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Skin metastasis from laryngeal carcinoma is rare and indicates a poor prognosis. A case of laryngeal carcinoma with unusual metastasis to the skin of the hand is reported. The patient underwent total laryngectomy, left radical neck dissection, and right functional neck dissection. After the operation, the patient received radiotherapy. In the postoperative 18th month, a mass was observed in the left hand. It was found to be a metastatic tumor from laryngeal carcinoma, histopathologically as well as immunohistochemically. Metastatic potential in malignant neoplasms is generally correlated with reduced cellular adhesiveness. We investigated the expression of the vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), and E-cadherin. Interestingly, the immunohistochemical expression characteristics of such an aggressive tumor were not positive.

Background: Alpha-tectorin is a noncollagenous component of the tectorial membrane which plays an essential role in auditory transduction. In several DFNA12 families mutations in TECTA, the gene encoding alpha-tectorin, were shown to cause hearing impairment (HI) with different phenotypes depending on the location of the mutation., Methods/results: Here we report a Turkish family displaying autosomal dominant inherited HI. Linkage analysis revealed significant cosegregation (LOD score: 4.6) of the disease to markers on chromosome 11q23.3- q24. This region contains the TECTA gene which was subsequently sequenced. A nucleotide change in exon 13, 4526T>G, was detected leading to a substitution from cysteine to glycine at codon 1509 of the TECTA protein. This cysteine is located in vWFD4 domain, a protein domain which is supposed to be involved in disulfide bonds and protein-protein interactions., Conclusions: It is conspicuous that the phenotype in this family correlates with other families, also displaying mutations involving conserved cysteines. In all three families these mutations result in progressive HI involving high frequencies. In contrast, mutations which are not affecting the vWFD domains seem to provoke mid-frequency sensorineural HI. Furthermore, evaluation of clinical data in our family revealed a gender effect for the severity of hearing impairment. Males were significantly more affected than females. The identification of the third family displaying a missense mutation in the vWFD domain of alpha-tectorin underlines the phenotype-genotype correlation based on different mutations in TECTA., (Copyright 2004 S. Karger AG, Basel)

Aim: Because the presence or absence of H pylori infection has important implications for therapeutic decisions based on histological assessment, the reproducibility of Sydney system is important. The study was designed to test the reproducibility of features of Helicobacter pylori gastritis, using the updated Sydney classification., Methods: Gastric biopsies of 40 randomly selected cases of H pylori gastritis were scored semiquantitatively by three pathologists. Variables analysed included chronic inflammation, inflammatory activity, atrophy, intestinal metaplasia, H pylori, surface epithelial damage. Kappa values below 0.5 represented poor, those between 0.5 and 0.75 good and values over 0.75 excellent interobserver agreement., Results: The best interobserver agreement (kappa=0.62) was present for intestinal metaplasia. The agreement was the poorest for evaluating atrophy (kappa=0.31)., Conclusion: Although the results of this study were in accordance with some previous studies, an excellent agreement could not be reached for any features of H pylori gastritis. This low degree of concordance is assumed to be due to the personal evaluation differences in grading the features, the lack of standardized diagnostic criteria, and the ignorance to reach a consensus about the methods to be used in grading the features of H pylori gastritis before initiating the study.

The antibody 34-betaE12 stains selectively the keratins of basal cells. The aim of this study is to investigate the staining pattern of 34-betaE12 in borderline (keratoacanthomas and solar keratosis), and benign lesions (seborrheic keratoses). The proliferation index Ki-67 staining was also evaluated in these and also in malignant (basal and squamous cell carcinomas) cases. The staining pattern where the 34-betaE12 positive cells found in the basal, suprabasal epidermal layers was called "focal"; and the staining in all layers including upper spinous layer was called "diffuse". Mean proliferation index and the distribution pattern of Ki-67 immunohistochemical expression were assessed. Basal and suprabasal expression of 34-betaE12 significantly predominated in the normal parts of the epidermis, in eight out of 11 seborrheic keratoses (%73), one out of the 19 keratoacanthomas (%5), two out of 11 solar keratosis (18%). Statistical analysis revealed significant differences between mean level of Ki-67 expression of malignant (squamous cell carcinoma, basal cell carcinoma), benign (seborrheic keratoses) and premalignant (solar keratoses, keratoacanthomas) lesions (p<0.01). The distribution of staining pattern for Ki-67 paralleled to the staining pattern of 34-betaE12. Basal cell status assessment completed by 34-betaE12 may resolve some, but not all of the problems in terms of determining the presence of dysplasia.

Atypical teratoid/rhabdoid tumor (AT/RT) is extremely malignant, highly aggressive primitive central nervous systemneoplasm of infancy with very poor prognosis. Histologically, AT/RT is defined as a polymorphous neoplasm often featuring rhabdoid, PNET, mesenchymal, and epithelial components. We report the clinical history, radiological, and pathological findings in a child affected bycentral nervous system AT/RT.

Objective: We investigated the effect of carnitine on wound healing of trachea in tracheotomyzed rats. This study was undertaken to test the hypothesis that treatment with carnitine would protect the wound tissue, which was evaluated by measuring nitrite and nitrate, thus nitric oxide, malondialdehyde and cholinesterase in blood, and examining the histopathological changes., Methods: Standard vertical tracheotomy was performed on 24 Wistar-Albino type rats. Then the animals were randomly divided into two groups; group A (the study group) was administered intraperitoneal carnitine 100 mg/kg for 10 days; group B (the control group) was administered intraperitoneal saline for 10 days. On the 10th day, all animals were decanulated. Three weeks later, cardiac blood samples were taken for biochemical assays and trachea specimens were harvested for histopathologic examination., Results: In the carnitine-administered group, granulation tissue thickness resulting from the wound healing in the level of tracheotomy incision was lower compared to the control group (P < 0.01). When serum malondialdehyde levels were considered, a lower malondialdehyde level was found in the carnitine-administered group (P < 0.01). However, serum nitric oxide levels were close to each other in both groups (P > 0.05), while serum cholinesterase level was higher in the carnitine-administered group than in the control group (P < 0.01)., Conclusion: Carnitine treatment partially prevents and significantly reduces the severity of tracheotomy induced laryngotracheal stenosis.

The exact aetiology of vestibulocochlear dysfunction after spinal anaesthesia is unknown. Low-frequency hearing loss occurs after spinal anaesthesia. The aim of this study was to investigate the effects of combined spinal-epidural (CSE) anaesthesia and size of spinal needle on vestibulocochlear dysfunction, using pure tone audiometry performed pre- and on the first and the second day postoperatively. Forty-five patients who were to undergo elective caesarean section were evaluated. In group I, CSE anaesthesia (18 G Tuohy, 25 G Whitacre pencil-point-design spinal needles) was performed in 15 patients. In group II, spinal anaesthesia was performed in 15 patients with 25 G Whitacre pencil-point-design spinal needles and, in group III, spinal anaesthesia was performed in 15 patients with 22 G Whitacre pencil-point-design spinal needles. In the pre- and on the first and the second day postoperatively, the pure tone audiogram was performed in the audiology laboratory of our hospital, using a calibrated Kamplex Diagnostic Audiometer AC 40 in a noise-free room. When the CSE anaesthesia group and 22 G spinal group were compared for change in hearing between the pre- and postoperative periods, a statistically significant difference was observed at R-right ear 125 Hz (P < 0.025) and at L-left ear 125 Hz (P < 0.023), and at L-left ear 1000 Hz (P < 0.036) and at R-right ear 1500 Hz (P < 0.006), and at L-left ear 1500 Hz (P < 0.022). At other frequencies, the difference was insignificant. When the CSE anaesthesia group and 25 G spinal group were compared for change in hearing between the pre- and postoperative periods, no statistically significant difference was detected at any frequency tested. When 22 G spinal group and 25 G spinal group were compared for change in hearing between the pre- and postoperative periods, there was some hearing loss at low frequency, although this difference did not reach statistical significance. The positive correlation of low-frequency hearing loss and increased pressure in the epidural space (which decrease the risk of cerebrospinal fluid leakage through the dura) suggests that cerebrospinal fluid leakage via the spinal puncture hole is not the only factor involved. Perioperative fluid replacement alone may not prevent hearing loss but CSF loss through the dural puncture site should also be prevented.

Background/aims: Chronicity of inflammation or fibrosis of liver parenchyma in patients with hepatitis C virus infection can be related to features of immunological responses in the liver. Adhesive interactions and free radicals are two important aspects of this inflammatory response. The aim of this study was to investigate serum sICAM-1 and nitric oxide levels in the sera of patients with post-hepatitis C chronic hepatitis., Methodology: Twenty chronic hepatitis patients diagnosed histopathologically and positive for antihepatitis C virus antibody and 20 healthy carriers of hepatitis C virus were included as study and control groups, respectively. Serum hepatitis C virus-RNA, sICAM-I, nitric oxide, blb, albumin and ALT determinations were made in the specimens of each subject in the study and control group., Results: The mean serum sICAM-I levels of study and control subjects were 463.85 +/- 20.42 ng/mL and 241.85 +/- 13.71 ng/mL, respectively (p < 0.01). The same values for nitric oxide levels were 53.57 +/- 3.63 mumol/L and 32.17 +/- 2.19 mumol/L in the same order and also significantly different from each other (p < 0.01). There was a close correlation between fibrosis scores and serum sICAM-I levels (r = 0.77, p < 0.001), serum albumin (r = -0.54, p = 0.014) and ALT (r = 0.49, p = 0.02). Nitric oxide levels, on the other hand, negatively correlated with fibrosis scores (r = -0.59, p = 0.006), sICAM-1 (r = -0.57, p = 0.009) and ALT (r = -0.54, p = 0.013)., Conclusions: Increased serum levels of sICAM are associated with increased fibrotic changes of patients with hepatitis C virus infection, whereas, nitric oxide which may be a suppressor molecule for fibrosing levels are inversely related to fibrotic process.

Objective: Radiological-cytopathological correlation in patients who are prediagnosed ultrasonographically as thyroiditis., Study Design: Fourty five patients with hypoechogenic, heterogeneous, and/or pseudolobulated thyroid gland sonographically were included in this prospective study. Except for the patients with subacute thyroiditis, none of the patients had a prediagnosis of thyroiditis clinically. All patients were evaluated for their thyroid gland functions and intraglandular vascularity and ultrasonography-guided fine needle aspiration biopsy (US-FNAB) was performed., Results: The diagnosis of thyroiditis was confirmed in 36 patients (16 lymphocytic thyroiditis, 20 Hashimoto thyroiditis, two subacute granulomatous thyroiditis) in sonographically suspected patients. In six patients, FNAB was thyroiditis negative. The true diagnosis ratio of thyroiditis was increased up to 81.8% (%95 Confidence Interval: 0.70-0.92) by performing US-FNAB, while it was 4.5% with only clinical and laboratory findings (p=0.0001)., Conclusion: Hypoechogenic, heterogeneous thyroid gland may be strongly related to thyroiditis, which does not have any specific radiological findings. The sonographic finding of generalized parenchymal abnormality should alert the clinician to consider diffuse thyroid disease as the underlying cause and FNAB should be performed and a follow-up examination of these patients must be continued due to the risk of neoplastic disease of thyroid.

This study was designed to examine the immunohistochemical expression of proliferating cell nuclear antigen (PCNA) and bcl-2 protein in 45 cases with advanced laryngeal squamous cell carcinoma who had undergone total laryngectomy with unilateral modified radical neck dissection, and the relation of this expression to some prognostic factors such as tumor front grading and neck lymph node metastases. Sections were reevaluated for routine histologic grade, tumor front grading and neck lymph node metastases, and were stained with monoclonal antibodies against PCNA and bcl-2. Significant correlation was present between the severity of PCNA expression and incidence of lymph node metastasis (p<0.05). No correlation was found between the severity of PCNA expression and tumor front grading. Bcl-2 expression did not associate with either parameters. In conclusion, PCNA is important in predicting prognosis and no association is present between the bcl-2 protein expression and prognostic factors.

Purpose: To describe a unique case of orbital hydatid cyst that was located solely within the medial rectus muscle., Design: Retrospective, interventional case report., Methods: A 20-year-old woman presented with right periocular pain induced by ocular movements. Magnetic resonance imaging studies showed a focal, well-circumscribed intramuscular cystic lesion of the right medial rectus muscle. The cyst was completely extirpated from the muscle, but some of the fluid content escaped into the surrounding tissues. Irrigation with hypertonic saline was performed., Results: Histopathologic examination showed an acellular cyst wall with inner germinal layer, diagnostic for hydatid cyst. Two cycles of oral albendazole were administered with no recurrence., Conclusions: In the orbit, hydatid cyst may be localized primarily within an extraocular muscle and produce painful eye movements. Hydatid cyst must be considered in the differential diagnosis of solitary cystic enlargements of extraocular muscles.

Objectives: To evaluate the efficacy and functional results of the combined suprahyoid-transoral approach in early-stage tongue base cancers., Patients and Methods: Five patients (4 females, 1 male; mean age 47 years; range 12 to 65 years) with tongue base tumors underwent surgery via the combined suprahyoid-transoral approach. Diagnoses were adenoid cystic carcinoma in three patients and squamous cell carcinoma in two patients. The mean follow-up period was 32.4 months (range 10 to 54 months)., Results: One patient with adenoid cystic carcinoma and two patients with squamous cell carcinoma required neck dissection. Postoperative radiotherapy was administered to two patients with squamous cell carcinoma. Tracheotomy was performed in all cases during surgery. All patients were safely decannulated within a mean of 11.4 days (range 9 to 14 days) and converted to oral feeding within a mean of 8.6 days (range 7 to 11 days) with no aspiration problem. All patients had negative surgical margins. All patients had satisfactory phonation. No local or regional recurrences developed during the follow-up period., Conclusion: Functional results obtained through the combined suprahyoid-transoral approach justify its use in the treatment of T1 or T2 tongue base carcinomas.

Purpose: To investigate the tear-film osmolarity of contact lens wearers for different types of contact lenses., Methods: Fifty six eyes of 56 cases were evaluated in four different groups according to the type of contact lens worn, with 14 eyes in each group. Groups 1 and 2 consisted of subjects who wore frequent-replacement daily wear soft contact lenses; group 1 lenses had 55% water content, and lenses in group 2 had 38% water content. Groups 3 and 4 consisted of subjects who wore rigid gas-permeable contact lenses, with a Dk value of 90 in group 3 and a Dk value of 52 in group 4. Tear-film osmolarity values in milliosmole (mosm) units were determined by auto-osmometer (Orstat 6030, Daiichi Kagacu, Kyoto, Japan) before and after contact lens wear for each group, and the results were compared statistically by ANOVA test., Results: Before the period of contact lens wear, the tear-film osmolarity values of group 1, 2, 3, and 4 were 283.61+/-12.83 mosm, 285.23+/-8.94 mosm, 285.57+/-11.39 mosm, and 280.15+/-12.07 mosm, respectively. After the period of contact lens wear, these values were measured at 312.15+/-16.03 mosm in group 1, 316.54+/-12.14 mosm in group 2, 313.14+/-9.66 mosm in group 3, and 316.38+/-11.60 mosm in group 4. Although the difference between the values before and after the period of contact lens wear was statistically significant for each group (F=291.45; P=0.0005), there was no statistically significant difference among the groups., Conclusions: When a contact lens is placed in the eye, the lens alters the normal structure of the tear film and affects its rate of evaporation; therefore tear-film osmolarity may increase. In our study, all contact lenses produced a similar effect on tear-film osmolarity.

Objective: The aim of this study is to investigate the therapeutic role of vitamin A in addition to standard antibiotic treatment on healing of experimental acute maxillary sinusitis., Material and Methods: Experimental maxillary sinusitis in rabbits was induced by blocking the left noses and direct inoculation of Staphylococcus aureus into the left maxillary sinuse cavities. Right maxillary sinuses were exposed to serum physiologic as the control group. Animals were divided into two groups. Forty-eight hours after the inoculation, Group A received only parenteral ampicilline-sulbactam (50 mg/kg), Group B were treated with same antibiotic regimen and parenteral a dose of 100.000 IU vitamin A in palmitate form. Animals were killed at 10th day and mucosas of each sinuses were examined histopathologically. Inflammation and sinus epithelium integrity were assessed. Groups were compared with using Mann-Whitney U test., Results: All of the infected sinuses displayed various degrees of inflammation but there was no statistically significant difference between the study and control groups. Although epithelium integrity was slightly better in Group B but the difference was not meaningful., Conclusion: The adjuctive therapeutic role of vitamin A in acute sinusitis was found doubtful but this topic is worth to investigate more comprehensively.

Villoglandular papillary adenocarcinoma of uterine cervix has been recently described and to date fewer than a hundred cases have been reported in the world literature. Here we present a 38-year-old woman who underwent radical hysterectomy combined bilateral pelvic lymphoadenectomy and after 28 months postoperatively no lymph node metastasis and no evidence of recurrent disease ocurred. Immunohistochemically Ki-67 overexpression was detected in the tumour, with no immunoreactivity with p53, estrogen and progesteron receptors and broadly-reactive human papilloma virus including types 6, 11, 16, 18, 31, 33, 42, 51, 52, 56, and 58. In this paper, clinical, macroscopical, microscopical and immunohistochemical characteristics of this tumour are reviewed.

Necrotizing sialometaplasia at the parotid gland location is rare and simulates malignant disease. If it is seen at this location, the causes may be previous dental or parotid gland surgical procedures, which result in blood vessel injuries and thrombosis. We report a parotid gland necrotizing sialometaplasia of a 17-year-old girl, possibly caused by primary vascular damage or vasculitis.

Apoptosis of tissues may contribute to ischaemia-reperfusion injury. The aim of the present study was to determine whether administration of a colloid solution would prevent apoptosis after liver ischaemia-reperfusion. New Zealand rabbits, weighing 1.5-2 kg, were randomized to receive either 4% SG (20 ml kg (-1)h(-1) ) by 30 min of intravenous (i.v.) infusion (Group I, n= 7) or equivalent volumes of 0.9% sodium chloride (Group II, n= 6) i.v. before a 45 min interruption of the portal vein blood flow and then 45 min of reperfusion. The animals were killed following the reperfusion period. Their livers were processed for histopathological examination and paraffin sections of these tissues were examined. The expression of Bcl-2, Bax and caspase 3 were analysed by immunohistochemistry. ANOVA and the Wilcoxon W -test were used for statistical analysis, and mean values were expressed +/-sd. Histologically, the foci of ischaemic necrosis were observed in liver specimens of the periportal area in one of the animals in Group I and in two in Group II. Immunhistochemical analysis demonstrated an increase in Bcl-2 protein levels in Group I compared to Group II ( P< 0.05). Bax expression was lower in Group I than in Group II. Immunoreactivity for caspase 3 did not differ significantly between the two groups (47.0 +/- 35.93 in Group I, 32.83 +/- 23.63 in Group II). Our results indicate that gelofusine did not protect the liver tissue against ischaemia-reperfusion-induced apoptosis.

Methyl methacrylate (MMA) is a monomer, commonly used in neurosurgery, orthopedic surgery, and in dental clinics. The adverse effects of this monomer are well described in the literature. This study was designed to evaluate the effects of MMA on nasal cavity, lung, and antioxidant status. For this purpose, two experimental groups of rats were exposed to MMA (at 1,000 ppm, 6 h/day, 5 days/week for 4 weeks) by inhalation under poor (group A, n = 12) and normal ventilation (group B, n = 11) conditions. A control group (group C, n = 10) received normal air. Degeneration of olfactory epithelium, bronchopneumonia, interstitial pneumonia, hemorrhage, atelectasis, edema, emphysema, and bronchial epithelial hyperplasia were observed in groups A and B. Emphysema was the most common lesion. Bronchopneumonia with abscesses was only observed in group A. Glutathione levels were significantly decreased and malondialdehyde levels were significantly increased in group A. No significant difference was observed in superoxide dismutase levels between the groups. The data presented indicate that before using MMA, adequate protection systems should be in place to prevent occupationally related MMA respiratory-tract injuries.

We attempted to determine Bcl-2, inducible nitric oxide synthase (iNOS), p53 and proliferating cell nuclear antigen (PCNA) expression, and the relationships between them, in endometrioid adenocarcinomas and precursor lesions. Expression of Bcl-2, iNOS, p53 and PCNA were investigated immunohistochemically in 91 samples from benign (proliferative (pEM), secretory (sEM), disordered proliferative (dEM), inactive/atrophic (aEM), hyperplastic endometrium) and malignant endometrial tissue. Staining scores for Bcl-2 in the dEM, endometrial hyperplasia (EMH) and endometrioid cancer (ECA) groups were higher than in the pEM group (P = 0.004; P = 0.036 and P = 0.020, respectively). A significant difference in proliferating cell nuclear antigen staining was found between simple and complex EMH samples (P = 0.000). An inverse relationship was found between iNOS and p53 in the hyperplasia group (r = -0.533, P = 0.019). While a significant difference was found in p53 staining in ECA between the pEM, dEM and EMH groups, no such difference was found in iNOS staining. In addition, there was no direct relationship between iNOS and p53 in the ECA group. It was concluded that the interaction between iNOS, p53 and Bcl-2 in proliferative processes in the development of type 1 endometrioid adenocarcinomas is different from that in tumors originating in other organs.

Helicobacter pylori (H. pylori) infection is associated with changes in epithelial turnover, through their significance of these in gastric carcinogenesis is still controversial. The purpose of this study was to determine the influence of H. pylori infection on cell proliferation and the relation with the cell-cycle regulators, and finally to provide insights into the mechanism by which H. pylori may lead to gastric carcinogenesis. We investigated Ki-67, p53, p21(Waf1/Cip1), cyclin D1 expression in 55 patients with H. pylori gastritis, and compared the results with patients those of non-H. pylori gastritis patients (n=21), gastric adenocarcinoma patients (n=8) and samples with normal gastric mucosa (n=12). Gastric biopsies were histologically evaluated for inflammatory reaction, intestinal metaplasia and atrophy according to the Sydney system. Overexpression of Ki-67, p53, p21(Waf1/Cip1) and cyclin D1 was found in H. pylori gastritis patients (32.7%, 10.9%, 20.0% and 7.3%, respectively), whereas only scattered expression in cells in the neck region of the crypts, but no overexpression was found in gastric antral epithelial cells in biopsy specimens from patients with non-H. pylori gastritis and noninflammed mucosa. A significant relationship was found between the grade of H. pylori colonization and Ki-67, p53, p21(Waf1/Cip1) and cyclin D1 expression. Expression was significantly higher in patients with intestinal metaplasia with atrophy, whereas no overexpression was found in patients without intestinal metaplasia with atrophy (p=0.05). H. pylori infection is associated with increased cell proliferation, increased epithelial DNA damage, and atrophy, which might contribute to the development of gastric cancer. Even if the exact mechanism has not been elucidated yet, our results suggest that H. pylori infection acts as a cofactor in gastric carcinogenesis.

Background: Surgical stress induces hormonal and cytokine responses proportional to the extent of the injury. Perioperative administration of cyclo-oxygenase inhibitors reduces cytokine production and nitrogen losses. The objective of this study is to evaluate clinically the metabolic and hormonal effects of ibuprofen which is cyclo-oxygenase inhibitor on surgical stress., Methods: A prospective clinic study was performed in 20 patients who undergone thyroidectomy. Patients were randomly divided two groups as ibuprofen group (n = 10) and control group (n = 10). In the ibuprofen group, pills containing ibuprofen (400 mg) were administered orally 12 and 2 hours before surgery, and every 8 hours until the third postoperative day. In the both groups, blood samples were collected 24 and 2 hours before surgery and 1, 4, 6, 24, 48, and 72 hours after skin incision for glucose, CRP, leukocytes, ACTH, cortisol determinations., Results: When preoperative values were compared with postoperative values, surgical stress caused significantly changes on the all parameters in the both groups. The highest levels of ACTH and cortisol were at 1st and 6th hours respectively. In both groups, plasma cortisol levels remained elevated for 3 days, whereas plasma ACTH levels returned to the basal level at 1 day. In the ibuprofen group, the levels of ACTH and cortisol were significantly less than those of control group (p < 0.001 and p < 0.001). In the ibuprofen group glucose level (p < 0.001) and count leukocyte (p < 0.001) increased mildly. The level of CRP increased gradually after first day and were high until 3rd days (p < 0.01). In the ibuprofen group the fever increased smaller (p < 0.01)., Conclusions: In conclusion, in perioperative period pretreatment with ibuprofen is able to reduce the neuroendocrine and humoral responses, but it can not completely suppress. Our present study suggests that ibuprofen may be useful in decreasing the surgical stress response in the serious patients.

Recently, some studies reported the presence of mast cells in various malignancies and their role in tumor growth. The aim of the study was to determine the utility of mast cell numbers in evaluating benign and malignant prostate lesions, and to ascertain whether there are variations in the numbers of mast cells with the Gleason grade. The relationship between mast cell numbers and patient age was also investigated. Retrospectively, 104 prostate specimens were examined for the presence of mast cells. The study group consisted of 57 benign prostatic hyperplasias and 47 prostate carcinomas. The paraffin sections were stained with anti-human mast cell tryptase immunohistologically. The numbers of positively staining cells in five high-power fields were counted, and their mean was calculated. There was no relationship found between mast cell numbers and age statistically. The mean mast cell numbers of the intratumoral region were significantly different from those of the peritumoral region (p = 0.0001). While the difference between benign hyperplasia and the intratumoral region was found to be significant (p = 0.0001), no difference between hyperplasia and the peritumoral region was noted (p = 0.762). There was no statistical difference between Gleason score groups (p = 0.452), and there was no interaction between score groups and intraperitumoral regions (p = 0.355).

Objective: To identify different cell types in the testis by using touch imprint cytology and to compare the cytologic findings to the histopathologic diagnosis in infertile men., Study Design: This prospective study used touch imprint preparations and included 20 infertile men. The biopsy material obtained was stained with toluidine blue, May-Grünwald-Giemsa stain and Papanicolaou stain. The cytologic results for oligospermic, normospermic and azospermic men were compared to the specific histopathologic diagnosis. The proportion of spermatogenic versus Sertoli cells was calculated. The scores were compared between three groups based on the results of the histologic biopsy: normal spermatogenesis, hypospermatogenesis and incomplete spermatogenic arrest., Results: The mean ratio of the spermatogenic cells versus Sertoli cells was statistically significantly different in the three groups (P < .01). The mean ratio of spermatogenic cells to Sertoli cells was higher in cases with normal spermatogenesis than in cases with hypospermatogenesis and incomplete spermatogenic arrest, revealing a statistical difference (P<.01). This ratio was not statistically significantly different between the hypospermatogenesis and incomplete spermatogenic arrest groups., Conclusion: A cytologic demonstration of germinal cells by using touch imprint preparations may be a guide for histologic diagnosis.

Pneumatization of the inferior turbinate is an extremely rare intranasal anatomical variation. Only a few cases have been reported yet. In this paper we present two cases, one unilateral and one bilateral case with pneumatization of the inferior turbinate.

Background and Objective: It is claimed that local anaesthetics have antimicrobial properties. Our aim was to investigate the antimicrobial effects of different concentrations of ropivacaine, bupivacaine, lidocaine and prilocaine on Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans., Methods: All local anaesthetic dilutions were exposed to microorganisms for 0, 30, 60, 120, 240 min at room temperature. The inoculums taken from diluted suspensions were reinoculated on blood agar and incubated for 18-24 h at 35 degrees C and then the colonies were counted., Results: Ropivacaine did not inhibit any of the microorganisms tested. Bupivacaine reduced the viable cells of P. aeruginosa at 0.5% and 0.25% solutions. Lidocaine 5% and 2% and prilocaine 2.0% dilutions reduced the viable cells of all microorganisms tested. Prilocaine 1.0% reduced the viable cells of E. coli, S. aureus and P. aeruginosa. Lidocaine 1% reduced only the viable cells of P. aeruginosa and prilocaine 0.5% reduced only E. coli., Conclusion: Ropivacaine had no antimicrobial effect on microorganisms tested. Bupivacaine showed poor antimicrobial effectiveness. Lidocaine and prilocaine had more powerful antimicrobial effects than the other two local anaesthetics.

Malignant tumours of the salivary glands in children are extremely rare. We present here a 12-year-old girl initially diagnosed as pleomorphic adenoma on fine needle aspiration biopsy, and adenoid cystic carcinoma (ACC) after the lesion was excised and examined by histopathology. A wide resection of the lesion and bilateral supraomyohyoid neck dissection was performed. To our knowledge this is one of the youngest patients with ACC of the minor salivary glands. Due to its benign histological appearance, the biological agressiveness of ACC is usually underestimated. Although fine needle aspiration cytology (FNAC) is very valuable in diagnosis, cytological variations of pleomorphic adenoma must be considered. ACC of the tongue in a young age group should be treated with wide resection and selective neck dissection if the tumour is localized in places where the risk of metastasis is increased and if there is a clinically palpable lymph node. In such cases the clinician should not avoid radical operations even in a young patient.

Myelolipoma is a tumor-like growth composed of mature fat tissue and bone marrow elements. It occurs in the adrenal gland or as an isolated soft tissue mass. It may be associated with endocrine disorders such as hermaphroditism, Cushing's disease, Addison's disease and obesity of unknown cause. These lesions rarely measure more than 5 cm in diameter, although giant tumors have been reported in the literature. The fifth largest surgically resected adrenal myelolipoma in the literature is reported and its clinical associations and, macroscopic and microscopic features are discussed.

Both laryngocele and laryngeal amyloidosis are uncommon, and simultaneous occurrences of these entities are extremely rare. A case of laryngeal amyloidosis with laryngocele in which the computed tomography (CT) and magnetic resonance (MR) imaging of the larynx, clearly demonstrating both disease processes, is discussed. Diagnosis is confirmed by histopathologic specimens. Only two cases have been reported in the world literature, and this is the third case of laryngeal amyloidosis associated with laryngocele.

Objectives: To determine the frequency of PIN (prostatic intraepithelial neoplasia) in prostate specimens and the relationship of PIN with PCA (prostatic carcinoma) and amount of sampling of the specimen., Materials and Methods: All the haematoxylin-eosin stained slides of 121 cases diagnosed between 1990 and 1995 were re-examined retrospectively. The amount of sampling of prostate specimens was also re-examined., Results: PIN was observed in 47.9% of all prostate specimens. The frequency of incidental PIN was 71.4% in cystoprostatectomy specimens. PIN was present in 58.3% of the cases with PCA. We observed foci of high-grade PIN adjacent to sites of invasive carcinoma in 100.0% of prostatectomy specimens with PCA. PIN was high-grade in 100.0% of the carcinomatous prostates with PIN. It was multifocal in 53.4% of 58 cases with PIN. Incidental PCA was identified in 14.3% of cytoprostatectomies for bladder cancer. The average number of paraffin blocks of prostatic tissue was 4.1 (+/-2.6) in cases with PIN and 3.2 (+/-1.4) in cases without PIN., Conclusion: In prostate specimens, the determination of PIN is very important since it is the most likely precursor of PCA. The probability of detecting PIN and PCA in a prostate specimen is directly related to the amount of sampling.

A case of a heterotopic gastric cyst of the oral cavity is described and a review of the literature, with emphasis on the possible etiological theories of this rare lesion, is presented. This developmental lesion is found more commonly in males. It most likely arises from misplaced embryonal tissue. Surgical treatment is the preferred choice of treatment, and CO2 laser is a safe alternative surgical approach for the removal of this lesion.

Salivary duct carcinoma (SDC) is an uncommon and highly aggressive neoplasm that reveals histopathologic features resembling infiltrating duct carcinoma of the breast and prostate. SDC arising on the basis of preexisting pleomorphic adenoma (PA) is very rare. This report describes the fine-needle aspiration (FNA) cytology of a case of SDC ex PA. FNA smears were cellular with cells with large, pleomorphic nuclei, some prominent nucleoli, and finely vacuolated cytoplasm. The neoplastic cells were forming groups, sheets, and papillary structures and a cribriform pattern was present in some sheets. Mitotic figures were frequently seen. Necrosis was prominent in the background. Histologic sections of the tumor revealed areas of comedo carcinoma, papillary carcinoma, and infiltrative carcinoma as well as multiple foci of PA. The presence of a cribriform pattern, tumor cells resembling breast ductal carcinoma cells, and a necrotic background are helpful features for an accurate cytodiagnosis of SDC.

Metastasis in the neck lymph system of primary tumours of the head and neck is frequently seen. In order to prevent this metastasis, neck dissection is carried out by various types of skin incisions. In this study, types of skin incision used in neck dissections were defined, and the advantages, disadvantages and results of J incisions, which have been performed on 320 radical neck dissection patients in our clinic between 1985-1996, were compared with those of other incision types.

OBJECTIVE: To evaluate the distribution of acquired resistance in isolates of Mycobacterium tuberculosis from treated patients in two periods, 1984--89 and 1990--95, in the Bursa (Southern Marmara) region. METHOD: Susceptibility of 531 M. tuberculosis isolates to four commonly used drugs (isoniazid (INH), streptomycin (SM), ethambutol (EMB) and rifampin (RMP) was determined by the absolute concentration method of Canetti et al. RESULTS: In 203 strains isolated in the years 1984--89, the total acquired resistance was 32.5%, and it was 37.5% in 328 strains isolated in 1990--95 (p>0.05). Resistance to INH, SM, RMP and EMB was found in 23.6%, 16.7%, 6.4% and 3.9%, respectively, in the first period (1984--89), and in 26.2%, 20.4%, 25.3% and 8.2%, respectively, in the second period (1990--95). The increase in RMP resistance was statistically significant (p<0.001). The incidence of multidrug-resistant strains was 12.3% in the first period, and 24.4% in the second period, a significant increase (p<0.001). CONCLUSIONS: We believe that progressive emergence of phenotypes resistant to INH+RMP in our region is caused by inadequate treatment for various reasons. In the present study, the fact that multidrug resistance occurred in nearly 25% of patients treated previously but still infective suggests that the approach to surveillance, patient therapy and follow-up programs should be fundamentally reconsidered in our region.

The prediction that the effect of self-serving attribution on personal attraction will vary according to task type was tested. Twenty-four groups of Turkish students, each consisting of 1 participant and 3 confederates, received success feedback after having performed either an additive or a conjunctive task. Two of the confederates made either self-serving or group-serving attributions, whereas the 3rd confederate attributed success to the collective efforts of all group members. Following these attributions, the participants filled out a form to indicate the degree to which they preferred each member as a friend and a work mate. Self-serving attributors in the conjunctive-task condition were less preferred as friends than the self-serving attributors in the additive-task condition. Also, the additive-task participants' ratings for other group members were systematically higher than those of the conjunctive-task participants. Thus, there was a main effect of task type for both friends and workmates.