Prediction of cytology–histology discrepancy when Bethesda cytology reports benign results for thyroid nodules in women: with special emphasis on pregnancy

ABSTRACTObjectives: Benign category of Bethesda classification is generally well known to carry a false-negative rate of 0–3%. The current study was designed to investigate the rate of false-negative cytology in patients who underwent thyroidectomy for presumably benign thyroid diseases. Predictive risk factors for false results and malignancy were evaluated along with cytology–histology discrepant cases.Materials and methods: Females who underwent thyroidectomy between May 2014 and December 2022 were included. Demographics, ultrasound (US) features, fine-needle aspiration (FNA) diagnosis, surgical indications and outcomes, final histology reports, risk factors, and malignancy rate were recorded. Cytology–histology discrepant cases were further evaluated for interpretation errors and risk factors. Statistical analyses were performed using Fisher’s exact and Mann–Whitney U tests.Results: Of 581 women with a benign thyroid disease who underwent thyroidectomy, 91 was diagnosed as incidental carcinoma (15.6%) and most was T1a (4.9 ± 2.7 mm, 95.6%). Final histology reports revealed mostly papillary carcinoma (93.4%). Predictors of malignancy such as age, family history, previous radiation exposure, and iodine-deficient diet did not help in risk stratification (p > 0.05, for each). However, FNA taken during pregnancy was determined as a risk factor (n = 7, 7.6%, p < 0.05) since it may cause a delay in diagnosis. Cytology–histology discrepant cases were seen to be mostly due to sampling errors (45%, p < 0.05), followed by misinterpretations (37.3%, p < 0.05). There was no reason for discrepancy in 17.5%, and this was linked to inherent nature of thyroid nodule with overlapping cytologic features. Best identifiable risk factor for misinterpretation was pregnancy as well (n = 5, 14.7%, p < 0.05).Conclusions: Risk of malignancy in a presumably benign thyroid disease should not be ignored. Radiology–cytology correlation by an experienced dedicated team may help in decreasing sampling errors. Physiologic changes caused by pregnancy may shade malignant transformation in thyrocytes, and it would be appropriate to be cautious about benign FNA taken during this period

P53 gene therapy for hepatocellular carcinoma

Hepatocellular carcinoma is a malignant tumor with a very high morbidity and mortality. It has a poor prognosis due to its common infiltrating. Liver carcinogenesis is driven by genetic alterations in combination with viral and environmental factors. P53 mutations represent main genetic alteration described in hepatocellular carcinoma. Because of this, p53 gene therapy is proposed as a potential treatment. P53 tumour suppressor gene is responsible for apoptotic signals in tumour signals and thus for their uncontrolled proliferation and recurrence. New approaches to hepatocellular carcinoma treatment are needed to improve patient survival

Incidentally detected gastrointestinal stromal tumor: A case report

Gastrointestinal stromal tumors (GIST) are mesenchymal tumors located primarily in the gastrointestinal tract. We aimed to present a case report of GIST incidentally detected during laparoscopic cholecystectomy.A 60-year-old woman was admitted to the emergency room due to abdominal pain for one day. The physical examination revealed sensitivity on the right upper quadrant. In the laboratory examinations, white blood cell count 6,490 k/uL, hemoglobin 12 g/dL, hematocrit 35% and other biochemical tests were normal. Abdominal ultrasound revealed hydropic gallbladder, several gallstones with a maximum diameter of 15 mm and pericholecystic fluid collection was present. Laparoscopic cholecystectomy was planned due to acute cholecystitis. In exploration, beside the presence of acute cholecystitis, a mass of approximately 5 cm, located 15 cm distal to the ligament of Treitz was detected. Laparoscopic cholecystectomy was performed. Conversion to open laparotomy was done; small intestine resection with end-to-end anastomosis was performed. Gastrointestinal stromal tumor with CD117, CD34 and S100 positivity was detected on histopathologic examination.It is thought that GISTs are mesenchymal tumors originating from precursors of Kajal cells. GISTs are usually detected in their 60s. The first option for treatment is surgical resection

Effects of Exogenous Salicylic Acid on Antioxidant Activity and Proline Accumulation in Apple (Malus domestica L.)

WOS: 000364387100006This study was conducted to determine the effects of exogenous application of different levels of salicylic acid (SA; 0 mM, 3.62 mM, and 7.24 mM) on antioxidant activity and proline accumulation in apple (Malus domestica Borkh cv. Red Chief Delicious) trees during late spring frost. The study was performed in Ulukisla, Nigde, Turkey from December 2012 to June 2013. We measured the levels of photosynthetic pigments, total proteins and proline in leaves, as well as superoxide dismutase and peroxidase enzymatic activities. We also performed morphological observations of the trees. The study was planned according to random experimental design. We determined that SA application increased the fruit number, shoot number, and carotenoid contents in the leaves, but this increase was not statistically significant. However, the fruit weights, superoxide dismutase and peroxidase activities, as well as chlorophyll, protein, and proline levels increased significantly in response to SA treatment compared to the control. In addition, the treated fruits were darker than the control. These results suggest that treating apple trees with exogenous SA may increase antioxidant enzyme activities as well as protein and proline levels and may alleviate the effects of late spring frost.Nigde University [FEB 2012/08]This study was supported by Nigde University, Coordinator of Scientific and Technological Research Projects, No: FEB 2012/08

Pelvic Exenteration: An Updated Mini-Review from 1948 to 2020

Introduction. Pelvic exenteration (PE) is a curative or palliative radical surgical procedure applied for advanced or recurrent pelvic or perineal cancers. From 1948 to date, improvements in surgical techniques, including urinary conduits and pelvic reconstruction, have improved its morbidity and mortality. Aim. The present study reviews the evolution of PE, indications, complications and current results. Material and methods. Large case series and studies on PE were searched in PubMed, covering all years available, and recent applications of PE were reviewed. Results. Indications of PE are primary or locally advanced tumors (cervix. rectum. vulva. bladder), recurrence after radiotherapy (cervix), recurrence after primary resection (vulva, vagina, cervix, rectum) and palliative treatment for advanced tumors or pubic fistulas. Contraindication are distant metastases, involvement of iliac vessels, pelvic side-wall or para-aortic lymph nodes and invasion of sacrum proximal to S1/S2 or sciatic foramen. However, recent studies have reported more radical resections, including side-wall and vessels. Patient’s health condition and fitness are also important in decision-making. Conclusion. PE can be the last chance of cure or improving quality of life for advanced or locally recurrent pelvic cancers. 5-year survival rates with PE are better, but complications of such a radical surgery are still high, and should be improved

Laparoscopic treatment of a bilobed gallbladder: A case report and review of the literature

A double or bilobed gallbladder is a rare congenital anomaly. Because other congenital vascular and biliary duct anomalies may accompany this pathology, open cholecystectomy was thought to be the best treatment of symptomatic patients. In this paper, we report a patient with a bilobed gallbladder whose symptoms were successfully treated with laparoscopic cholecystectomy. We also discuss the characteristics and the embryology of this rare anomaly

Relationships among iron, protein oxidation and lipid peroxidation levels in rats with alcohol-induced acute pancreatitis

It has been previously shown that alcohol induces the damage of pancreatic parenchyma tissue, but the mechanism of this damage is still poorly understood. Assuming that oxygen radical damage may be the involved, we measured markers of oxidative damage in pancreatic tissue, blood serum, plasma, and whole blood of rats with early-stage alcohol-induced acute pancreatitis. Thirty-eight male Wistar rats were divided into three groups: the control group (group 1), the acute pancreatitis group 1 day (group 2), and 3 days (group 3) after the injection of ethyl alcohol into the common biliary duct, respectively. The levels of Fe in tissue and serum, whole blood viscosity, plasma viscosity, fibrinogen and homocysteine (Hcy) levels, erythrocyte and plasma malondialdehyde (MDA), and tissue and plasma protein carbonyl levels were found to be significantly higher in groups 2 and 3 than in group 1. However, the levels of reduced glutathione (GSH) in tissue and erythrocytes were significantly lower in groups 2 and 3 than in group 1. These results suggest that elevated Fe levels in serum and pancreatic tissue in rats with early-stage alcohol-induced acute pancreatitis is associated with various hemorheological changes and with oxidative damage of the pancreas

Oxidative stress and nitric oxide in rats with alcohol-induced acute pancreatitis

AIM: Oxygen free radical mediated tissue damage is well established in pathogenesis of acute pancreatitis (AP). Whether nitric oxide (NO) plays a deleterious or a protective role is unknown. In alcohol-induced AP, we studied NO, lipooxidative damage and glutathione in pancreas, lung and circulation

Does the early ligation of the splenic artery reduce hemorrhage during laparoscopic splenectomy?

The aim of this study was to investigate whether early ligation of the splenic artery before splenic lysis has an effect on the amount of intraoperative bleeding and conversion rate during laparoscopic splenectomy. Laparoscopic splenectomy was performed in 34 patients with hematological diseases or splenic cysts between January 1993 and January 2003. The splenic artery was ligated before manipulation of the spleen in 22 patients (group 1) and laparoscopic splenectomy was performed with no previous ligation of the splenic artery in 12 patients (group 2). Prospective data was collected and the groups compared regarding intraoperative blood loss, platelet count, operative time, hospital stay, and conversion rate. Laparoscopic splenectomy was successfully completed in 30 (88%) patients. One patient in group 1 (5%) and 3 patients in group 2 (25%) required conversion due to bleeding. Estimated average blood loss was 161 mL (range 70-450 mL) in group 1, and 292 mL (range 100-700 mL) in group 2 (P 0.05). There were no statistically significant differences between the two groups comparing splenic size, conversion rate, hospital length of stay and platelet count