The role of neoangiogenesis and vascular endothelial growth factor in the development of carpal tunnel syndrome in patients with diabetes

Objective: Carpal tunnel syndrome (CTS) is an entrapment neuropathy which is caused by the disruption of blood supply in the median nerve under transverse carpal ligament. Systemic factors facilitate the formation of the syndrome. In this study, neovascularization in the subsynovial tissue and proliferative activity in the stroma are analyzed within the cases of diabetic and idiopathic CTS. Materials and Methods: Subsynovial connective tissue samples of 30 diabetes mellitus patients with CTS and 30 patients with idiopathic CTS were evaluated. Vascular endothelial growth factor (VEGF), CD31, CD34, Factor VIII-related antigen, and smooth muscle actin (SMA) was used to make a comparative study of neovascularization. Proliferative index was assessed using anti-Ki-67 antibody. Results: As a result of the proliferation of endothelial elements, de novo blood vessel formations in the subsynovial tissue were assessed by vascular markers. Significant neovascularization was seen in diabetic group for VEGF, CD31, SMA (P 0.01); and for CD34 (P 0.05) when compared with idiopathic CTS group. In addition, more intense positive staining for CD34, SMA (P 0.01); and for VEGF (P 0.05) was found at isolated stromal cells of diabetic CTS group against idiopathic CTS group. Significantly high proliferative index in subsynovial connective tissue with Ki-67 was observed the diabetic group (P 0.01). Conclusion: VEGF expression has an importance within CTS pathogenesis. Increased ischemia-reperfusion damage, neoangiogenesis, and VEGF expression has an important role frequently CTS occurrence in diabetic patients. Our study supports enhancement in VEGF expression similar to changes in diabetic nephropathy and retinopathy in the neovascularization within the subsynovial connective tissue in the cases of diabetes

Protective Effect of Ursodeoxycholic Acid in Experimental Endometriosis Induced Rat Model

Background: Considering the presence of an inflammatory process in the pathogenesis of endometriosis, anti-inflammatory agents could be an alternative option. The study aimed to elucidate the curative efficacy of Ursodeoxycholic acid (UDCA) on the experimental rat model of endometriosis. Methods: This experimental research included a total of 60 mature female Wistar albino rats (250 ± 50 g) with no pregnancy. They were grouped as Standard (n: 20), Laparoscopic Pretreatment (n: 10), Laparoscopic Posttreatment (Sham) (n: 10), UDCA-Pretreatment (n: 10) and UDCA-Posttreatment (n: 10). Transforming growth factor β1 (TGF-β1), matrix metallo-proteinases-2 (MMP-2), Tissue inhibitor of metalloproteinase-1 (TIMP-1), Tumor necrosis factor-α (TNF-α) were analyzed. Results: In the UDCA post-treatment group, endometriotic focal volume (43.3 ± 24.04 mm3) was lower than the pre-treatment values (165.7 ± 21.7 mm3) (p = 0.005). There was no significant change UDCA group before and after the treatment in terms of MMP-2, TGF-β1, TIMP-1 and TNF-α levels (p > 0.05). Comparing the posttreatment values of the Sham srugery group and the UDCA group, while the endometriotic focal volume was 251 ± 51 mm3 in the Sham group, it decreased to 43.3 ± 24 mm3 in the UDCA (p < 0.0001). Histological scoring decreased from 2.6 ± 0.51 to 1 ± 0.81 after the treatment (p = 0.001). Conclusions: The pre-treatment laparotomy group exhibited elevated TNF-α levels, indicating an inflammatory response. UDCA treatment reduced endometriotic focal volume and histological scoring, indicating a potential therapeutic benefit

Aggressive papillary adenocarcinoma on atypical localization: A unique case report.

INTRODUCTION: Aggressive digital papillary adenocarcinoma (ADPA) is a rare sweat gland tumor that is found on the fingers, toes, and the digits. To date, <100 cases have been reported in the literature. Apart from 1 case reported in the thigh, all of them were on digital or nondigital acral skin. CASE PRESENTATION: A 67-year-old Caucasian woman was admitted to the hospital due to a mass on the scalp. This lesion was present for almost a year. It was a semimobile cyctic mass that elevated the scalp. There was no change in the skin color. Its dimensions were 1.5 × 1 × 0.6 cm. The laboratory, clinic, and radiologic findings (head x-ray) of the patient were normal. It was evaluated as a benign lesion such as lipoma or epidermal cyst by a surgeon due to a small semimobile mass and no erosion of the skull. It was excised by a local surgery excision. The result of the pathologic examination was aggressive papillary adenocarcinoma. This diagnosis is synonymous with ADPA. CONCLUSION: In our case, localization was scalp. This localization is the first for this tumor in the literature. In addition, another atypical localization of this tumor (ADPA) is thigh in the literature. This case was presented due to both the rare and atypical localizations. That is why, in our opinion, revision of “digital” term in ADPA is necessary due to seem in atypical localizations like thigh and scalp

Retroperitoneal Malignant Peripheral Nerve Sheath Tumour: A Rare Case Report

Malignant nerve sheath tumours (MPNST) are rare neoplasias and retroperitoneal cases are fairly rare and clinically difficult to be detected, but they are very agressive neoplasias. MPNST are frequently seen in head, neck and upper extremities. In patients with NF1; MPNST, a poor-prognostic lesion, may result from a malignant degeneration of a former plexiform neurofibroma. It is necessary to be aware of a potential malignancy in patients diagnosed with plexiform neurofibroma

Bilateral synchronous ossifying fibromas of the mandible: a case report.

Ossifying fibroma of the jaw is a benign fibroosseous tumour. The growth of it is slowly and it is well circumscribed. Occurrence of multiple ossifying fibromas (synchronous) is rare in the jaw, and only a few cases have been documented. The most of these cases were in only maxilla. The fewer cases were reported in both of maxilla and mandible. We report a case of bilateral synchronous ossifying fibromas involving the mandible of a 37 years old male. The importance of our case is that bilaterality and synchronous of the lesions. Our case is the first synchronous mandibler lesion in literature reported

Cytotoxic Effects of Intranasal Midazolam on Nasal Mucosal Tissue

The aim of this experimental study was to investigate the cytotoxic effects of intranasal midazolam on nasal mucosal tissue in rats. Forty healthy rats were randomly divided into 5 groups. Group 1 (n = 8) was the control group, group 2 (n = 8) received intranasal saline, group 3 (n = 8) received intranasal midazolam, group 4 (n = 8) received intraperitoneal saline, and group 5 received intraperitoneal midazolam (n = 8). Midazolam and saline were administered via intraperitoneal and intranasal routes at doses of 200mg/kg. Nasal septal mucosal stripe tissues were removed at the 6th hour. All materials were evaluated according to Ki67 and p53 staining to evaluate proliferation and apoptosis, respectively, and hemotoxylin and eosin staining was performed for histopathology evaluation. Ki67 values and inflammation in group 3 were statistically higher compared to group 1, group 2, and group 4. P53 values in group 3 were statistically higher compared to group 1. Assessment of subepithelial edema between group 3 and the other groups revealed no statistically significant differences. Assessment of cilia loss between group 3 and group 1, group 2, and group 4 revealed no statistically significant difference. The evaluation of goblet cell loss between group 3 and group 1 revealed a statistically significant difference. Intranasal midazolam had adverse effects on nasal mucosa. However, intranasal midazolam is as safe as systemic midazolam administration with respect to nasal mucosa