Retrorektal/presakral epidermoid kist: Olgu sunumu

Epidermal kistler vücudun her yerinde sık görülmesine rağmen, retrorektal/presakral bölgede oldukça nadir görülmektedir. Retrorektal epidermal kistler ektodermal orijinli, konjenital lezyonlar olup genellikle reprodüktif dönemdeki kadınlarda görülür. Bu olgu sunumunda yaklaşık 25 yıldır perianal bölgeden retrokoksigeal bölgeye uzanan kitle şikayeti olan, 47 yaşında bir kadın hasta tartışıldı. Hastaya spinal anestezi altında parakoksigeal insizyon ile total kitle eksizyonu uygulandı. Histopatolojik inceleme sonucu epidermoid kist tespit edildi. Tüm retrorektal tümörlerde, ilk karşılaşıldığında doğru tanı ve uygun tedavi nüks ve komplikasyon riskini önemli ölçüde azaltır. Tedavide kitle total olarak çıkarılmalıdır.Although epidermal cysts are frequently observed throughout the body, they are rarely found in the retrorectal/presacral regions. Retrorectal epidermal cysts are congenital lesions of ectodermal origin and generally occur in women during the reproductive period. In this case report, a 47 year old female patient with 25 years of complaint of a mass extending from the perianal region to the retro-coccygeal region is discussed. A total mass excision with paracoccygeal incision was performed under spinal anesthesia. The histopathologic examination demonstrated an epidermal cyst. Correct diagnosis and appropriate treatment when first detected significantly decrease the recurrence and complication risks in all retrorectal tumors. Any mass should be completely removed in the treatment

Serum malondlaidehyde level in patients with cystic echinococcosis

WOS: 000243577200013PubMed ID: 17106545Objective: To investigate the changes of serum malondialdehyde (MDA) level for the oxidative stress hypothesis in patients with cystic echinococcosis (CE). Methods: The study was conducted on patients with CE before the surgical treatment. Anti-Echinococcus granulosus antibodies were determined by serological method. We assayed MDA activities measured of 57 subjects and matched in 45 healthy controls. This study took place in the Faculty of Medicine, University of Cukurova, Balcali Hospital in Adana, Turkey, between March 2004 and October 2005. Results: The mean SD of MDA levels of patients with CE was 6.70 +/- 1.66 and healthy controls was 2.53 +/- 0.43. The difference between MDA levels of patients and controls was statistically significant (p < 0.001). Conclusion: The high infection/control ratio of MDA concentration and the significant correlation strongly indicate the occurrence of oxidative stress and lipid peroxidation as a mechanism of tissue damage in cases of CE. Our study highlights the usefulness of serum markers to investigate complex pathological situations, including distinct forms of chronic liver inflammation associated with CE

Aksilla tutulumu olmayan erken evre meme kanserli hastalarda, sentinel lenf nodu biyopsisinin güvenilirliğive etkinliğinin değerlendirilmesi

Amaç: Bu çalışmada klinik olarak aksilla negatif erken evre meme kanserli hastalarda sentinel lenf nodu biyopsisinin etkinliği araştırıldı. Yöntemin sen- tinel lenf nodunu bulma ve yanlış negatiflik oranları hesaplanarak erken evre meme kanserli hastalarda aksillanın değerlendirilmesinde sentinel lenf nodu biyopsisinin yerinin belirlenmesi amaçlandı. Gereç ve Yöntem: Bu prospektif çalışma, erken evre meme kanseri tanısıyla Mart 2006 – Mart 2009 tarihleri arasında Çukurova Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda tedavi edilen 57 hastada yapıldı. Hastalar iki farklı gruba ayrıldı. Grup I’de 35 hastada mavi boya tekniği, Grup II’de 22 has- tada kombine teknik uygulandı. İnvaziv kanser saptanan 46 hastaya sentinel lenf nodu biyopsisi sonrası aksiller lenf nodu diseksiyonu yapıldı. Bulgular: Grup I’de 2 hastada, Grup II’de 1 hastada olmak üzere toplam 3 hastada sentinel lenf nodu saptanamadı. Sentinel lenf nodu bulma oranı tüm hastalar için %94,7 olup bu oran Grup I’de %94,2 , Grup II’de %95,4 idi. Yanlış negatiflik oranı Grup I’de %22,2 , Grup II’de %30 olup tüm hastalar için %26,3 idi. Tekniği öğrenme sürecindeki ilk 15 olgu değerlendirme dışı bırakıldığında tüm grupta sentinel lenf nodu bulma oranı %96,8’e yükselirken yanlış negatiflik oranı %0’a geriledi. Sonuç-Yorum: Bu çalışmada erken evre meme kanserli hastalarda aksillanın evrelemesinde sentinel lenf nodu biyopsisinin etkin ve güvenli bir yöntem olduğu belirlendi. Her merkezin yeterli deneyim kazanıncaya kadar, sentinel lenf nodu biyopsisi ile aksiller lenf nodu diseksiyonunu beraber yapmasının daha güvenli olacağı düşünüldü.Purpose: In this study, sentinel lymph node identification and false negative rates were calculated and determination of the place of sentinel lymph node biopsy in the evaluation of axilla in patients with early stage breast cancer was aimed. Materials and Methods: This prospective study was performed on 57 patients with early stage breast cancer who were treated at the Department of Sur- gery in Medical Faculty of Çukurova University between 2006-2009. Blue dye technique was performed in 35 (Group I ) and the combined technique was performed in 22 patients (Group II). Axillary lymph node dissection was per- formed after sentinel lymph node biopsy on 46 patients who have invasive breast cancer. Results: Sentinel lymph node was not detected in two patients in Group I and one in Group II. Sentinel lymph node identification rate was 94.7% for all pa- tients, and it was 94.2% in Group I and 95.4% in Group II. False negative rate was 26.3% for all patients which was 22.2% in Group I and 30.0% in Group II. Sentinel lymph node identification rate was increased to 96.8% and false negative rate decreased to 0% when the first 15 patients within the learning period was excluded from the statistical analysis. Conclusion: Sentinel lymph node biopsy is a safe and effective technique on staging of axilla in patients with early stage breast cancer. Nevertheless, every medical center should perform sentinel lymph node biopsy and axillary lymph node dissection together untill getting experienced

Hydatid disease involvement of primary subcutaneous tissue in the posterior proximal thigh - an unusual localization

WOS: 000254501400024PubMed ID: 18377614

Effectiveness of nitric oxide derivates in hydatid disease

WOS: 000249907000012Background: The purpose of this study was to assess the possible alterations of the levels of plasma NO derivates which are thought to reflect the immune status of the body against cystic echinococcus ( CE). Materials and Methods: Plasma NO2 and NO3 levels of 95 patients with CE were analyzed before treatment and then after a 1 year. All patients were classified according to the WHO-IWGE classification of cystic hydatid disease. The levels of NO2 and NO3 were detected from sera by using a photometric endpoint determination on the basis of absorbance in the visible range at 550 nm. Results: Pretreatment levels of plasma NO2 and NO3 of the CE group were significantly higher than those in the control group ( p < 0.001). However, the posttreatment NO2 and NO3 levels of the CE group were significantly lower than the pretreatment levels ( p < 0.001). Hence, a positive correlation was found between fertile capacity of CE and the levels of NO2 and NO3 ( p < 0.05). Conclusion: The analysis of the levels of plasma NO derivates should be considered for the at preoperative detection of hydatid disease and postoperative follow-up in addition to radiological and serological methods

Effect of neoadjuvant chemotherapy on estrogen receptor, progesterone receptor, Cerb-B-2, vascular endothelial growth factor and Ki-67 in patients with locally advanced breast cancer

WOS: 000458742100030Purpose: The aim of this study is aimed to demonstrate the changes in the tumor diameter and expressions of vascular endothelial growth factor (VEGF), estrogen receptor (ER), progesterone receptor (PR), Ki-67, and Cerb-B2 status after neoadjuvant chemotherapy in the patients with locally advanced breast cancer. Materials and Methods: Sixty-nine patients who diagnosed with locally advanced breast cancer and treated with were prospectively evaluated. The tumor diameter and VEGF, Ki-67, ER, PR, and Cerb-B2 expressions tested by immunohistochemistry (IHC) were evaluated before and after neoadjuvant chemotherapy. Results: There was a statistically significant reduction in the tumor diameter and in the expression of VEGF, Ki-67, ER, PR, and Cerb-B2 after neoadjuvant chemotherapy. Conclusion: The significant reduction in VEGF expression suggests that the tumor angiogenesis and its metastatic ability may be reduced by neoadjuvant chemotherapy. The significant change in the Ki-67 proliferation index may suggest the reduced proliferative activity of malignant cells with neoadjuvant chemotherapy

Expression of p53, Ki67, epidermal growth factor receptor, transforming growth-factorα, and p21 in primary and secondary hyperparathyroidism

Background: Secondary hyperparathyroidism (SH) is major problem in chronic renal failure. There are studies to examine proliferation and apoptosis associated biomarkers expressions in parathyroid lesions to reveal specific features. In this study, we evaluated the expression of some growth factors and their receptors in parathyroid gland of patients with SH or primary hyperparathyroidism (PH). Materials and Methods: A total of 49 patients had been operated for PH and 26 for SH. Parathyroid tissue samples were evaluated histopathologically and immunohistochemically using antibodies to human p53, Kİ-67, anti-human p21, antitransforming growth factor (TGF) α, CPP32 (caspase 3), and epidermal growth factor receptor (EGFR). Results: Adenoma was higher in PH compared with SH as 48/49 and 3/26, respectively (P = 0.000). Parathyroid hyperplasia was found in 23/26 patients with SH and 1/49 patient with PH. In parathyroid tissue there were no difference between PH and SH for p53, Ki-67, caspase, EGFR expressions; while there were significantly difference for TGFα (P = 0.047) and borderline significant difference for p21 (P = 0.06) expressions. Conclusion: Adenoma was priority present in PH patients, hyperplasia was present in SH. There were no differences between primary and SH or adenoma and hyperplasia for expressions of cycline-dependent kinase inhibitor p21, p53, EGFR, Ki67, caspase; while TGFα expression was found to be different

Tumor-derived CTF1 (cardiotrophin 1) is a critical mediator of stroma-assisted and autophagy-dependent breast cancer cell migration, invasion and metastasis

Macroautophagy/autophagy is an evolutionarily conserved cellular stress response mechanism. Autophagy induction in the tumor microenvironment (stroma) has been shown to support tumor metabolism. However, cancer cell-derived secreted factors that initiate communication with surrounding cells and stimulate autophagy in the tumor microenvironment are not fully documented. We identified CTF1/CT-1 (cardiotrophin 1) as an activator of autophagy in fibroblasts and breast cancer-derived carcinoma-associated fibroblasts (CAFs). We showed that CTF1 stimulated phosphorylation and nuclear translocation of STAT3, initiating transcriptional activation of key autophagy proteins. Additionally, following CTF1 treatment, AMPK and ULK1 activation was observed. We provided evidence that autophagy was important for CTF1-dependent ACTA2/alpha-SMA accumulation, stress fiber formation and fibroblast activation. Moreover, promotion of breast cancer cell migration and invasion by activated fibroblasts depended on CTF1 and autophagy. Analysis of the expression levels of CTF1 in patient-derived breast cancer samples led us to establish a correlation between CTF1 expression and autophagy in the tumor stroma. In line with our in vitro data on cancer migration and invasion, higher levels of CTF1 expression in breast tumors was significantly associated with lymph node metastasis in patients. Therefore, CTF1 is an important mediator of tumor-stroma interactions, fibroblast activation and cancer metastasis, and autophagy plays a key role in all these cancer-related events