200 mg/kg of mildronate were intraperitoneally administered 5 minutes after the procedure and continued for 3 days as daily administrations of the same dose. At the end of the third day, the cerebrum, cerebellum, and brain stem were perfused, fixated, and removed for histopathological examination. Tissues were examined for arterial wall thickness, luminal area, and hippocampal neuronal degeneration., Results: Mildronate group showed significantly increased luminal area and reduced wall thickness of the basilar artery compared with the subarachnoid hemorrhage group. In addition, the hippocampal cell degeneration score was significantly lower in the mildronate group than in the SAH and vehicle groups., Conclusion: These results show that mildronate exerts protective effects against SAH-induced vasospasm and secondary neural injury.

Introduction: Tetracosactide is an engineered peptide that applies the same biological impacts as the endogenous adrenocorticotropic hormone. Previous studies indicated that tetracosactide has anti-inflammatory, antioxidant and neurotrophic activity. In this study, we hypothesized that tetracosactide may have protective effects in spinal cord ischemia-reperfusion injury., Material and Methods: Rabbits were randomized into the accompanying four groups of eight animals each: group 1 (control), group 2 (ischemia), group 3 (methylprednisolone) and group 4 (tetracosactide). In the control group, just a laparotomy was performed. In the various groups, the spinal cord ischemia model was made by the impediment of the aorta only caudal to the renal vein. Neurological assessment was conducted with the Tarlov scoring system. Levels of myeloperoxidase, malondialdehyde and catalase were analyzed, similar to the activities of xanthine oxidase and caspase-3. Histopathological and ultrastructural assessments were additionally performed., Results: After ischemia-reperfusion injury, increments were found in the tissue myeloperoxidase levels ( p < 0.001), malondialdehyde levels ( p < 0.001), xanthine oxidase action ( p < 0.001) and caspase-3 movement ( p < 0.001). Conversely, both serum and tissue catalase levels were diminished ( p < 0.001 for both). After the administration of tetracosactide, declines were seen in the tissue myeloperoxidase levels ( p < 0.001), malondialdehyde levels ( p = 0.003), xanthine oxidase action ( p < 0.001) and caspase-3 movement ( p < 0.001). Conversely, both the serum and tissue catalase levels were expanded ( p < 0.001). Besides, tetracosactide treatment indicated enhanced results related to the histopathological scores ( p < 0.001), the ultra-structural score ( p = 0.008) and the Tarlov scores ( p < 0.001)., Conclusions: The findings showed for the first time that tetracosactide shows significant neuroprotective activity against ischemia-reperfusion injury of the spinal cord.

Castleman disease is a rare disorder characterized by benign lymph node hyperplasia involving lymphatic tissue in the neck, mediastinum, abdomen and other areas. Disease was described for the first time in 1956 by Castleman. The etiopathogenesis of the disease is unknown. The disorder can be classified into three histopathological types: hyalin-vascular, plasma-cell and mixed. We report three cases of the Castleman's disease (hyaline-vascular type) in three female patients with unilateral swelling of the neck. None of the patients developed any local or distant recurrence in postoperative follow-up.