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A 60-year old man with a history of coronary-artery bypass grafting presented with symptoms of acute coronary syndrome. Coronary angiography revealed a huge intraluminal thrombus in the saphenous vein graft to the second obtuse marginal branch of the left circumflex artery. A glycoprotein IIb/IIIa inhibitor (tirofiban) was administered intravenously. Two days later, thrombus dissolution and Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow were evident on repeat coronary angiography. Glycoprotein IIb/IIIa inhibitors may be useful in a thrombus-laden saphenous-vein graft., (Copyright 2010 Elsevier Inc. All rights reserved.)

Objectives: To determine if there are differences in the expressions of the E-cadherin adhesion molecule of precancerous laryngeal lesions classified according to Ljubljana and World Health Organization (WHO) classification., Patients and Methods: We examined 41 cases (3 females, 38 males; mean age 54 years; range 8 to 80 years) of laryngeal hyperplastic-dysplastic lesions from the Kocaeli University Pathology Department archives between 1998-2005. Forty-one laryngeal hyperplastic-dysplastic lesions were classified according to Ljubljana and WHO classification. The cases were classified as pertaining to either low or high risk groups. Sections were stained according to the E-cadherin immunohistochemical method. The relations between risk groups in two different classification systems and E-cadherin expression frequency were detected by Chi-square test., Results: According to the WHO classification, the loss of expression detected 32.1% (9/28) in high-risk epithelium and 15.4% (2/13) in low-risk epithelium (p=0.26). According to the Ljubljana classification, the loss of expression detected 38.1% (8/21) in high-risk epithelium and 15% (3/20) in low-risk epithelium (p=0.09)., Conclusion: E-cadherin expression is down regulated with histologic progression in the precancerous lesions of the larynx. However, the presence of normal expression in some carcinoma insitu cases limited their diagnostic value. The presence of normal E-cadherin expression in laryngeal squamous cell carcinoma support this opinion. The Ljubljana system is more accurate for predicting the E-cadherin expression's decrease, or in other words, for demonstrating its malignant potential.

Purpose: To evaluate the efficacy of sildenafil citrate only, 25 mg. Four times/week, tamsulosin only, 0.4 mg once daily, and the combination of both on lower urinary tract symptoms (LUTS) suggestive of benign prostate hyperplasia (BPH) and erectile dysfunction., Methods: A total of 60 men with BPH-related LUTS were randomized to receive sildenafil citrate only (n = 20), tamsulosin only (n = 20), and the combination of both (n = 20) for 8 weeks. Changes from baseline in International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q (max)), post voiding residual urine volume (PRV), Sexual Health Inventory for Male (SHIM) score, 3rd and 4th questions of International Index of Erectile Function (IIEF) were assessed at the end of the treatment., Results: The mean age was 58 years. IPSS, Q (max), PRV, SHIM scores, and 3rd and 4th questions in IIEF significantly improved in each group. Improvement of IPSS was more remarkable in combination (40.1%) and tamsulosin only (36.2%) groups in comparison with sildenafil citrate only group (28.2%; p < 0.001). Improvement of Q (max) and PRV were greater in tamsulosin only and combination than sildenafil citrate only group. SHIM scores significantly improved in sildenafil citrate only (65%) and combination (67.4%) than tamsulosin only (12.4%; p < 0.001). Increases in the 3rd and 4th questions of IIEF were greater in sildenafil only and combination than tamsulosin only (p < 0.001)., Conclusions: Treatment with the combination of tamsulosin only and sildenafil citrate only was not superior to tamsulosin only to enhance voiding symptoms. Also, sexual function improvement was similar for both the combination and sildenafil citrate only treatments.

Primary cardiac lymphoma (PCL) is an extremely rare disorder. In this report, a 57-year-old male with diffuse large B-cell lymphoma involving the heart and great vessels is presented. Trans-thoracic echocardiography was the first modality used to establish the diagnosis. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) showed diffuse increased metabolic activity of the heart walls and hypermetabolic lesions occupying cardiac chambers in some areas. The patient underwent systemic chemotherapy, and after 13 days, a marked regression of the tumour mass was evident based on echocardiographic examination. After completing six R-CHOP chemotherapy treatments, PET imaging was planned to control the residual mass, but the patient was intubated due to pneumonia that developed after the sixth chemotherapy session and subsequently died due to sepsis.

Giant cell tumor, excluding its prototype in bone, is usually a benign but local aggressive neoplasm originating from tendon sheath or soft tissue. Malignant behavior is uncommon. Visceral organ involvement including urinary bladder is rare. Giant cell tumors in visceral organs usually accompany epithelial tumors and the clinical behavior of giant cell tumor in urinary bladder is similar to its bone counterpart. Here, we report two cases of giant cell tumor located in urinary bladder in comparison with nine reported cases in the English literature. Concurrent noninvasive urothelial carcinoma was also described in all these previous reports and only one patient with follow-up died of disease. One of the two cases we present had no concurrent urothelial tumor at the time of diagnosis but had a history of a low grade noninvasive urothelial carcinoma with three recurrences. The histology of these two cases was similar to the giant cell tumor of bone and composed of oval to spindle mononuclear cells with evenly spaced osteoclast-like giant cells. Immunohistochemically, the giant cells showed staining with osteoclastic markers including CD68, TRAP, and LCA. Immunohistochemical expression of vimentin, CD68, LCA, and smooth muscle actin in mononuclear cells supported a mesenchymal origin with histiocytic lineage. The histologic and immunohistochemical properties in our cases as well as their clinical courses were consistent with a giant cell tumor. Consequently, tumors in urinary bladder showing features of giant cell tumor of bone may also be considered and termed "giant cell tumor".

Surface-enhanced Raman scattering (SERS) is a powerful technique for characterization of biological samples. SERS spectra from healthy brain tissue and tumors are obtained by sudden freezing of tissue in liquid nitrogen and crashing and mixing it with a concentrated silver colloidal suspension. The acquired spectra from tissues show significant spectral differences that can be used to identify whether it is from a healthy region or tumor. The most significant change on SERS spectra from the healthy/peripheral brain tissue to tumor is the increase of the ratio of the peaks at around 723 to 655 cm(-1). In addition, the spectral changes indicate that the protein content in tumors increases compared to the peripheral/healthy tissue as observed with tumor invasion. The preliminary results show that SERS spectra can be used for a quick diagnosis due to the simplicity of the sample preparation and the speed of the spectral acquisition.

Fascin is a globular actin cross-linking protein that is important in carcinogenesis. It shows differential staining in various tumors, dependent on grade and stage. The purpose of this study was to compare fascin expression in benign, dysplastic and malignant (metastatic and non-metastatic) melanocytic lesions of the skin, and also to investigate the potential role of fascin in their differential diagnosis. Fascin expression was investigated through the immunohistochemistry of paraffin-embedded tissue in 73 cases of melanocytic lesions of the skin, including 20 benign nevi, 12 dysplastic nevi, 4 lentigo malignas, 25 malignant melanomas and 12 metastatic melanomas. The cases were scored on the basis of staining extension (from 0 to 4) and intensity (from 1 to 3), and were assigned a combined score. Fascin expression was present in 19/20 (95%) benign nevi, 8/12 (67%) dysplastic nevi, 1/4 (25%) lentigo malignas, 7/25 (28%) malignant melanomas and 3/12 (25%) metastatic melanomas. There was significantly less frequent expression of fascin in malignant melanoma than in benign nevi (p < 0.001) and dysplastic nevi (p = 0.036). The results of this study indicate that differential fascin expression exists between benign nevi and malignant melanomas. Fascin can therefore serve as a reliable immunohistochemical marker in distinguishing malignant melanomas from melanocytic nevi and dysplastic nevi, and it may be used with histological criteria for differential diagnosis.

Spinal epidural abscess is a collection of suppurative material that forms between the dura mater and the ligamentum flavum. If not recognized early and treated correctly, it can lead to life-threatening sepsis. Here we report the case of a female patient, 51 years of age, with difficulty walking and bilateral leg pain after having had degenerative discogenic pain for many years. The patient had occasionally received intramuscular non-steroidal anti-inflammatory drug injections. The current report is that of an unusual case of epidural abscess that formed following multiple dose of intramuscular non-steroidal anti-inflammatory drug over a 1-year period. Hematogenous or direct dissemination is the suspected cause. To prevent serious morbidity and mortality, early diagnosis is essential. Patients with localized back pain who are at risk for developing such epidural spinal abscesses should receive a magnetic resonance imaging scan with contrast enhancement without delay. The existence of predisposing factors such as intramuscular injections should be considered in the assessment of suspected spinal epidural abscess.

Background: The aim of the study was to analyse parameters reflecting the sympathovagal control of ventricular depolarisation and repolarisation [heart rate variability (HRV) and QT interval dispersion (QTd)] in patients undergoing elective percutaneous transluminal coronary angioplasty (PTCA), and determine whether HRV correlates with QT dispersion parameters., Methods: The study consisted of 26 consecutive patients (16 men, 10 women) with single-vessel coronary artery disease (CAD) who underwent elective coronary angioplasty. HRV analyses of all subjects were obtained with the time- and frequency-domain methods. For frequency-domain analysis, low-frequency HRV (LF), high-frequency HRV (HF) and the LF:HF ratio were measured. For time-domain analysis, standard deviations of the normal-to-normal QRS intervals (SDNN) and square roots of the mean squared differences of successive N-N intervals (rMSSD) were obtained. QT intervals were also corrected for heart rate using the Bazett's formula, and the corrected QT interval dispersion (QTcd) was then calculated. All measurements (HRV parameters and QTcd) were made before and immediately after PTCA., Results: QTcd was significantly decreased after PTCA (52.2 +/- 3.5 vs 42 +/- 3.9 ms). SDNN (94.1 +/- 22 vs 123.9 +/- 35.2 ms), rMSSD (43.7 +/- 20.1 vs 73.4 +/- 14.5 ms) and HF (51.1 +/- 48.8 vs 64.2 +/- 28.6 ms(2)) were significantly higher after PTCA, whereas LF (142 +/- 41.5 vs 157.2 +/- 25.9 ms(2)) and the ratio of LF:HF (3.3 +/- 1.9 vs 2.1 +/- 1.2) were significantly decreased after PTCA. We observed a significant negative correlation after PTCA between QTcd and LF (r = -0.87, p = 0.01) and between QTcd and the ratio of LF:HF (r = -056, p < 0.05)., Conclusion: Among the patients with CAD undergoing PTCA, QTcd significantly decreased after PTCA, and negatively correlated with LF, the parameter reflecting the sympathetic system.

Mitochondrion is one of the most important organelles in cells with several vital responsibilities. The consequence of a deficiency in the function of mitochondrion could result with the wide range of diseases and disorders. In this study, we investigated the feasibility of utilizing surface-enhanced Raman scattering (SERS) to understand the mode of interaction of gold nanoparticles (GNPs) with mitochondria. The living lung cancer cells and the isolated mitochondria from these cells were treated with gold colloidal suspension for SERS experiments. The AFM images of the mitochondria confirmed that the treatment did not cause substantial damage to mitochondria. The localization of GNPs in living cells is investigated with confocal microscopy and found that GNPs form aggregates in the cytosol away from the mitochondria. However, SERS spectra obtained from isolated mitochondria and living cells indicate that GNPs escaped from the endosomes or entered into the living cell through another route may be in contact with mitochondria in a living cell. The findings of this study indicate that SERS can be used for mitochondrial research.

Summary: The diagnosis of malignant, uncertain malignant potential, and benign uterine smooth muscle tumors is derived from histologic criteria such as tumor cell necrosis, mitotic activity, and cytologic atypia. Morphologically, some variants of leiomyoma can be confused with leiomyosarcoma (LMS). In this study, we compared fascin expression in cases of leiomyoma, leiomyoma variants (LVs), uterine smooth muscle tumor of uncertain malignant potential (STUMP), and LMS, and sought to determine the potential role of fascin in differential diagnosis. Fascin expression was investigated through the immunohistochemistry of paraffin-embedded tissue in 79 cases of uterine smooth muscle tumor including 22 usual leiomyoma, 31 LV, 4 STUMP, and 22 LMS cases. The cases were scored on the basis of staining extent (from 0 to 4) and intensity (from 1 to 3), and were assigned a combined score. Fascin expression was present in 20 of 22 (90.9%) LMS, 2 of 4 (50%) STUMP, 1 of 31 (3.2%) LV, and 1 of 22 (4.5%) usual leiomyoma cases. There was a statistically significant difference in fascin extent and intensity between the LMS and benign groups, but no difference between the LMS and STUMP groups. The results of this study indicate that more distinct fascin expression exists in LMS than in the benign groups. Fascin can serve as a reliable immunohistochemical marker in distinguishing uterine LMS from LVs and usual leiomyoma, and it may usefully be used with histologic criteria in diagnosing problematic cases.

Surface-enhanced Raman scattering (SERS) is proven to be a powerful tool for investigation of biological structures. In this study, tissues obtained from different rat organs are examined using SERS. The tissue samples are crushed with a pestle after sudden freezing in liquid nitrogen and mixed with a concentrated colloidal silver nanoparticle suspension. The reproducibility of SERS spectra acquired from several tissue samples from different organs is demonstrated. The collected spectra are comparatively evaluated based on the physiological function of the organ from which the tissue is obtained. The spectra from the tissues show significant differences and indicate that they can be used for tissue characterization and differentiation. The identification of the origins of the bands on the spectra is also attempted. This study suggests that SERS can be used to monitor the changes at the molecular level during metabolic changes in an organ or tissue as a result of a disease or another cause.

The Brenner tumor is an uncommon ovarian tumor in pregnancy with only three previous cases in the English published reports. A 35-year-old woman delivered abdominally because of distress symptoms and a Brenner tumor was resected incidentally. Histological examination revealed a tumor composed of epithelial nests and areas of stromal luteinization. The patient was treated conservatively. Brenner tumor should be considered in the differential diagnosis of adnexal masses during pregnancy. These tumors are mainly benign and show typical luteinization associated with the hormonal milieu in pregnancy.

We report a rare case of a giant ovarian tumor presenting as an incarcerated umbilical hernia. A 61-yr-old woman was admitted to the hospital with severe abdominal pain, an umbilical mass, nausea and vomiting. On examination, a large, irreducible umbilical hernia was found. The woman underwent an urgent operation for a possible strangulated hernia. A large, multilocular tumor was found. The tumor was excised, and a total abdominal hysterectomy and bilateral salphingo-oophorectomy were performed. The woman was discharged 6 days after her admission. This is the first report of incarcerated umbilical hernia containing a giant ovarian tumor within the sac.

Background: Aim of the study was to compare the pleurodesis results from the intrapleural injection of talc, polidocanol and ethanol into the rabbit pleura., Methods: Twenty-nine New Zealand white rabbits were randomized into three groups for the intrapleural administration of 200 mg/kg (n = 10) of talc, 15 mg/kg (n = 10) of 3 % polidocanol or 1 mL (n = 9) of 4.2 % ethanol in 2 mL saline solution, respectively. The pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation, thickness, cellularity, neovascularity and mesothelial cell proliferation in both pleura., Results: The mean degrees of gross pleurodesis were 2.0 +/- 0.66 (on a scale from 0 to 4) for talc, 2.2 +/- 0.91 for polidocanol and 0.7 +/- 0.86 for ethanol. The parietal pleura thickness was 191 +/- 213.6 microm, 236 +/- 224.6 microm and 45 +/- 44.2 microm, while the visceral pleura thickness was 109 +/- 103.7 microm, 164 +/- 161.4 microm and 48 +/- 42.2 microm in the talc, polidocanol and ethanol groups, respectively. The results of microscopic examination were similar in the talc and polidocanol groups., Conclusion: The intrapleural injection of polidocanol produces better pleurodesis than does the intrapleural injection of talc or ethanol in rabbits. Because of the efficacy of polidocanol as a sclerosing agent, its use in humans should be considered after further animal studies.

The size influence of 3D silver nanoparticle aggregates on surface-enhanced Raman scattering (SERS) is investigated. Micrometer- and nanometer-sized wells prepared on a polydimethylsiloxane (PDMS) surfaces are filled with cetyltrimethylammonium bromide (CTAB)-coated silver nanoparticles. A concentration of CTAB around its critical micelle concentration is used not only to form a bilayerlike structure around the nanoparticles and thus generate nanometer-sized gaps in the aggregates, but also to improve the compatibility of the surface charge properties of the silver nanoparticles with the surface of PDMS and thus successfully fill the wells by assembly of silver nanoparticles into 3D structures. A resonance-free enhancement factor of 10(7) can be easily achieved on larger aggregates, and the enhancement factor increases with decreasing size of the 3D aggregates, which is contrary to reported studies on conventional silver clusters. We find that the number of silver nanoparticles in the 3D aggregate should be less than 200-300 for optimal SERS performance.

Unlabelled: OBJECTIVE. To evaluate the effects of short term use of dutasteride and Serenoarepens before transurethral resection of the prostate (TURP) on the amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in the patients with benign prostatic hyperplasia., Patients and Methods: The study involved 75 male patients who planned to have a TURP. The patients were randomly divided into three groups. The control group comprised 21 patients. Group 2 comprised 27 patients who used dutasteride 5 mg/day, and group 3 comprised 27 patients who used S. repens 160 mg/day for 5 weeks before the operation. The amount of intraoperative haemorrhage was calculated. Total blood loss, total blood loss/time, total blood loss/weight of resected tissue and total blood loss/weight/time were calculated for each patient and all were recorded. Sections from the prostatic stromal and suburethral tissues were examined for suburethral and prostatic MVD., Results: The total amount of intraoperative blood loss, total blood loss/time, total blood loss/weight of resected tissue, total blood loss/weight/time, serum haemoglobin level change, prostatic MVD and suburethral MVD of the groups were compared. No significant statistical differences were found between the groups for any of these variables (p > 0.05)., Conclusions: Dutasteride and S. repens therapies were not superior to control in terms of the decrease in total blood loss during TURP. Moreover, MVD showed no statistical differences in the treatment groups compared with the control group.

Background: Cytarabine (ARA-C) has been used for many years in the treatment of patients with leukemia and lymphoma. Gastrointestinal ulceration and mucositis are two of the well-known side effects of ARA-C. We set out to investigate whether vitamin A (VA) can help prevent ARA-C-induced mucosal lesions in mice., Materials and Methods: Mice were divided into 5 groups. Group I (control group) received only saline; group II received ARA-C plus saline; group III received ARA-C plus VA; group IV received ARA-C plus a lipid solution, and group V received VA alone. VA (5000 IU/kg) was administered orally to the mice once daily for 7 days. ARA-C (3.6 mg) was administered intraperitoneally for 5 days to groups II, III and IV, starting on the third day of VA treatment. Intestinal segments from the proximal end of the jejunum of treated mice were isolated., Results: There was improved mucosal integrity, less necrosis and increased villus length with advanced mucosal proliferation in crypts in the VA plus ARA-C group when compared to the ARA-C groups without VA., Conclusion: We conclude that VA has a protective effect against ARA-C-induced mucosal damage in mice.

Angiogenesis is a multistep process that depends on the balance of proangiogenic factors and inhibitors as well as on interactions with the extracellular matrix. We examined the immunohistochemical expression of the defining angiogenic agents, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9), and the antiangiogenic agent thrombospondin-1 (TSP-1) in 131 patients with urothelial carcinoma and correlated their expression levels with clinicopathological parameters. VEGF and MMP-9 expression was higher in high-grade tumors than in low-grade tumors (p=0.000 and p=0.001, respectively), whereas the reverse was true for TSP-1 (p=0.000). VEGF and MMP-9 expression was higher in deeper tumors compared to superficial tumors and in invasive tumors compared to non-invasive tumors (p=0.001 and p=0.001, respectively), while TSP-1 was lower (p=0.000). We could differentiate 22 of 41 muscle-invasive (T2) cases as superficial (T2a; n=7) or deep (T2b; n=15), but no difference was found between them regarding VEGF, MMP-9, or TSP-1 expression (p=0.783, p=0.289, and p=0.783, respectively). There was a positive correlation between VEGF and MMP-9 expression (p=0.008, r=0.23) but a negative correlation between MMP-9 and TSP-1 expression (p=0.014, r=-0.21). Increased VEGF and MMP-9 expression as well as decreased TSP-1 expression may play considerable roles in the invasion and differentiation of urothelial carcinoma.

Background/aims: This study aims to investigate the expression of bcl-2 in the chronic hepatitis B, C and hepatocellular carcinoma., Methodology: In this study, 23 chronic hepatitis C, 17 chronic hepatitis B and 29 hepatocellular carcinoma cases were examined. Liver biopsies have been immunohistochemically stained for the expression of bcl-2. Positive staining was semi-quantitatively graded from + to +++., Results: Two out of 23 hepatitis C cases and 3 out of 17 hepatitis B cases were found to express bcl-2, staining was more intense in areas adjacent to active inflammatory process. Of the 29 hepatocellular carcinoma cases 6 stained positively for bcl-2; 9 biopsies in this group had also non-neoplastic liver tissue, and, of these 6 stained positively for bcl-2. Of the latter 6 bcl-2 positive biopsies 3 also showed tumoral staining while in the remaining 3, neoplastic elements were bcl-2 negative., Conclusions: As the present study is a cross-sectional study, no causative relation between bcl-2 positivity and hepatocellular carcinoma can be implied, however high incidence of bcl-2 activity in the non-neoplastic liver parenchyma of the HCC cases suggest that bcl-2 activation may be involved in the development of at least some cases of hepatocellular carcinoma. Case control and/or prospective studies are needed to show whether bcl-2 positivity in a chronic hepatitis case has a predictive value for the development of hepatocellular carcinoma.

Rice body formation is generally a rare disorder related to rheumatoid arthritis. It can also be observed in cases of systemic lupus erythematosus, seronegative arthritis, infectious arthritis (tuberculosis, atypical mycobacterial infection), nonspecific arthritis, and osteoarthritis. It is generally located within joints or bursae. Multiple rice bodies of tendon sheaths are rarely encountered. Rice body formation may also be encountered without underlying systemic disorders. We present a case of multiple rice body formation that accompanied chronic nonspecific tenosynovitis of the flexor tendons of the wrist.

Diagnosis of low-grade clear cell lesions in kidney can be challenging to the pathologist in practice. There is limited information in the literature addressing the practical issues that may be encountered in this regard. Herein is presented two cases: one was an adrenal cortical nodule; the second, an intrarenal adrenal heterotopia that was assumed to be renal cell carcinoma initially. Certain red flags should prompt pathologists to investigate further; close morphological examination including immunohistochemistry may be warranted in these lesions.

Soft tissue tumours of the thoracic wall are a rare entity. Elastofibroma which occurs mainly in women, is commonly localized in the subscapular region, and is characterized by slow growth. We report the case of a 64-year-old woman who presented with a soft tissue tumour located in the right pectoral region, anterior chest wall. Magnetic resonance imaging showed a tumour on the right anterolateral thoracic wall that measured 5x4x5 cm with contrast enhancement. The findings were suggestive of partial infiltration of pectoral and intercostal muscles and were suspicious of a malignant tumour. The patient underwent complete resection of the tumour at a district hospital. The tumour was resected with clear surgical margins and minimum defect of the pectoral muscles. The specimen measured 4x4x3 cm and histopathology showed a lesion composed of fibrotic connective tissue of low cellularity with strongly eosinophilic, partially swollen, and plump fibers. Histology from the specimen was consistent with elastofibroma.

Malignant tumors of the larynx are extremely rare in children and adolescents. Adenoid cystic carcinoma accounts for less than 1% of all malignant tumors in the larynx. We presented a 16-year-old girl with subglottic adenoid cystic carcinoma, whose symptoms of prolonged and exacerbating dyspnea had been attributed to asthma at another medical center. Indirect flexible and rigid laryngoscopy revealed a smooth mass in the subglottic region occupying 80% of the airway passage. The lesion was also confirmed by both CT and MRI. There was no lymphadenopathy in the neck. The patient was successfully treated by surgery and postoperative radiotherapy. Pathological staging was T4N0M0 according to the AJCC, 2003. During six years of follow-up, there was no evidence for local recurrence or regional and distant metastasis.

Evaluation of prophylactic effects of omeprazole and/or vitamin E on the formation of free oxygen radicals (FOR) and bowel histopathology in the newborn rat model of hypoxia/reoxygenation (H/R) that resembles human necrotizing enterocolitis (NEC). Eighty newborn rats were randomly divided into eight groups. H/R was done using airtight chamber. Rats were exposed to 100% CO2 for 15 min followed by a reoxygenation for the next 15 min with 100% O2. Group 1 (n = 10) was the control group. Group 2 (n = 10) rats received vitamin E. In Group 3 (n = 10) omeprazole was administrated. Group 4 (n = 10) rats received omeprazole and vitamin E. Group 5 (n = 10) rats were subjected to H/R two times for 2 days and one time for 3 days. Group 6 (n = 10) received vitamin E in addition to H/R for 5 days and in Group 7 (n = 10) omeprazole in addition to H/R for 5 days. In Group 8 (n = 10), vitamin E and omeprazole and H/R were applied for 5 days. Rats were killed at the end of the each process and bowel specimens were harvested for histopathological and biochemical investigations. We administrated vitamin E intramuscularly 300 unit/kg per day and omeprazole orally 20 mg/kg per day. Malondialdehyde (MDA), xanthine oxidase (XO), xanthine dehydogenase (XDH) and XO/(XO + XDH) were measured. Vitamin E and/or omeprazole treated rats had significantly less XO% levels than H/R only group (0.36, 0.38 and 0.57, respectively). Similarly, the MDA levels were significantly lower in vitamin E and/or omeprazole received rats than H/R only rats (88.8, 97.9 and 122.6, respectively). All rats treated with omeprazole and/or vitamin E had better biochemical and histopathological levels compared to H/R rats (p < 0.05). Histopathological results show that Group 5 (H/R only) had significantly more intestinal damage when compared with Group 6 (vitamin E + H/R), Group 7 (omeprazole + R/H) and Group 8 (vitamin E + omeprazole + H/R) (p < 0.001). Grade 2 and 3 intestinal damages were only in Group 5 and there were no statistical difference between in Groups 6, 7 and 8 (p > 0.001). Omeprazole and/or vitamin E may protect the biochemical and histopathological intestinal damage of H/R injury in rats. These drugs may be beneficial in the prophylaxis of NEC in humans as well.

Background: Blindness or visual deterioration after neck dissection is a known and a rare complication of the operation. Visual impairment usually occurs immediately after bilateral radical neck dissections either performed synchronously or in a stepwise manner, resulting in permanent blindness. Hypotension and blood loss during long operations, elevated venous pressure postoperatively result in optic neuropathies, which are anterior ischemic optic neuropathy (AION) or mostly posterior ischemic optic neuropathy (PION) affecting different portions of the nerve., Methods: Review of literature and case report., Results: To date there are only three cases of AION after neck dissection reported in the literature, with a different visual prognosis., Conclusion: Vision loss may be reversible when both internal jugular veins are preserved, but permanent when any of them are resected. Here we present the first case of anterior ischemic optic neuropathy developed after unilateral radical neck dissection, resulting in partial visual deterioration.

Objectives: To investigate the effectiveness of disposable transrectal ultrasound needle guide in the prevention of possible infectious complications after transrectal prostate biopsy., Methods: One hundred ninety-eight patients who underwent transrectal needle biopsy of the prostate were included in the study. Patients were randomly assigned into 2 groups; in group 1 (110 patients), prostate biopsies were taken with reusable needle guide. In group 2 (88 patients), biopsy was performed by using a disposable transrectal needle guide. Patients received 500 mg ciprofloxacin orally twice daily beginning the day before biopsy and continued for 1 week. Infectious complications were recorded as asymptomatic bacteriuria, acute urinary infection, high fever, and bacteremia., Results: The mean age of the patients was 63.9 years. The mean age of the patients were 65.1 and 64.4 years in group 1 and 2, respectively (P = 0.428). There were no significant differences between the regarding serum total and free prostate-specific antigen (PSA) levels, total prostate volume, and transitional prostat volume (P(total PSA) = 0.822, P(free PSA) = 0.510, P(prostate volume) = 0.323, P(transitional zone volume of the prostate) = 0.376). Although asymptomatic bacteriuria was found in a total of 14 (7.1%) patients, acute urinary tract infection was diagnosed in 11 (5.5%) patients and high fever was observed in 16 (8.1%) patients. Blood cultures did not show bacteremia in either of the groups. Infectious complication rates were significantly lower in group 2 than the other group (P <0.001)., Conclusions: The use of a disposable needle guide helps minimize infection risk after transrectal prostate needle biopsy. The novel disposable needle guide seems to be the alternative to a reusable needle guide.

Objectives: Inflammation has been reported as an important component of vascular aneurysm formation, as found in obstructive vascular disorder. Neopterin is produced by activated macrophages and is thought to represent a marker of immune activation and macrophage activity. The plasma neopterin levels were investigated in coronary artery ectasia (CAE) patients to investigate the role of inflammation., Study Design: The study population consisted of three groups: the first consisted of 28 patients with isolated CAE without stenotic lesion; the second of 27 patients with obstructive coronary artery disease (O-CAD) without CAE; and the third group of 15 control subjects with normal coronary arteries (NCA). Plasma soluble neopterin levels were measured in all patients and control subjects using commercially available enzyme-linked immunosorbent assay kits., Results: Plasma neopterin levels were found to be significantly higher in patients with isolated CAE compared with control subjects with angiographically NCA (18.5 +/- 8.8 versus 8.7 +/- 2.6 nmol/L, respectively, P = 0.006). Although neopterin levels were higher in patients with CAE than in patients with O-CAD, they did not reach the statistically significant levels (18.5 +/- 8.8 versus 16.8 +/- 8.2 nmol/L, respectively, P = 0.77). Patients with O-CAD had significantly higher levels of neopterin compared with subjects with angiographically NCA (16.8 +/- 8.2 versus 8.7 +/- 2.6 nmol/L, respectively, P = 0.03). The mean serum neopterin levels in patients with single-vessel, two-vessel, and diffuse ectasia were as follows: 17.4 +/- 9.9 nmol/L, 19.5 +/- 8.9 nmol/L, and 20 +/- 5.5 nmol/L, respectively (P = 0.4)., Conclusion: Patients with isolated CAE have raised levels of neopterin compared with patients with NCA, showing the possible role of inflammatory processes (monocyte/macrophage activity) in the higher levels of neopterin in patients with O-CAD.

The aim of the study reported here was to evaluate the biochemical and histopathologic effects of omeprazole and vitamin E in rats with corrosive esophageal burns. A total of 144 Wistar Albino rats were divided into 12 experimental groups (12 rats per group) and used in an animal study. Group I rats were given a laparotomy and received no treatment (control group), while groups II, III and IV received a laparotomy and were treated with omeprazole, vitamin E or omeprazole/vitamin E, respectively. Groups V-XII rats received a laparotomy and were given a caustic acid burn through acid instillation (1 ml caustic 10% sulphuric acid; groups V-VIII) or alkali instillation (corrosive 10% sodium hydroxide solution; groups IX-XII) into the isolated esophageal segment via a 22-Fr cannula for 2 min. Each group of rats subjected to caustic burn received either no treatment (groups V and IX) or were treated with omeprazole, vitamin E or omeprazole/vitamin E, respectively (remaining six groups). Omeprazole (20 mg/kg) or vitamin E (10 mg/kg) was administered to the rats intraperitoneally or intramuscularly, respectively. Seventy-two rats (50% of each group, n = 6) were killed immediately after the experimental treatment (acute phase). The remaining rats were kept under standard conditions for 21 days (late phase) before being killed. The distal esophageal segments were harvested from all animal and used in histopathologic and biochemical analyses. Compared to the controls (no caustic burn), rats receiving only the acid or alkali installation (and no subsequent treatment) had the highest mean malondialdehyde (16.9 and 15.8 micromol MDA/g protein, respectively) and hydroxyproline (5.9 and 5.7; mg HP/g wet tissue) levels of all groups. In comparison, rats treated with acid + omeprazole and/or vitamin E had relatively lower MDA (12.9 and 11.6 micromol/g protein, respectively) and HP levels (4.3 and 4.08 mg/g wet tissue, respectively). Similarly, rats treated with alkali + omeprazole and/or vitamin E had low levels of MDA (13.9 and 11.7 micromol/g protein, respectively) and HP (4.3 and 4.4 mg/g wet tissue, respectively). The glutathione (GSH) levels of acid-only- or alkali-only-treated rats were lower than those found in omeprazole- and/or vitamin E-treated rats. Based on these results, we conclude that vitamin E and omeprazole affect the biochemical and histopathologic parameters in rats receiving corrosive esophageal burn from acid and alkali. The effect of both substances was slightly greater in the acid-treated groups.

Tracheo-innominate artery fistula is a rare but usually fatal complication of tracheostomy or intubation. To our knowledge, this complication has been reported following laryngectomy only in two patients. A 45-year-old woman with hypopharynx carcinoma developed tracheo-innominate artery fistula one month after total laryngopharyngoesophagectomy, as a complication of permanent tracheostomy, induced by the erroneous use of a 12-mm diameter silver tracheostomy cannula. With a median sternotomy, the innominate artery was reconstructed with Gore-Tex vascular graft interposition and separated from the trachea by a pedicled pericardial patch. Unfortunately, the patient sustained intermittent postoperative hemorrhages due to mediastinitis and died on the 15th day. After this tragic result, our attention was focused on both prevention of tracheo-innominate artery fistulas and methods of preventing and dealing with hemorrhages.

We report 3 siblings from a nonconsanguineous white family with bilateral persistent pupillary membranes with dissimilar forms of severity. Two of the patients required no treatment; 1 was treated surgically for occlusion of the pupillary axis and moderate visual acuity decrease. Anterior segment examination was otherwise normal in the siblings. Although persistent pupillary membranes are usually sporadic, cases in which they are associated with other anterior chamber abnormalities might be inherited autosomal dominant. To our knowledge, this is the first report of a familial isolated persistent papillary membrane case with no other anterior chamber abnormality.

The differential diagnosis of psoriasis affecting palmoplantar skin might be troublesome because of the anatomic properties of this region. Both palmoplantar psoriasis and eczematous dermatitis of this skin area share similar histologic features. The punch biopsies from 17 patients with psoriasis and 25 with eczematous dermatitis were evaluated, blind to the clinical diagnosis. Vertically situated multiple foci of parakeratosis, alternating with orthokeratosis,were the only statistically significant feature in the differential diagnosis of palmoplantar psoriasis [76.5% (13/17), p = 0.005]. In contrast,multiple foci of parakeratosis [70.6% (12/17)], loss of granular layer at least in focal areas [41.2% (7/17)], presence of neutrophils at the summits of parakeratosis [4% (1/17)], presence of neutrophils and/or plasma in the parakeratotic foci [94.1% (16/17) and 11.8% (2/17)],psoriasiform epidermal hyperplasia [88.2% (15/17)], spongiosis restricted to the lower parts of the epidermis [47.1% (8/17)],dyskeratotic cells [82.4% (14/17)], thinning of suprapapillary plate[58.8% (10/17)], edema of the papillary dermis [29.4% (5/17)],presence of tortous and dilated capillaries in the papillary dermis[52.9% (9/17) and 76.5% (13/17)] and extravasated erythrocytes[29.4% (5/17)] were found to be more common in palmoplantar psoriasis compared with eczematous dermatitis; but none of them was statistically significant. Interestingly, spongiotic vesicles were seen in most of the patients with psoriasis [76.5% (13/17)]. In conclusion,according to our findings, many features of palmoplantar psoriasis overlapped with those of eczematous dermatitis. However, detection of multiple parakeratotic foci, placed vertically, alternating with orthohyperkeratosis, could be considered in favor of palmoplantar psoriasis.

Different sources of pollution in Karasu Creek were investigated to obtain the water quality and ratio of contamination in this region. To achieve the main objectives of the present study, water samples were collected from Karasu Creek, starting from flow pattern at the upstream site of Akkaya Dam to the end of the dam, crossing the place where the Creek drains into. Dissolved oxygen, electrical conductivity, temperature and maximum/minimum pH were measured systematically for 12 months in the stations, where the water samples were collected. Chemical analyses of the water samples were carried out by using Cadas 50 S brand UV spectrometer to find out the Pb, Fe, Cu, Zn, Ni, Cr, Cd, S, F and Cn concentrations. These concentration were determined in microg/lt as 80-850; 180-4,920; 10-6,100; 440-25,530; 130-2,400; 120-280; 20-150; 214,250-1,113,580; 1,560-4,270 and 40-690, respectively. To determine metal levels of the water samples, multivariate analyses (element coefficient correlation, coefficient correlation dendrogram, hierarchical cluster analysis dendrogram, model summary and ANOVA) were used. The analyses yielded highly accurate results. There were positive correlations between some elements and their possible sources were the same. The stations which resembled each other along the creek were divided into three groups. The water quality of the creek was low and had toxic qualities. Eutrophication developed in Akkaya Dam along the creek. The source of pollution was thought to be industrial and residential wastes. Absolute (0-100 m), short distance (100-500 m) and medium distance (500-2,000 m) conservation areas should be determined in pollution areas along Karasu Creek and they should be improved.

Metastasis of a breast carcinoma to an endometrial polyp is extremely rare, with only ten cases having been reported in the literature up to now. We present the case of a 60-year-old woman with invasive ductal carcinoma who complained of vaginal bleeding. She underwent hysteroscopy with biopsy. Microscopic examination revealed an endometrial polyp which contained foci of adenocarcinoma. The morphologic features of the tumor were identical to the original breast carcinoma.

The mutations of c-kit gene, which encodes a transmembrane receptor tyrosine kinase (CD117-KIT) or activation of CD117, lead to the activation of signal transduction cascades regulating cell proliferation, apoptosis, chemotaxis, and adhesion. The aim of this study was to investigate the expression of CD117 in normal, inflammatory, neoplastic, and reactive lesions of the thyroid. Using polyclonal anti-CD117 antibody, we performed immunohistochemical staining on tissue blocks from 230 cases obtained from the archives of the Department of Pathology, Ondokuz Mayis University (Samsun, Turkey), collected between 1990 and 2006. Each slide was evaluated for extent and intensity of staining. Staining extent was expressed as the percentage of stained cells. Staining of <10% of the cells was accepted as negative. Staining intensity was evaluated only in positive cases. By addition of the extent and intensity scores, the combined score was calculated. In our study, the combined CD117 staining scores of neoplastic and inflammatory groups were found to be higher than the reactive and normal groups. Within the neoplastic group, papillary carcinomas differed from follicular adenomas significantly, although papillary carcinomas showed no statistically significant difference compared to follicular carcinomas. Immunohistochemical CD117 positivity was detected in a wide range of neoplastic and inflammatory thyroid diseases. The neoplastic group and, within them, the papillary carcinomas showed a higher ratio of CD117 positivity. Although our results need to be confirmed by other molecular and genetic studies, the high rate of positivity in papillary carcinomas was one of the striking findings, which may result in novel diagnostic and therapeutic approaches.

This study evaluated the molecular epidemiology and biodiversity of Mycobacterium tuberculosis isolates in Zonguldak, Turkey, and investigated the presence and significance of the LAM7-TUR clone by spoligotyping and mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) analysis. In total, 128 isolates were tested by spoligotyping; 25 selected isolates representative of the LAM7-TUR clone and similar types were also tested by MIRU-VNTR analysis. In total, 47 distinct patterns were revealed by spoligotyping, represented by 13 clusters containing between two and 28 isolates (94 isolates in total), and 34 unique patterns (a clustering rate of 73%). Using MIRU-VNTR analysis, the clustering relationships revealed by spoligotyping were confirmed. The most common spoligotyping profile was SIT53, followed by SIT41 (LAM7-TUR) and SIT50. The SIT284 clone was another phylogeographically specific clonal complex whose presence in Turkey may be endemic. The LAM7-TUR genotype was highly prevalent in Zonguldak.

Massive ovarian oedema is a rare entity described as accumulation of oedema fluid within the ovarian stroma, separating normal follicular structures. Our case was a 27-year-old woman who presented with a large solid pelvic mass after recurrent episodes of self-limited abdominal pain. On physical examination, she had left abdominal tenderness with minimal rebound and guarding. With a diagnosis of malignant ovarian tumor, an exploratory laparotomy was done and a twisted ovarian mass was found which was excised completely. Histopathological evaluation of the mass revealed massive oedema of the ovary. Massive ovarian oedema should be suspected in women at the fertile age range with solid enlargement of the ovary.

Subpubic cartilaginous cysts are rare cystic lesions that have been radiologically identified only in recent years, and the our understanding of the cautions to be observed in the diagnostic approach and the radiologic characteristics is still incomplete. The medical literature search revealed three reported cases of a subpubic cartilaginous cyst diagnosed histopathologically and one case that was suggested by radiological findings. Definitive diagnosis of all the cases was confirmed by excisional biopsy. This report discusses the radiological features and the important issues necessary in the diagnostic approach of subpubic cartilaginous cysts.

Background: Cause-specific mortality statistics are primary evidence for health policy formulation, programme evaluation, and epidemiological research. In Turkey, a partially functioning vital registration system in urban areas yields fragmentary evidence on levels and causes of mortality. This article discusses the application of innovative methods to develop national mortality estimates in Turkey, and their implications for national health development policies., Methods: Child mortality levels from the Demography and Health Survey (DHS) were applied to model life tables to estimate age-specific death rates. Reported causes of death from urban areas were adjusted using re-distribution algorithms from the Global Burden of Disease (GBD) Study. Rural cause structure was estimated from epidemiological models. Local epidemiological data was used to adjust model-based estimates., Results: Life expectancy at birth in 2000 was estimated to be 67.7 years (males) and 71.9 years (females), about 8-10 years lower than in Western Europe. Leading causes of death include major vascular diseases (ischaemic heart disease, stroke) causing 35-38% of deaths, chronic obstructive lung disease and lung cancer in men, but also perinatal causes, lower respiratory infections and diarrhoeal diseases. Injuries cause about 6-8% of deaths, although this may be an underestimate., Conclusions: Mortality estimates are uncertain in Turkey, given the poor quality of death registration systems. Application of burden of disease methods suggests that there has been progress along the epidemiological transition. Key health development strategies for Turkey include improved access to communicable disease control technologies, and urgent attention to the development of a reliable, nationally representative health information system.

Aims: Cardiac arrhythmias are still a major cause of mortality in western countries. Currently available antiarrhythmic drugs are limited by a low efficacy and proarrhythmic effects. The role of the protein kinase C (PKC) signalling pathway in arrhythmogenesis is still unclear. The goal of the present study was to test the effects of PKC stimulation on whole heart electrophysiology and its pro-/antiarrhythmic activity., Methods and Results: Left ventricular (LV) action potential duration (APD 90%) was determined in 27 Langendorff-perfused rabbit hearts, using Tyrode solution plus the PKC agonist phorbol-12-myristate-13-acetate (PMA; 100 nM) alone (nine rabbits), Verapamil alone (n = 6), or PMA in combination with Verapamil (0.25 mg/L, six rabbits), or bisindolylmaleimide (0.5 microM, n = 6). Intermittent programmed extra-stimulation was performed to induce ventricular arrhythmias. Administration of PMA alone led to a significant shortening of repolarization (APD 90%, 157 +/- 8 vs. 128 +/- 5 ms, P<0.05). Non-sustained ventricular fibrillation (VF) could be induced in seven out of nine animals. After perfusion of Verapamil (156 +/- 6 vs. 169 +/- 4 ms, P>0.05) or bisindolylmaleimide, a selective inhibitor of PKC (136 +/- 4 vs. 146 +/- 4 ms, P>0.05), PMA-induced shortening of repolarization could be inhibited, and induction of VF failed. Verapamil alone did not affect APD and VF could not be induced., Conclusions: Activation of PKC facilitates induction of VF, which is most likely due to a shortening of repolarization and a prominent calcium influx. These findings demonstrate involvement of the PKC-signalling pathway in arrhythmogenesis.

Objective: This report describes a case of a 62-year-old male with giant cell carcinoma of the larynx that presented as a neck mass and hoarseness., Methods: Case report, review of the world literature, and an immunohistochemical examination., Results: Extended total laryngectomy and bilateral functional neck dissection were performed. Microscopical examination showed that the tumor was composed of solid masses of anaplastic small cells with hyperchromatic nuclei. There were multinucleated giant cells with huge nuclei, prominent nucleoli, and clear or eosinophylic cytoplasm. The diagnosis of giant cell carcinoma of the larynx was made. An immunohistochemical staining was applied to the case and tumor showed immunoreactivity with cytokeratin 8/18, cytokeratin 18, cytokeratin 19, vimentin, epithelial membrane antigen, S-100, cytokeratin 7 and did not show immunoreactivity with cytokeratin 10, cytokeratin 20, and carcinoembryogenic antigen., Conclusion: Giant cell carcinoma of the larynx is an extremely rare tumor the origin of which is not clearly understood. It is believed to be the counterpart of giant cell carcinoma of the lung in larynx. It is the sixth case reported in English literature and also the first case that is examined immunohistochemically. In conclusion, giant cell carcinoma of the larynx is confirmed to be a specific entity of simple epithelial origin and it is the counterpart of giant cell carcinoma of the lung.

Objective: Gore-Tex has not yet been used as an injection material, and no animal study has been performed. The purpose of this study was to investigate the histopathological and volumetric changes of minced and injected expanded polytetrafluoroethylene (Gore-Tex) in the quadriceps muscle of rats to find out its possibility as an injection material in future injection laryngoplasty., Design: A prospective study was performed in 13 Wistar rats., Methods: The 50+/-5 mg Gore-Tex vascular graft was minced until it was fine enough to pass through a 16G injection cannula. To create viscosity in order to avoid precipitation, minced Gore-Tex was mixed with sodium hyaluronate (SH) gel. 0.5 ml of this mixture was injected into the middle part of the right quadriceps muscle of each subject. Then, pure SH (0.5 ml) was injected into the middle part of the left quadriceps muscle of each subject. To compare the volumetric and histopathological changes of the injection area occupied by the materials over the time, two rats were sacrificed 1 day after the procedure, four rats after 1 month, four rats after 3 months and three rats after 6 months., Results: In pure SH: SH was observed as an effusion in the muscle of one subject on the first day only. We did not detect SH in the muscle in the first, third and sixth months and, as a result, there was no augmentation. Inflammation and fibrosis was not detected in any of these applications of SH. In minced Gore-Tex+SH gel mixture: SH was again eliminated from the muscle in a very short period of time, but the remaining Gore-Tex created a 15.8% volumetric gain. Fibrosis and capsule formation began in the first month and, in the sixth month; we observed connective tissue surrounding the Gore-Tex material. Ingrowth of connective tissue into the Gore-Tex, though not present in the first month, occurred partially in the third and significantly in the sixth month. In addition, we observed foreign body granuloma formation after the third month., Conclusions: Pure SH, though easily applicable, was immediately eliminated leaving no trace. In the relatively difficult applications of Gore-Tex mixed with SH, however, there was residual Gore-Tex present in all subjects throughout the study. Gore-Tex may be an applicable material for injection laryngoplasty.

Background: Appendiceal parasites can cause symptoms of appendiceal pain, independent of microscopic evidence of acute inflammation. The diagnosis of a parasitic infestation is generally achieved only after the pathologic examination of the resected appendices., Patients/methods: Pathology department records were reviewed for all patients who required an operation for symptoms of acute appendicitis between 2000 and 2006. The specimens which were pathologically diagnosed to contain parasites were reevaluated for features of acute inflammation, and parasite type. The medical records were reviewed in detail to achieve a diagnostic score(Eskelinen). Radiologic imaging findings were correlated, if present., Results: Of the 190 appendectomies performed, 6 specimens (3,15%) were found to contain parasites(4 Enterobius vermicularis, 2 Taenia subspecies). Appendectomies with Taenia showed acute inflammation, while acute inflammation was absent in the ones with Enterobius vermicularis. The Eskelinen score was higher than the threshold in two cases with an acute inflammation, and in two without. Ultrasound scans, and a computed tomography scan were performed in 5 patients. In 3 of 4 bland appendices, results favored acute appendicitis., Conclusion: The diagnosis of gastrointestinal parasites is not only made by examining the stool but the diagnosis can be made by histology from surgical specimens. Timely diagnosis and appropriate therapy might prevent probable future complications that may necessitate surgical procedures, at least in some of the patients. The clinical management of these infections is different from that for classical appendicitis.

In this article we review the historically important cases of conjoined twins (Biddenden Maids, Siamese twins, Blazek sisters) and contemporary knowledge regarding incidence, etiopathogenesis, antenatal diagnosis, antenatal management, and outcome of conjoined twins. We also present a case of male cephalothoracoomphalopagus, which is extremely rare.

Background: The aim of this study was to evaluate our experience on the diagnosis and treatment of choanal polyps (CP)., Methods: This study consists of 53 patients with CP diagnosed by means of rhinoscopy, nasal endoscopy, computerized tomography, surgical, and histologic findings between 1996 and 2005., Results: The origins of the CPs were the unilateral maxillary sinus in 47 patients, simultaneously bilateral maxillary sinus in 2 patients, septum in 2 patients, sphenoid sinus in I patient, anterior ethmoid sinus in 1 patient. The most common presenting symptoms were unilateral nasal obstruction, snoring, and rhinorrhea. In the cases of the antrochoanal polyps, the most common preoperative radiological finding was the total opacification of the maxillary sinus., Conclusion: Endoscopic approach for complete removal of the CPs is an extremely safe and effective procedure. It should be focused on the detection of the exact origin and the extent of the polyp to prevent recurrence.