Primary renal neuroblastoma mimicking Wilms’ tumor

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The Effects of Baicalin on Myoglobinuric Acute Renal Failure in Rats

Background: Myoglobinuric acute kidney injury is a uremic syndrome that develops due to damage of skeletal muscle. Free radicals and nitric oxide play an important role in the pathogenesis of myoglobinuric acute kidney injury. Baicalin has multiple bioactivities, including antimicrobial, anti-inflammatory and antioxidant properties and is a potent free radical scavenger. Aims: To investigate the nephroprotective mechanism of baicalin on myoglobinuric acute kidney injury. Study Design: Animal experimentation. Methods: In our study, male Sprague Dawley rats were divided into 4 groups. Control (n=8), Baicalin (n=8), myoglobinuric acute kidney injury (n=10) and myoglobinuric acute kidney injury + baicalin (n=10). The rats were deprived of water for 24 hours before receiving intramuscular injection. The control and baicalin groups were injected intramuscularly with saline (8 ml/kg), and the myoglobinuric acute kidney injury and myoglobinuric acute kidney injury + baicalin groups were given 50% glycerol 8 ml/kg. One hour later, the control and myoglobinuric acute kidney injury groups received saline intraperitoneally, and the baicalin and myoglobinuric acute kidney injury + baicalin groups were given 200 mg/kg baicalin. Twenty-four hours after the glycerol injection, urine and blood samples were taken, and the kidneys of the rats were harvested under intraperitoneally injections of anaesthesia. Results: We found that the levels of creatinine, urea, nitric oxide, alanine transaminase, aspartate aminotransferase, creatine kinase in serum samples, malondialdehyde, nitric oxide, inducible nitric oxide synthase, and endothelial nitric oxide synthase concentrations in renal tissue were increased in the myoglobinuric acute kidney injury group compared with the control group (p<0.05). The nitric oxide and glutathione levels in the kidney were significantly decreased in the myoglobinuric acute kidney injury + baicalin group compared with the myoglobinuric acute kidney injury group (p<0.05). There were no significant differences between any other parameters. Conclusion: Our results did not show any protective effect of baicalin on myoglobinuric acute kidney injury, possibly because the different effective factors in the pathogenesis of experimental myoglobinuric acute kidney injury used in this experiment deviate from other experimental models. Moreover, detailed studies are needed to clarify the effects of baicalin in different doses and treatment durations in glycerol-induced acute kidney injury mode

Histopathological Features of Gastrointestinal Stromal Tumors and the Contribution of DOG1 Expression to the Diagnosis

Background: Gastrointestinal stromal tumors (GIST) have KIT or platelet-derived growth factor receptor ? (PDGFR?) mutations affecting receptor tyrosine ki-nase activity and do not benefit from classic treatment regimens.Aims: The aim of this study was to review the al-gorithm that may be followed for the diagnosis and differential diagnosis in GISTs by investigating the histomorphological parameters and expression charac-teristics of classical immunohistochemical antibodies used in routine tests in addition to DOG1 expression.Study Design: Diagnostic accuracy study.Methods: We reevaluated the histological and immu-nohistochemical parameters of 37 GISTs. The standard immunohistochemical diagnosis and differential diag-nosis panel antibodies (CD117, PDGFR?, CD34, vi-mentin, desmin, SMA, S-100, and Ki67) were studied on the tumor sections. We also used the popular marker DOG1 antibody with accepted sensitivity for GISTs in recent years and the PDGFR? immune marker for which the benefit in routine practice is discussed.Results: Classification according to progressive dis-ease risk groups of the 37 cases revealed that 54% were in the high risk, 19% in the moderate risk, 16% in the low risk, 8% in the very low risk and 8% in the no risk group.Cytological atypia, necrosis, mucosal invasion and the Ki67 index were found to be related to the progressive disease risk groups of the tumors (p&lt;0.05).Positive immunoreaction was observed with CD117 and PDGFR? in all GISTs in the study (100%). Posi-tivity with the DOG1 antibody was found in 33 (89%) cases. CD34 was positive in 62% (23) of the cases.Conclusion: The CD117 antibody still plays a key role in GIST diagnosis. However, the use of DOG1 and PDGFR? antibodies combined with CD117 as sensitive markers can be beneficia

A case of urachal malacoplakia that seems like urachal cancer

Background: Urachal masses observed in adults should be considered malignant unless they are confuted. It is very difficult to differentiate between malignant or benign lesions, including especially calcified foci and solid areas. Case Report: Our case was a 63-year-old male patient who was diagnosed as Beh&ccedil;et’s Disease 26 years ago. Upon clinical examination, he was also diagnosed with adenocarcinoma of prostate. He was examined by computerized tomography to define the stage of prostatic adenocarcinoma. The existence of a hypodense multiseptated cystic lesion with irregular margins and solid areas located between anterosuperior of bladder and umbilicus was reported. Hence, the lesion was evaluated as urachal carcinoma and locally advanced prostate cancer by the urooncology council. Resection of the mass, partial cystectomy and pelvic lymphadenectomy were performed as one of the surgical approach options in urachal carcinoma. After pathological examination, the mass was diagnosed as malakoplakia and metastasis of prostate adenocarcinoma was also detected in the right obdurator lymph nodule. In the literature, case reports of urachal malakoplakia are extremely rare. It is also interesting to note the absence of specific clinical symptoms for the urachal mass and the existence of concomitant adenocarcinoma in our case. Conclusion: Malakoplakia can only be diagnosed by pathological examination. Particularly, urachal malakoplakia should also be taken into consideration in the differential diagnosis of lesions which include solid areas and are located in the urachus. Keywords: Michaelis Gutmann bodies, urachal malacoplakia, urachal malacoplakia mimicking cance

The Effects of Irisin on N?-Nitro-L-arginine Methyl Ester Hydrochloride-Induced Hypertension in Rats

Background: The cause of about 95% of hypertension, an important public health problem, is unknown. Intensive studies are underway to understand the physiopathology of hypertension. Irisin, a newly discovered hormone, has been reported to dilate vascular smooth muscle and lower blood pressure acutely. Aims: To investigate the effects of chronic irisin treatment on blood pressure and renal functions in a hypertension model established by nitric oxide synthase inhibition by treatment with N?-nitro-L-arginine methyl ester hydrochloride. Study Design: Animal experimentation. Methods: Male Sprague?Dawley rats were divided into four groups (n=8). Control and irisin groups received an intravenous saline injection, hypertension and hypertension + irisin (hypertension + irisin) groups received 1.5 mg/100 g N?-nitro-L-arginine methyl ester hydrochloride. N?-nitro-L-arginine methyl ester hydrochloride (150 mg/L) was added to the drinking water of rats in groups hypertension and hypertension + irisin for three weeks. In the second week of the experiment, irisin (50 nmol/day) was given to rats in groups irisin and hypertension + irisin, and saline was administered to rats in groups control and hypertension for two weeks through subcutaneously placed osmotic minipumps. Blood pressure was measured by the tail-cuff plethysmography method. On the twenty-first day of the experiment, 24-hour urine, blood, and both kidneys of the rats were collected. Results: The hypertension group had elevated systolic, diastolic, and mean arterial blood pressure values compared with the control group, with decreased glutathione levels in tissue and serum, but an increase in serum oxidized glutathione level (p<0.05). Histopathologically, increased tubular injury, cast formation, glomerular sclerosis, and peritubular fibrosis levels were observed (p<0.05). Irisin treatment did not cause any significant change in blood pressure, renal functions, and injury scores. However, renal nitric oxide levels significantly increased, and endothelial nitric oxide synthase immunoreactivity was determined to be reduced (p<0.05). Conclusion: Treatment with chronic irisin at a physiological dose does not reduce blood pressure in an experimental model of hypertension. In different models of experimental hypertension, the effects of irisin administration at different doses and at different periods should be thoroughly investigated

KRAS Mutation in Small Cell Lung Carcinoma and Extrapulmonary Small Cell Cancer

Background: Lung cancer is one of the most lethal cancers. It is mainly classified into 2 groups: non-small cell lung can-cer (NSCLC) and small cell lung cancer (SCLC). Extrapul-monary small cell carcinomas (EPSCC) are very rare. The Ras oncogene controls most of the cellular functions in the cell. Overall, 21.6% of human cancers contain a Kirsten Ras (KRAS) mutation. SCLC and EPSCC have several similar features but their clinical course is different.Aims: We investigated the KRAS mutation status in SCLC and EPSCC.Study design: Mutation research.Methods: Thirty-seven SCLC and 15 EPSCC patients were included in the study. The pathological diagnoses were confirmed by a second pathologist. KRAS analysis was performed in our medical genetic department. DNA isola-tion was performed with primary tumor tissue using the QIAamp DNA FFPE Tissue kit (Qiagen; Hilden, Germany) in all patients. The therascreen KRAS Pyro Kit 24 V1 (Qia-gen; Hilden, Germany) was used for KRAS analyses. Results: Thirty-four (91.9%) of the SCLC patients were male, while 11 (73.3%) of the EPSCC l patients were fe-male. SCLC was more common in males, and EPSCC in females (p=0.001). A KRAS mutation was found in 6 (16.2%) if SCLC patients. The most common mutation was Q61R (CAA&gt;CGA). Among the 15 EPSCC patients, 2 had a KRAS mutation (13.3%). When KRAS mutant and wild type patients were compared in the SCLC group, no differ-ence was found for overall survival (p=0.6).Conclusion: In previous studies, the incidence of KRAS mutation in SCLC was 1-3%; however, it was 16.2% in our study. Therefore, there may be ethnic and geographical differences in the KRAS mutations of SCLC. As a result, KRAS mutation should not be excluded in SCL

The comparison of angiogenetic and prognostic factors in renal cell carcinomas

Tıpta Uzmanlık TeziRenal hücreli karsinom, böbrek tubul epitelinden kaynaklanan malign bir tümördür. Çalışmamızda tümör histolojik özellikleri, boyutu, evrelendirme, nükleer derecelendirme ve sarkomatoid diferansiyasyon parametrelerle HIF-1?, HIF-2 ?, p53, Ki-67 ve CD34 antikorları kullanılarak tümör prognozu ve anjiyogenezini etkileyen faktörler araştırıldı. 2000-2008 yılları arasında renal hücreli karsinom tanısı almış 78 nefrektomi olgusu 2004 WHO sınıflamasına göre yeniden değerlendirildi. Beş histolojik alt tipte sınıflandırılan olguların Fuhrman Nükleer Dereceleri, evreleri, boyutları, sarkomatoid diferansiyasyon varlığı ve sağkalım oranları kaydedildi. Tüm parametrelerin birbirleriyle ilişkileri istatistiksel yöntemlerle değerlendirildi. Çalışmamızda yüksek nükleer derece, ileri evre, sarkomatoid diferansiyasyon ve p53 pozitifliği gösteren olgularda sağkalım süreleri kısaydı (p<0,05). HIF-1? ve HIF-2? ile histolojik tip, nükleer derece, evre, boyut arasında istatistiksel analiz yapılamadı. Bu antikorlarla sarkomatoid diferansiyasyon ve sağkalım arasında anlamlı ilişki saptanmadı. Ancak düşük nükleer dereceli ve evreli, uzun sağkalıma sahip olgularda HIF-1? ve HIF-2? pozitifliğinin yüksek olması dikkat çekiciydi. Mikrodamar yoğunluğunun nükleer derece, evre, boyut, sarkomatoid diferansiyasyon ve sağkalımla anlamlı ilişkisi yoktu. Ancak agresif seyirli tümörlerde mikrodamar yoğunluğunun azalması dikkat çekiciydi. Nükleer derecesi yüksek, evresi ileri, sarkomatoid diferansiyasyon gösteren olgularda Ki-67 pozitifliği yüksekti (p<0,05). Bu olgularda sağkalım süresi de kısaydı (p<0,05). Sonuç olarak, renal hücreli karsinomlarda prognostik değeri olan histopatolojik parametreler ile sağkalım arasında literatürle uyumlu olarak anlamlı ilişki saptandı. İmmunohistokimyasal belirleyicilerden HIF-1? ve HIF-2?, Ki-67, p53 ve mikrodamar yoğunluğunun birbirleri arasında anlamlı ilişki görülmedi. Ki-67, p53'ün sağkalımla arasında ters ilişkinin varlığı; HIF-1? ve HIF-2? pozitifliğinin erken evre böbrek tümörlerinde literatür çalışmaları ile paralel seyredecek şekilde daha fazla görülmesi önemli bir bulguydu. Çalışmamızda böbrekte HIF-1? ve HIF-2? pozitifliğinin diğer organ tümörleri gibi kötü prognoz ve agresif seyir ile ilişkili olmadığını gösteren bulgular saptanmakla beraber gelecekte istatistiksel analizlerin desteklediği daha geniş çalışmalara ihtiyaç vardır.AbstractWe have investigated histological types, tumor size, pathological stage, nuclear grade and sarcomatoid differentiation of tumors with HIF-1? ve HIF-2?, p53, Ki-67 and CD34 immunostaining in order to assay the effects of factors on tumor prognosis and angiogenesis in renal cell carcinoma. Seventy-eight nephrectomy specimen diagnosed between 2000 and 2008 were reevaluated. In five subtypes, reclassified cases were scored for Fuhrmann nuclear grading, stage, size, sarcomatoid differentiation and survival rate. All parameters were statistically analyzed. On our study, cases with high nuclear grade, advanced stage, sarcomatoid differentiation and p53 positivity revealed pure survival rates (p<0,05). Statistical analysis couldn't be performed among HIF-1? ve HIF-2? and histological types, nuclear grade, stage, and size. There was no statistical difference between these antibodies, sarcomatoid differentiation and survival rate. Ever then, cases with low nuclear grade, early stage and long survival rate had striking high HIF-1? ve HIF-2? positivity. Microvessel density didn't show any statistical difference among nuclear grade, stage, size, sarcomatoid differentiation and survival rate. Nevertheless lower microvessel density was remarkable on aggressive renal tumors. High Ki-67 immunreactivity was observed on tumors with high nuclear grade, advanced stage, sarcomatoid differentiation (p<0,05). Also survival duration period was low on these cases (p<0,05). In conclusion, the difference consistent with literature findings was statistically significant among prognostic histopathological parameters and survival rates. There was no significant statistical result in between the immunohistochemical markers. The presence of inverse relation between Ki-67, p53 and survival rate, as well as high HIF-1? ve HIF-2? immunopositivity in early stage kidney tumors which is consistent with literature findings was an important result on our study. Our results indicating that there was no relationship between HIF-1? ve HIF-2? immunopositivity, poor prognosis and agressive behavior

A Rare Cause of Headache and Increased Intracranial Pressure: Primary Leptomeningeal Melanomatosis

Primary leptomeningeal melanomatosis is a rare central nervous system neoplasm originating from leptomeningeal melanocytes. The cases can be presented with focal neurologic deficit, seizure, neuropsychiatric symptoms or increased intracranial pressure symptoms along with encephalitis or meningitis. Diagnosis can be made upon imaging studies, cytopathologic examination of cerebrospinal fluid and biopsy. Biopsy can return false negative since the leptomeningeal involvement is not diffuse. In this study, a case is presented who admitted to hospital with leptomenengitis symptoms such as headache, fever and altered state of consciousness and developed additional neurologic signs after months. First biopsy came out as normal while the second one did as positive. This case has been found worth presenting since this is a tumor of rare existence and the diagnosis was made upon the second biopsy

Evaluation of Cardiovascular Risk Factors in Women with Uterine Leimyoma: Is There a Link with Atherosclerosis?

Objective: Both uterine leimyoma (UL) and cardiovascular disease are public health problems affecting women at different age ranges. Smoking, obesity, and hypertension have been shown to be associated with UL in different random studies. However cardiovascular risk factors have not been evaluated systematically in patients with UL. Accordingly, we aimed to evaluate the cardiovascular risk factors and their relation with the presence of UL.Material and Methods: One hundred and eighty nine patients with the pathological diagnosis of UL and one hundred and eighty nine age matched control subjects without UL were retrospectively included in the study from our data base of the pathology and gynecology departments. Controls were patients with intact uteri who had visited the same physicians for a routine checkup that included a pelvic examination and uterine sonogram and without mention of physical findings consistent with UL. The following clinical and demographic parameters were recorded; age, sex, hypertension, diabetes mellitus, and hypercholesterolemia. Current cigarette smoking was defined as active smoking within the past 12 months. Results: Comparison of cardiovascular risk factors between with and without UL revealed that the presence of hypertension (80 (42.3%) vs 53 (28%) p=0.004) diabetes mellitus (33 (17.4%) vs. 16 (8.4%) p=0.009), smoking (31 (16.4%) vs. 11 (5.8%) p=0.001), were significantly higher in patients with UL than in control subjects. The mean-age and presence of hyperlipidemia were comparable between the two groups. Logistic regression analysis revealed an independent and positive association of UL with the presence of hypertension (odds ratio 2.02 CI: 1.25-3.27 p=0.004), diabetes mellitus (odds ratio 2.43 CI: 1.23-4.79 p=0.010), and smoking status (odds ratio 3.46 CI: 1.65-7.22 p=0.001).Conclusion: We have shown that major cardiovascular risk factors namely, hypertension, diabetes mellitus and smoking are significantly and independently associated with UL. Our findings highlight the possible association of UL with atherosclerosis

Farklı implant materyalleri üzerinde osteoblasta farklılaştırılmış kemik iliği stromal kök hücrelerinin (KİSKH) kemik tamirindeki rolü

Amaç: Uterus leiomyomu (UL) ve kardiyovasküler hastalıklar kadınları değişik yaşlarda etkileyen halk sağlığı problemleridir. Farklı çalışmalarda sigara, obezite ve hipertansiyonun UL ile ilişkisi gösterilmiştir. Buna karşın, UL olanlarda kardiyovasküler risk faktörleri sistematik olarak değerlendirilmemiştir. Bu doğrultuda, kardiyovasküler risk faktörleri ve bunların UL varlığı ile ilişkisini araştırmayı hedefledik. Hastalar ve Metodlar: Patoloji ve jinekoloji bölümlerinin veri tabanında kayıtlı UL tanısı almış 189 hasta ve yaş bakımından eşleştirilmiş UL bulunmayan 189 kontrol vakası retrospektif olarak incelendi. Kontrol hastaları rutin check-up amacıyla aynı hekimlere başvuran, pelvik muayene ve ultrasonografisiye göre uterusu normal olup, UL fizik bulgusu saptanmayan kişilerden oluştu. Yaş, cinsiyet, hipertansiyon, diabetes mellitus ve hiperkolesterolemi için klinik ve demografik parametreler kaydedildi. Aktif sigara kullanımı son 12 ayda aktif sigara içmek olarak tanımlandı. Bulgular: UL olan ve olmayan hastalarda kardiyovasküler risk faktörleri kıyaslandığında, hipertansiyon varlığı [80 (42.3%) vs 53 (28%) p=0.004], diabetes mellitus [33 (17.4%) vs 16 (8.4%) p=0.009], sigara kullanımı [31 (16.4%) vs 11 (5.8%) p=0.001] UL olanlarda kontrollere göre anlamlı fazla bulundu. Ortalama yaş ve hiperlipidemi varlığı iki grup arasında benzer saptandı. Lojistik regresyon analizinde UL ile hipertansiyon varlığı (odds oranı 2.02 GA: 1.25-3.27, p=0.004), diabetes mellitus (odds oranı: 2.43, GA: 1.23-4.79, p=0.01) ve sigara kullanımı (odds oranı: 3.46, GA: 1.65-7.22, p=0.001) arasında bağımsız ve pozitif ilişki gösterildi. Sonuç: Majör kardiovasküler risk faktörlerinden hipertansiyon, diabetes mellitus ve sigara kullanımının UL ile belirgin ve bağımsız olarak ilişkili olduğunu saptadık. Sonuçlarımız UL ile ateroskleroz olası ilişkisine ışık tutabilir.Objective: Both uterine leimyoma (UL) and cardiovascular disease are public health problems affecting women at different age ranges. Smoking, obesity, and hypertension have been shown to be associated with UL in different random studies. However cardiovascular risk factors have not been evaluated systematically in patients with UL. Accordingly, we aimed to evaluate the cardiovascular risk factors and their relation with the presence of UL. Material and Methods: One hundred and eighty nine patients with the pathological diagnosis of UL and one hundred and eighty nine age matched control subjects without UL were retrospectively included in the study from our data base of the pathology and gynecology departments. Controls were patients with intact uteri who had visited the same physicians for a routine checkup that included a pelvic examination and uterine sonogram and without mention of physical findings consistent with UL. The following clinical and demographic parameters were recorded; age, sex, hypertension, diabetes mellitus, and hypercholesterolemia. Current cigarette smoking was defined as active smoking within the past 12 months. Results: Comparison of cardiovascular risk factors between with and without UL revealed that the presence of hypertension (80 (42.3%) vs 53 (28%) p=0.004) diabetes mellitus (33 (17.4%) vs. 16 (8.4%) p=0.009), smoking (31 (16.4%) vs. 11 (5.8%) p=0.001), were significantly higher in patients with UL than in control subjects. The mean-age and presence of hyperlipidemia were comparable between the two groups. Logistic regression analysis revealed an independent and positive association of UL with the presence of hypertension (odds ratio 2.02 CI: 1.25-3.27 p=0.004), diabetes mellitus (odds ratio 2.43 CI: 1.23-4.79 p=0.010), and smoking status (odds ratio 3.46 CI: 1.65-7.22 p=0.001). Conclusion: We have shown that major cardiovascular risk factors namely, hypertension, diabetes mellitus and smoking are significantly and independently associated with UL. Our findings highlight the possible association of UL with atherosclerosis