The Value of Ensari’s Proposal in Evaluating the Mucosal Pathology of Childhood Celiac Disease: Old Classification versus New Version

Objective: Small intestinal biopsy remains the gold standard in diagnosing celiac disease (CD); however, the wide spectrum of histopathological states and differential diagnosis of CD is still a diagnostic problem for pathologists. Recently, Ensari reviewed the literature and proposed an update of the histopathological diagnosis and classification for CD. Materials and Methods: In this study, the histopathological materials of 54 children in whom CD was diagnosed at our hospital were reviewed to compare the previous Marsh and Modified Marsh-Oberhuber classifications with this new proposal. Results: In this study, we show that the Ensari classification is as accurate as the Marsh and Modified Marsh classifications in describing the consecutive states of mucosal damage seen in CD.Conclusions: Ensari’s classification is simple, practical and facilitative in diagnosing and subtyping of mucosal pathology of CD

Cytological Diagnosis of Small Cell Carcinoma of Urinary Bladder in a Patient with CLL

Small cell carcinoma of the urinary bladder (SCCUB) is an extremely rare bladder malignancy characterized by an aggressive clinical behavior. So, it is important to diagnose this high grade disease by urinary cytology. We report a case of SCCUB in an old man with chronic lymphocytic leukemia (CLL) in remission, while bladder tumor was diagnosed by cytology. With this article, we aimed to review and to update the literature concerning this tumor

A Case of Etanercept Induced Palmoplantar Pustular Psoriasis

Abstract Observations: Etanercept is a human recombinant soluble tumor necrosis factor (TNF-α) receptor fusion protein. Etanercept has been used successfully to treat a wide range of inflammatory disorders including psoriasis and psoriatic arthritis resistant to classical disease-modifying treatments. The widespread use of TNF-α antagonists led to the recognition of adverse effects. Herein, we report a case of palmoplantar pustular psoriasis in a 37-year-old man during the etanercept therapy

Comparison of the efficiency of subconjunctival aflibercept ranibizumab and bevacizumab in corneal neovascularization in a rat model

Background: Corneal neovascularization (CN) might be a sight-threatening condition via reducing the corneal transparency. One of the most significant proangiogenic factors is vascular endothelial growth factor (VEGF) that is shown to be upregulated in CN. Accordingly, we aimed to evaluate and compare the effectiveness of aflibercept, ranibizumab, and bevacizumab in CN in a rat model. Material and methods: Twenty-eight male Wistar-Albino rats were administered general anesthesia. 2-mm-diameter central burns were formed on the corneas. Rats were divided into four groups randomly, and one group was administered subconjunctival saline solution as the control group. Subconjunctival aflibercept, bevacizumab, and ranibizumab were applied to the other three groups, respectively. Three rats from each group were randomly selected, and digital photographs of the corneas were taken under general anesthesia. Then, rats were euthanized, and eyes were enucleated one week and one month after the corneal injury. Three enucleated eyes from each group were prepared for histological evaluation with hematoxylin and eosin. Results: According to the first week results, there was no central CN in all groups except the control group. There was no statistically significant difference in total CN among the groups according to the Kruskal-Wallis test (p = 0.09). The control group had a higher inflammation score than the other groups in the central cornea. On the other hand, the control group had less intense fibrosis than the other groups in the central cornea. In the first month, there was a spontaneous regression in central CN in the control group. There was again no statistical difference among the groups regarding the CN (p = 0.46). There was no inflammation in the central cornea in any groups. Conclusion: single-dose subconjunctival injection of aflibercept, ranibizumab, and bevacizumab prevents thecentral CN and reduces the inflammation

Expression of Sigma-Class Glutathione-S-Transferase in Fetal and Pediatric Filum Terminale Samples: A Comparative Study

Background and objectives: The pathophysiology of tethered cord syndrome (TCS) in children is not well elucidated. An inelastic filum terminale (FT) is the main factor underlying the stretching of the spinal cord in TCS. Our study aimed to investigate the expression of glutathione-S-transferase (GST) in children and fetal FT samples in order to understand the relationship between this enzyme expression and the development of TCS. Materials and Methods: FT samples were obtained from ten children with TCS (Group 1) and histological and immunohistochemical examinations were performed. For comparison, FT samples from fifteen normal human fetuses (Group 2) were also analyzed using the same techniques. Statistical comparison was made using a Chi-square test. Results: Positive GST-sigma expression was detected in eight (80%) of 10 samples in Group 1. The positive GST-sigma expression was less frequent in nine (60%) of 15 samples from Group 2. No statistically significant difference was detected between the two groups (p = 0.197). Conclusions: Decreased FT elasticity in TCS may be associated with increased GST expression in FT. More prospective studies are needed to clarify the mechanism of the GST–TCS relationship in children

Expression of M30 and M65 in celiac disease. Analytical cross-sectional study

ABSTRACT BACKGROUND: The role of villous atrophy in apoptosis, a distinctive feature of celiac disease, is a matter of controversy. The aim of this study was to determine the apoptosis rate through immunohistochemical staining for M30 and M65 in celiac disease cases. DESIGN AND SETTING: Analytical cross-sectional study in a tertiary-level center. METHODS: Duodenal biopsies from 28 treatment-naive patients with celiac disease, 16 patients with potential celiac disease, 10 patients with a gluten-free diet and 8 controls were subjected to immunohistochemical staining for the end-apoptotic marker M30 and the total cell death marker M65. H-scores were compared. Several laboratory parameters were recorded concomitantly, and at the one-year follow-up for celiac disease and potential celiac disease patients. RESULTS: There was a significant difference in H-score for M30 expression between the celiac disease, potential celiac disease and gluten-free diet groups (P = 0.009). There was no significant difference in H-score for M65 expression. There was a positive correlation between the H-score for M30 expression and the anti-tissue transglutaminase immunoglobulin A (anti-tTgIgA) and anti-tissue transglutaminase immunoglobulin G (anti-tTgIgG) levels (R = 0.285, P = 0.036; and R = 0.307, P = 0.024, respectively); and between the H-score for M65 expression and the anti-tTgIgA and anti-tTgIgG levels (R = 0.265, P = 0.053; and R=0.314, P = 0.021, respectively). There was no difference between celiac disease and potential celiac disease patients regarding the laboratory parameters selected. CONCLUSION: The rates of apoptosis and nutritional deficiencies in patients with potential celiac disease were similar to those in patients with celiac disease