Evaluation of microsatellite instability in colorectal adenomas and carcinomas by immunohistochemistry and a comparison of histopathological features

Objective: Approximately 15% of sporadic colorectal carcinomas (CRCs) develop along the microsatellite instability (MSI) pathway. In this study, we compared the MLH1, MSH2, Ki-67, and p53 immunostaining properties with histopathological features of colorectal adenomas and CRCs. Methods: A total of 102 cases were selected, including 50 adenomatous polyps, 25 adenocarcinomas, 10 adenocarcinomas with mucinous component, 14 mucinous adenocarcinomas, and three signet-ring cell carcinomas. The tissues were stained for MLH1, MSH2, p53, and Ki-67 primary antibodies. Results: Negative staining was observed for MLH1 in 25% and MSH2 in 3.8% of all CRC cases. Compared with adenocarcinoma not otherwise specified (NOS), mucinous adenocarcinomas showed weaker staining for MLH1, which was statistically significant. There was also a statistically significant difference between adenocarcinoma NOS and signet-ring cell carcinomas in terms of negative staining for MLH1. A total of 69.2% of the MLH1-negative cases were high-grade. There was a statistically significant relationship between the histological grade and MLH1 negativity. A positive correlation was found between the grade of dysplasia and p53 staining intensity and Ki-67 proliferation index. No negative staining was observed for MLH1 and MSH2 in any of the adenomatous polyps. Conclusion: For the histopathological examination of CRCs, in the presence of mucinous and poorly differentiated morphology, tumor-infiltrating lymphocytes and Crohn-like inflammatory response, immunohistochemical staining for MLH1, and MSH2 antibodies may be useful in the detection of tumors showing MSI

Laparoscopic cholecystectomy technique in a patient with situs inversus totalis

Situs inversus totalis is a rare congenital anomaly. It mayproduce difficulties in diagnosis and therapeutic managementof abdominal pathology, particularly in laparoscopicsurgery because of the mirror-image anatomy. Here wereport a case of situs inversus totalis and cholelithiasissuccessfully treated laparoscopically.Key words: Situs inversus totalis, cholelithiasis, laparoscopiccholecystectom

Influence of infliximab pretreatment on ischemia/reperfusion injury in rat intestine

Erdivanli, Basar/0000-0002-3955-8242;WOS: 000335969500004PubMed: 24802959The Pringle maneuver is used in hepatic surgery to prevent blood loss but is associated with ischemia-reperfusion injury. To investigate the effect of infliximab on inflammation and apoptosis in rat intestinal mucosa during ischemia-reperfusion (IR) injury. A total of 30 male Wistar albino rats were equally divided into three groups to be subjected to (i) sham operation (sham), (ii) IR injury via Pringle maneuver (pringle) or (iii) infliximab (IFX) group (IFX was given at a dose 3 mg/kg for 3 days before IR injury). Following reperfusion period of 60 min., intestinal tissue and blood samples were taken and processed by standard histological methods. the Pringle maneuver and following reperfusion caused significant histopathological changes, increased serum transaminases' activity and the levels of oxidative stress markers and decreased glutathione peroxidase activity. IFX pretreatment partially prevented these changes. Infliximab pretreatment may protect intestinal mucosa against ischemia-reperfusion injury. Further studies are needed to investigate mechanism and evaluate safety and optimal dosing of IFX in humans exposed to the possible tissue damage by ischemia-reperfusion

Increased pulse wave velocity and carotid intima-media thickness in patients with ulcerative colitis

Durakoglugil, Emre/0000-0001-5268-4262WOS: 000322650900024PubMed: 23508984Ulcerative colitis (UC) is characterized with chronic, progressive inflammation of the gastrointestinal tract. the association of UC with cardiovascular disease is still a matter of debate. the aim of this study was to investigate whether carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) as surrogates of atherosclerosis and arterial stiffness are increased in patients with UC. Our study was cross-sectional and observational in design. Baseline characteristics were recorded during interview with the patient. Patients with previous cardiovascular disease, rheumatoid arthritis, chronic renal failure, and infectious and inflammatory disorders other than UC were excluded. Thirty-seven consecutive patients with UC and 30 control participants underwent cf-PWV assessment and CIMT measurement. the diagnosis of UC was based on clinical, radiologic, endoscopic, and histological findings. CIMT, cf-PWV, and C reactive protein were significantly higher in patients with UC. Although linear regression analyses identified UC as an independent predictor of CIMT (beta +/- A SE, 0.39 +/- A 0.08; p < 0.001), only age independently predicted cf-PWV (beta +/- A SE, 0.08 +/- A 0.03; p = 0.003) in our study population. Moreover, we revealed higher CIMT and PWV values in patients with higher disease activity and more extensive involvement, compared to patients with mild activity and limited disease. We revealed increased pulse wave velocity and CIMT in patients with UC. UC appears to be associated with arterial stiffness and atherosclerotic burden, but the underlying mechanisms require further studies to be identified

The effect of irritable bowel syndrome on carotid intima-media thickness, pulse wave velocity, and heart rate variability

Objective: Irritable bowel syndrome (IBS), a subgroup of functional somatic disorders, may be associated with autonomic dysfunction (AD). Heart rate variability (HRV), a measure of autonomic dysfunction, may predict survival. The aim of this study was to investigate the effect of IBS on HRV parameters, carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) as surrogates of AD, subclinical atherosclerosis and arterial stiffness, respectively. Methods: Our study was cross-sectional and observational. Thirty consecutive patients with IBS and 30 control participants underwent 24-hour Holter monitoring, cf-PWV assessment and CIMT measurement. The diagnosis of IBS was based on Rome III criteria. There were 24 patients with IBS-Constipation (80%), 4 patients with IBS-Diarrhea (13.3%), and 2 patients with IBS-Mixed (6.7%) in IBS group. Student t-test and &#967;2 test were utilized in order to compare continuous and categorical variables between two groups, respectively. Results: Biochemical parameters did not differ between groups except for slightly increased creatinine in patients with IBS. cf-PWV and CIMT values were similar between groups. SDNN index and RMSSD were significantly impaired in patients with IBS compared to controls. Frequency analyses revealed lower LF, HF, and VLF in subjects with IBS. Conclusion: We demonstrated decreased parasympathetic modulation in patients with constipation predominant IBS. However, we could not demonstrate any changes in vascular structure and functions measured by carotid intima-media thickness and pulse wave velocity. Our results do not support accelerated atherosclerosis in IBS population (Anadol

Isolated jejunal perforation following blunt abdominal trauma

Künt karın travmasına bağlı izole jejunum perforasyonu oldukça nadirdir. Klinik bulgular başlangıçta genellikle spesifik olmadığından tanısı güçtür. Bu nedenle tedavisi geciken hastalarda mortalite ve morbidite riski artar. Bu tip travmalarda klasik radyolojik yöntemler tanı açısından yetersizdir. Erken tanı açısından barsak perforasyonu ihtimalinin düşünülmesi ve tekrarlayan muayeneler önemlidir. Burada künt karın travmasına bağlı izole jejunum perforasyonu gelişen 28 yaşında erkek hasta sunuldu.Isolated perforation of the jejunum, following blunt abdominal trauma, is extremely rare. These injuries are difficult to diagnose because initial clinical signs are frequently nonspecific and a delay in treatment increases mortality and morbidity of the patients. Conventional radiograms are often inadequate for diagnosing this subset of trauma. For an accurate and timely diagnosis, the possibility of bowel perforation and the need for repeated examinations should be kept in mind. Herein, we present a 28-year-old man with isolated jejunal perforation following blunt abdominal trauma

(Appendiksin Primer Taşlı Yüzük Hücreli Karsinomu: Olgu Sunumu)

Apendikste primer taşlı yüzük hücreli karsinom oldukça nadir görülmekte olup, tüm appendiks tümörlerinin %0,5’den azını oluşturur. Sunduğumuz olguda akut apendisit ön tanısı nedeniyle operasyona alınan ve apendikste kitle görülmesi üzerine sağ hemikolektomi yapılan hastanın, sağ hemikolektomi materyalinin patolojik incelemesinde apendiksi diffüz tutan kas tabakaları arasında infiltrasyon gösteren iri hiperkromatik nükleuslu taşlı yüzük görünümünde atipik epitelyal hücrelerden oluşan taşlı yüzük hücreli karsinom izlenmiştir. Olgumuzun appendikste oldukça ender görülmesi ve prognozunun appendiksin klasik adenokarsinomlarından kötü olması nedeni ile sunulmaya değer bulunmuştur.Primary signet ring cell carcinoma is rarely seen in appendix and accounts for less than 0.5% of all tumors of the appendix. In our case due to the diagnosis of acute appendicitis, patient was operated and right hemicolectomy was performed when a mass in the apendix was observed. Pathology of right hemicolectomy revealed signet ring cell carcinoma that large hyperchromatic nuclei with signet ring appearance of atypical epithelial cells which diffusely infiltrated muscle layers. We presented the case because it’s occurence in apendix is very rare and prognosis is poorer than the classical adenocarcinomas of apendix

Comparison of Levofloxacin- and Moxifloxacin-Based Triple Therapies with Standard Treatment in Eradication of Helicobacter Pylori as First-Line Therapy

WOS: 000348659900008PubMed: 25547786Aim: It is recommended that treatments that include clarithromycin should be avoided in eradication of Helicobacter pylori (HP) in cases where clarithromycin resistance is higher than 20%. We aimed to compare levofloxacin-and moxifloxacin-based triple therapies with standard treatment and with each other in eradication of helicobacter pylori as firstline therapy. Materials and Methods: Patients were randomized prospectively as three groups. There were 102 patients in the levofloxacin group, 101 patients in the moxifloxacin group, and 103 patients in the standard treatment group. the patients received levofloxacin 500 mg daily, amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. for ten days (LAL) in the levofloxacin group; moxifloxacin 400 mg daily, amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. (MAL) in the moxifloxacin group; and clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. (CAL) in the standard treatment group. At post-treatment week 6, HP was checked by using stool antigen test. Results: in the eradication of Helicobacter pylori, the success rate as determined by per protocol (PP) analysis was 92% in the LAL group, 91.8% in the MAL group, and 82.4% in the CAL group. A statistically significant difference was found in the LAL and MAL groups compared to the CAL group (p < 0.05). There was no difference between the LAL and MAL groups. Conclusions: It was determined that levofloxacin-and moxifloxacin- based triple therapies were more effective than the standard treatment in first-line setting in the eradication of Helicobacter pylori. in addition, no difference was found between levofloxacin-and moxifloxacin-based triple therapies. Currently observed high efficacy may be evaluated in treatment. Although quinolon resistance is not considered a major problem, it appears to be a factor that may reduce treatment success over a period of time. (C) 2014 S. Karger AG, Base

Acute Liver Failure Due to Hbv Reactivation After Rituxzimab Treatment in a Patient with Hbsag (Hepatitis B Surface Antigen) Negativity and AntiHbs (Hepatitis B Surface Antibody) Positivity

İmmünsupresif tedavi sonrası gelişen hepatit Breaktivasyonu, yarattığı olumsuz sonuçlar nedeniyle sonyıllarda güncellik kazanmıştır. Profilaktik tedavinin,yüksek riskli bazı gruplarda hayat kurtarıcı olmasınedeni ile, tedavi öncesi, hastaları titizlikle taramakönem kazanmaktadır. Anti-HBs pozitifliği nedeniyleimmünsupresif tedavi sırasında hepatit B profilaksisiyapılmayan bir hastada gelişen akut karaciğeryetersizliği dolayısıyla konuyu irdelemeyi amaçladıkThe reactivation of hepatitis B virus afterimmunosuppressive treatment causes unfavorableoutcomes. Thus, this important topic has increasinglygained interest over the past few years. It is vital toscreen patients carefully before the prophylactictreatment as this treatment is lifesaving for some highrisk groups. We aimed to discuss a case who wasunder immunosuppressive treatment for anti-HBspositivity. He developed acute liver failure as he didnot receive hepatitis B prophylaxis treatment durringthe immunosuppressive treatmen

Heterotopic bone formation in colorectal carcinoma: A case report

Heterotopik kemik oluşumu (kemik metaplazisi) gastrointestinal sistemde nadir olarak görülür. Genellikle kolorektal benign veya malign epitelyal tümörler ve sıklıkla müsinöz adenokarsinom ile birliktelik gösterir. Gastrointestinal sistemde rektum en sık tutulan bölgedir. Kemik metaplazisinin patogenezi bilinmemekte fakat fibroblastların metaplazisi sonucu oluştuğu düşünülmektedir. Yetmiş üç yaşında erkek hastada gözlenen primer kolorektal adenokarsinomda heterotopik kemik oluşumu irdelenmiştir.Heterotopic bone formation (osseous metaplasia) is rarely seen in the gastrointestinal tract. It usually occurs in the colorectum in association with benign or malignant epithelial tumors, and most often with mucinous adenocarcinoma. The rectum is the most common location of ossification in the gastrointestinal tract. The pathogenesis of the heterotopic ossification is unknown, but it is probably the result of metaplasia of fibroblasts. We present a case of heterotopic bone formation in a primary rectal adenocarcinoma which was observed in a 73-year-old man