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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]

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]

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]

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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.