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Vascular tumors in neonates are mostly benign; however, locally aggressive voluminous forms may destabilize the hemodynamics of a neonate. Herein, we present an unusual case of a neonatal giant vascular tumor in the right upper extremity, causing a consumption coagulopathy and acute deterioration of vital signs. The patient required mechanical ventilation, inotropic support, and administration of blood products by the seventh day. Vascular embolization attempts failed to improve the general condition of the patient. Due to the deteriorating and life-threatening general condition of the patient, amputation around the upper arm level occurred under emergency conditions on the twelfth day. The patient's hemodynamic parameters were regained immediately, with neither inotropic agents nor blood products required after the second postoperative day. Clinical and pathological diagnosis revealed kaposiform hemangioendothelioma. Patient monitoring proceeded until the age of 15 months, with no local recurrence around the stump or soft tissue coverage complications. Therefore, since other treatment options failed, the early amputation decision was life-saving.

Objective Wide variation exists in ovarian cancer incidence rates suggesting the importance of environmental factors. Due to increasing environmental pollution, trace elements and heavy metals have drawn attention in studies defining the etiology of cancer, but scant data is available for ovarian cancer. Our aim was to compare the tissue concentrations of lead, selenium and nickel in epithelial ovarian cancer, borderline tumor and healthy ovarian tissues. Methods The levels of lead, selenium and nickel were estimated using atomic absorption spectrophotometry in formalin-fixed paraffin-embedded tissue samples. Tests were carried out in 20 malignant epithelial ovarian cancer, 15 epithelial borderline tumor and 20 non-neoplastic healthy ovaries. Two samples were collected for borderline tumors, one from papillary projection and one from the smooth surface of cyst wall. Results Pb and Ni concentrations were found to be higher both in malignant and borderline tissues than those in healthy ovaries. Concentrations of Pb and Ni in malignant tissues, borderline papillary projections and capsular tissue samples were not different. Comparison of Se concentrations of malignant, borderline and healthy ovarian tissues did not reveal statistical difference. Studied metal levels were not found to be different in either papillary projection or in cyst wall of the borderline tumors. Conclusions This study revealed the accumulation of lead and nickel in ovarian tissue is associated with borderline and malignant proliferation of the surface epithelium. Accumulation of these metals in epithelial ovarian cancer and borderline ovarian tumor has not been demonstrated before.

Giant-cell tumor (GCT) of bone in the hand is very rare. Although this disorder is benign, GCTs show a tendency of significant bone destruction, local recurrence and, occasionally, pulmonary metastasis. Approximately 3% of GCTs is known to metastasize to the lung. Here we report a case of GCT of proximal phalanx of the middle finger in a 21 years old male. In this case recurrence occurred early and there were both local and distant metastasis during the recurrence. The patient underwent ray amputation of the finger and the diagnosis was confirmed by means of microscopy on the specimen. No surgery was performed for metastases and it was controlled by chemotherapy. [Hand Microsurg 2020; 9(3.000): 162-166]

Amaç: Lenfadenopatilerde maligniteçıkma olasılığı %1-3 oranındadır ve ensık lenfomalar gözlenir. Ultrasonografi ayırıcı tanıda hekime bazı bulgularıile malignite yönünde yardımcı olabilir. Tanısı kesinleştirilememiş, malignitedüşünülen vakalarda biyopsi yapılması esastır. Bu çalışmada patolojik lenfadopatili hastaların sosyo demografik verileriklinik laboratuvar, ultrason bulgularıve histopatoloji sonuçlarının karşılaştırılması hedeflenmiştir.Yöntemler: Buçalışmada Kahramanmaraş Sütçü İmam Tıp Fakültesi Hastanesi’ne Ocak 2014 veEylül 2016 tarihleri arasında başvuran 857 lenfadenopatili hastadan (328kız-529 erkek) 50 adet (39’u erkek, 11’ikız) patolojik lenfadenopatili hasta geriye dönük olarak değerlendirildi.Bulgular: Patolojiklenfadenopati tanılı 50 hastanın yaşları 12-192 ay arasında değişmektedir.Hastaların 24’ünde lenfadenopati boyutu 3 cm’nin üzerindeydi.Lenfadenopatilerden 35’i servikal, 15’i ise servikal dışı lokalizasyonasahipti. Bu hastalardan 35’ine reaktif, 15’ine ise non-reaktif USG sonucusaptandı. Hastalardan 38’inde benign hastalık, 12’sinde ise malignite saptandı.Yapılan istatistiksel analizler neticesinde patoloji sonuçları ile USG özelliğiarasında ve aynı zamanda lenfadenopati boyutu ile USG’de tespit edilen boyutarasında anlamlı bir ilişki saptandı (p, OBJECTIVE: The likelihood of malignancy in lymphadenopathies is 1-3% and the mostly lymphomas are seen. Ultrasonography may be helpful in malignancy with some findings in the differential diagnosis of the disease. In cases where malignancy is suspected, which the diagnosis is incomplete, the biopsy is required. In this study, we aimed to compare sociodemographic data of clinical, laboratory, ultrasound findings and histopathology of patients with pathologic lymphadenopathy.MATERIAL AND METHODS: For this purpose, among 857 lymphadenopathic patients (328 females-529 males) who were admitted to Kahramanmaras Sütçü İmam University Medical Faculty Hospital between January 2014 and September 2016, 50 patients (39 male, 11 female) were retrospectively evaluated.RESULTS: The ages of the 50 patients included in the study ranged from 12 months to 192 months. Lymphadenopathy size was over 3 cm in 24 of the patients. Of the lymphadenopathies, 35 had cervical and 15 had non-cervical localization. Among these patients, it was diagnosed with reactive in 35 patients and non-reactive in 15 patients. Of the patients, 38 had benign disease and malignancy was observed in 12 patients. As a result of the statistical analyzes, a significantly correlated relationship was found between pathology results and ultrasonography as well as lymphadenopathy size and the size observed in ultrasonography (p

The aim of this study was to evaluate the effect of an electromagnetic field (EMF), generated close to the ovaries, on primordial follicles. A total of 16 rats were used in this study. The study group consisted of rats exposed to an EMF in the abdominal region for 15 min/d for 15 days. Both the study and control group were composed of eight rats. After the treatment period of 15 days, the ovaries of the rats were extracted, and sections of ovarian tissue were taken for histological evaluation. The independent samples t test was used to compare the two groups. In the study group, the means of the right and left ovarian follicle numbers were 34.00 +/- 10.20 and 36.00 +/- 10.53, respectively. The average total ovarian follicle number was 70.00 +/- 19.03. In the control group, the means of the right and left ovarian follicle numbers were 78.50 +/- 25.98 and 71.75 +/- 29.66, respectively, and the average total ovarian follicle number was 150.25 +/- 49.53. The comparisons of the means of the right and left ovarian follicle numbers and the means of the total ovarian follicle numbers between the study and control groups indicated that the study group had significantly fewer follicles (p < 0.001, p = 0.011, and p = 0.002, respectively). This study found a significant decrease in the number of ovarian follicles in rats exposed to an EMF. Further clinical studies are needed to reveal the effects of EMFs on ovarian reserve and infertility. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.

Objective: Serum Lipocalin 2 (LCN2) levels are a general indicator for increased inflammation in the patients with psoriasis. In this study, we aimed to investigate the receptor levels of LCN2 in psoriatic lesions. Methods: Immunohistochemical expression of LCN2 was investigated in 31 skin biopsy samples of patients with psoriasis and 31 skin biopsies of control group and the results were compared between the groups. Results: Among patient group, 19 patients (61.3%) had plaque psoriasis and in all of these, medium to strong staining intensity of LCN2 immunohistochemical expression was detected in the upper epidermal layer. In remaining 12 patients (38.7%) with pathologically early stage psoriatic lesions and control group epidermal LCN2 immunohistochemical expression was not observed. LCN2 immunohistochemical expression was detected in the inner root sheath of the hair follicles in both groups without any statistically difference (p=1.00). Conclusion: In our study, medium to strong staining of LCN2 receptor was detected in the superficial epidermis of the psoriatic plaques. But LCN2 immunohistochemical staining was not observed in control skin biopsies. These findings may point out the significance of LCN2 in pathogenesis of psoriasis. On the other hand, absence of expression in patients with early psoriatic lesions imply that LCN2 may be active at the later stages of the pathology.

Objectives: The aims of this study were to describe the histopathological findings of placenta creta samples obtained over a six year period and to report the obstetric conditions related to the histopathologic findings. Materials and Methods: Pathology records from gravid hysterectomies performed due to placenta creta from 2006 to 2012 were reviewed. We evaluated the decidual layer, percent of multinucleation, and depth of invasion of Interstitial Trophoblasts (ITs) at the implantation site. Spiral arteries were also assessed to determine the degree of remodeling. Results: During the study period, 20 cases of placenta creta occurred: 3 (15%) were placenta accreta, 7 (35%) were placenta increta, and 10 (50%) were placenta percreta. In 25% of cases, vessels had no remodeling at all, whereas 45% had partially remodeled vessels, and 30% completely remodeled vessels. The proportion of incomplete or complete physiological changes in the vascular wall did not significantly differ between the different subtypes of creta (P=0.68). Depth of IT invasion varied significantly between the groups (accreta 1.30±0.17 mm, increta 3.56±1.12 mm, and percreta 2.00±1.31 mm, P=0.011). The number of multinucleated trophoblasts in the placenta accreta and increta were higher than those in placenta percreta cases. A history of Cesarean Section (CS) was present in 80% of the patients. All cases with placenta percreta (N=10) had undergone more than two previous CSs. Placenta previa was identified in four cases (20%). Conclusion: Uterine damage caused by CSs results in poor decidualization, abnormal trophoblastic invasion, incomplete vascular remodeling, fewer multinuclei trophoblasts and deep infiltrative pathology.

Langerhans’ cell histiocytosis (LCH) is a group of diseases of unknown cause resulting from abnormal proliferation of bone marrow-originated dendritic cells called histiocytes. The incidence is between 0.5-5.4 per million. More common in childhood, it is extremely rare in adults. In adults, pulmonary involvement with Langerhans’ cell histiocytosis usually occurs as a single-system disease. In this article, the clinical, radiological and histopathological findings of a 51-year-old male patient with both skin, bone and pulmonary involvement were presented and discussed with recent literature.

Objective To evaluate the accuracy of imprint cytology of core needle biopsy specimens in the diagnosis of prostate cancer. Methods Between December 24, 2011 and May 9, 2013, patients with an abnormal DRE and/or serum PSA level of >2.5 ng/mL underwent transrectal prostate needle biopsy. Samples with positive imprint cytology but negative initial histologic exam underwent repeat sectioning and histological examination. Results 1,262 transrectal prostate needle biopsy specimens were evaluated from 100 patients. Malignant imprint cytology was found in 236 specimens (18.7%), 197 (15.6%) of which were confirmed by histologic examination, giving an initial 3.1% (n = 39) rate of discrepant results by imprint cytology. Upon repeat sectioning and histologic examination of these 39 biopsy samples, 14 (1.1% of the original specimens) were then diagnosed as malignant, 3 (0.2%) as atypical small acinar proliferation (ASAP), and 5 (0.4%) as high-grade prostatic intraepithelial neoplasia (HGPIN). Overall, 964 (76.4%) specimens were negative for malignancy by imprint cytology. Seven (0.6%) specimens were benign by cytology but malignant cells were found on histological evaluation. On imprint cytology examination, nonmalignant but abnormal findings were seen in 62 specimens (4.9%). These were all due to benign processes. After reexamination, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate of imprint preparations were 98.1, 96.9, 98.4, 92.8, 99.3, 1.6, 3.1%, respectively. Conclusion Imprint cytology is valuable tool for evaluating TRUS-guided core needle biopsy specimens from the prostate. Use of imprint cytology in combination with histopathology increases diagnostic accuracy when compared with histopathologic assessment alone. Diagn. Cytopathol. 2015;43:91–97. © 2014 Wiley Periodicals, Inc.

IntroductionAlthough lymphomas can arise from a wide variety of tissues, primary extranodal presentation is predominantly a feature of non-Hodgkin's lymphomas. Primary pelvic extranodal Hodgkin's lymphoma is a rare malignancy. We presented a case of primer retroperitoneal Hodgkin's lymphoma initially presumed gynecologic malignancy. We discussed its rarity, staging and management.Case ReportA 75-year-old woman was referred to our hospital with persisting pelvic mass. Pelvic examination revealed an ill-defined immobile mass with hard in consistency. The mass 100 × 75 mm in diameter, invading right parametrium, perivesical space and bladder wall was detected in CT and there were no signs of metastases or enlarged lymph nodes. Diagnostic laparoscopy was suggested but the patient refused the surgery due to her advanced age. One year later, she presented with the symptoms of fever, sweats and fatigue. Hodgkin's lymphoma was diagnosed via laparoscopic biopsy of the mass located at retroperitoneal space anteriorly to the uterus. CT examination revealed multiple swollen lymph nodes and a pulmonary nodule; thus, stage 4 disease was established. International prognostic score was 2, indicating 67% progression free survival; however, patient died due to respiratory failure after the first course of ABVD chemotherapy.ConclusionAlthough gynecologists rarely experience primary extranodal lymphomas particularly Hodgkin's disease, lymphoid malignancies should be kept in mind in differential diagnosis of pelvic masses. This disease can rarely arise adjacent to gynecologic organs in retroperitoneal space, and this presentation can be misinterpreted as a gynecological malignancy.How to cite this articleKiran G, Canaz E, Sayar H, Serin S, Balakan O. Primary Extranodal Hodgkin's Lymphoma presenting with a Single Pelvic Mass. J South Asian Feder Obst Gynae 2014;6(3):183-186.

Azathioprine (AZA) is an immunosuppressive drug that is widely used in the treatment of autoimmune diseases. Although AZA is used widely, many studies reported that AZA-related hepatotoxicity is rather rare. We aimed to present a case with severe cholestatic hepatitis due to AZA use for Behcet’s disease. Three weeks after starting AZA for the treatment of uveitis, the patient was admitted to our clinic with cholestasis and constitutional symptoms. In liver biopsy, findings were in accordance with drug reaction, and the AZA treatment was stopped. After 2 months, bilirubin levels and liver tests results became normal. As a result, given that AZA may cause severe cholestasis, the drug should be stopped if idiosyncrasy or hypersensitivity develops. If there is a debate in the diagnosis, histopathological evaluation of the liver would be the major issue because of the correct diagnosis of the drug toxicity and excluding other aetiologies.

Objective: The aim of this study was to analyze the effect of dexketoprofen trometamol, a non-steroidal anti-inflammatory drug, on fracture healing. Methods: Closed tibia fracture was created in the right tibia of 60 male Wistar albino rats. Fixation was achieved by closed reduction and 0.5 mm intramedullary nails. Intramuscular dexketoprofen trometamol was administered at a dose of 5 mg/kg daily to the 30 rats in the study group. Rats were sacrificed in groups of 10 at the 2nd, 4th, and 6th weeks following the fracture. Fracture healing was compared mechanically, radiologically, and histopathologically between the groups. Results: There was no statistically significant difference between the study and control groups in terms of mean values of radiological or histopathological scores at the 2nd, 4th and 6th weeks (p>0.05). Biomechanical evaluation could not be conducted in all rats in the study and control groups at the 2nd week due to early stage fracture healing. Mean biomechanical examination values were not statistically significant at the 4th and 6th weeks between the study and control groups (p>0.05). Conclusion: No radiological, biomechanical, and histological effects were detected in the healing of closed fractures of the tibia fixed with intramedullary nail with the long-term use of dexketoprofen trometamol. Dexketoprofen trometamol may be used in patients undergoing surgical fixation for traumatic fractures, taking into account other drugs administered together.

Background: High-grade transformation or dedifferentiation in carcinoma is progression of a low-grade malignant neoplasm to a high-grade carcinoma or poorly differentiated adenocarcinoma. This is rarely observed in adenoid cystic carcinoma of the salivary glands. Case Report: A 39 year-old woman presented with a painless mass at the left submandibulary region that had been growing slowly for 5 years. Submandibulary mass resection revealed a mass with peripheral adenoid cystic carcinoma and a central high-grade tumor delineated with a fibrous rim, raising the possibility of a hybrid or composite carcinoma, requiring differential diagnosis depending upon morphology and immunohistochemistry findings. The final histopathological diagnosis was high-grade transformation of adenoid cystic carcinoma. After surgical therapy, the patient was irradiated to the neck and submandibulary region. No sign of tumor recurrence has been evident for 36 months. Conclusion: This present case seems to be another rare case with high-grade transformation of adenoid cystic carcinoma and the fibrous rim may be a histopathological feature of such cases, which should be kept in mind. Turkish Başlık: Adenoid kistik karsinomdan fibroz bir bantla ayrılan yüksek dereceli transformasyon : olgu sunumu Anahtar Kelimeler: Adenoid kistik karsinom, submandibular gland, dediferansiyasyon, yüksek derece transformasyon. Arkaplan: Karsinomlarda yüksek derece transformasyon yada dediferansiyasyon düşük derece malign neoplazmın yüksek derecede karsinom veya kötü diferansiye adenokarsinoma ilerlemesidir. Bu durum tükürük bezlerindeki Adenoid kistik karsinom'da nadiren görülmektedir. Olgu Sunumu: 5 yıldır boyun sol submandibular alanda ağrısız, yavaş büyüyen kitle şikayeti olan 39 yaşında bayan hasta kliniğimize başvurdu. Submandibular kitle rezeke edildiğinde ortada yüksek dereceli tümörün ince fibröz bantla çevresindeki Adenoid kistik karsinom'dan ayrıldığı görüldü. Hibrid veya kompozit karsinom olasılığı yüksek olduğu için morfolojik ve immunohistokimyasal bulgularla ayırıcı tanısı yapılması gerekti. Final histopatolojik tanı yüksek derece transformasyonlu Adenoid kistik karsinom olarak kondu. Cerrahiden sonra boyun ve submandibular bölgeye radyoterapi uygulandı. 36 ay boyunca takiplerinde tümör rekürrensi görülmedi. Sonuç: Bu sunulan yüksek dereceye transforme adenoid kistik karsinom olgusu nadir gibi görünmektedir ve bu tür vakalarda fibröz bantın bir histopatolojik özellik olabileceği akılda tutulmalıdır., Arkaplan: Karsinomlarda yüksek derece transformasyon yada dediferansiyasyon düşük derece malign neoplazmın yüksek derecede karsinom veya kötü diferansiye adenokarsinoma ilerlemesidir. Bu durum tükürük bezlerindeki Adenoid kistik karsinom'da nadiren görülmektedir. Olgu Sunumu: 5 yıldır boyun sol submandibular alanda ağrısız, yavaş büyüyen kitle şikayeti olan 39 yaşında bayan hasta kliniğimize başvurdu. Submandibular kitle rezeke edildiğinde ortada yüksek dereceli tümörün ince fibröz bantla çevresindeki Adenoid kistik karsinom'dan ayrıldığı görüldü. Hibrid veya kompozit karsinom olasılığı yüksek olduğu için morfolojik ve immunohistokimyasal bulgularla ayırıcı tanısı yapılması gerekti. Final histopatolojik tanı yüksek derece transformasyonlu Adenoid kistik karsinom olarak kondu. Cerrahiden sonra boyun ve submandibular bölgeye radyoterapi uygulandı. 36 ay boyunca takiplerinde tümör rekürrensi görülmedi. Sonuç: Bu sunulan yüksek dereceye transforme adenoid kistik karsinom olgusu nadir gibi görünmektedir ve bu tür vakalarda fibröz bantın bir histopatolojik özellik olabileceği akılda tutulmalıdır.

Necrosis of random pattern flaps caused by inadequate blood flow, especially in the distal part of the flap is one of the biggest challenges in reconstructive surgery. Various agents have been used to prevent flap ischemia. In this study, we used omeprazole, which is a potent inhibitor of gastric acidity to increase flap viability.In this study, 35 Wistar-Albino type rats which were divided into 5 equal groups were used. Random-pattern dorsal skin flaps were raised in all groups at seventh day of the study. Group 1 was accepted as control group, and the rats in this group was only given distilled water intraperitoneally for 14 days. Group 2 and group 3 received 10 and 40 mg/kg omeprazole daily for 14 days, respectively. Group 4 and group 5 were given distilled water for the first 7 days and then after the operations they received 10 and 40 mg/kg omeprazole daily for 7 days, respectively. Survival rates of the flaps were examined seventh day after elevation of the flaps by digital imaging and scintigraphy. After assessment of the amount of necrosis, number of vascular structures were counted histopathologically.Percentage of flap necrosis was found to be less in all omeprazole received groups. On digital imaging, percentages of flap necrosis in the study groups were statistically significantly lower than that of the control group (P0.001), but there was no significant difference between the study groups (P0.05).In the histopathologic specimens, it was detected that the mean number of vessels in proximal (a) and distal (c) portions of the flap in the study groups showed a significant increase when compared with the control group (P0.01 for groups 2, 4 and 5, and P0.05 for group 3).In conclusion, possible clinical usage of medications increasing gastrin during flap surgeries can be thought as a positive contributor. In this sense, this study showed that parenteral administration of omeprazole in skin flap surgery increases flap viability possibly by increasing gastrin levels.

Sertoli--Leydig hücreli tümör (SLHT)'lerin %70--75'i 40 yaşın altında, 0/010'dan azı menarştan önce veya postmenopozal dönemde görülmektedir. Bu çalışmada, postmenopozal lekelenme şek-- linde vajinal kanama ile hastanemize başvuran, sağ adneksiyal kitle saptanan 59 yaşındaki kadın olgu sunulmuştur. Olguya batın yıkama sıvısı örneklemesi, total abdominal histerektomi ve bilate-- ral salpingooferektomi yapıldı. İntraoperatif frozen kesitlerin değerlendirilmesinde seks kord stro-- mal tümör düşünüldü. Periton biyopsileri, omentektomi ve pelvik, paraaortik lenf nodu diseksiyonu ile evreleme cerrahisi yapıldı. Solid ve kistik alanlar içeren kitleden hazırlanan kesitlerin histopa-- tolojik incelemesinde; immatür görünümdeki sertoli hücrelerinin tübüller yanı sıra geniş sarko-- matöz dağılım paterni oluşturduğu görüldü. İmmünohistokimyasal çalışmada CD 56 ile kuvvetli, kalretinin, inhibin ile fokal pozitif boyanma görüldü. Histopatolojik ve immünohistokimyasal bul-- gular değerlendirilerek az diferansiye SLHT tanısı verildi. Az diferansiye SLHT nadir görülen, ayı-- rıcı tanısında iğsi hücre komponentli tümörlerin düşünülmesi gereken overin seks kord stromal tümörüdür. 70—75% of Sertoli—Leydig cell tumors (SLCT) are diagnosed at before age of 40, and less than 10% takes place before menarche and following menapouse. We report case of right adnexal mass in 59 year—old postmenapousal woman who presented with vaginal bleeding. Sex—cord stro— mal tumor was diagnosed at peroperative frozen section assesment. Staging surgery consisting of peritoneal biopsies, omentectomy and pelvic paraaortic lymph node dissection was performed. ln histopathologic assesment of the slides which were prepared from solid—cyctic areas of the mass, revealed immature sertoli cells forming tubules and wide sarcomatoid differantiation. lmmunhis— tochemically, neoplastic cells stained strongly and diffusely positive with CD 56, focal positive with calretinin and inhibin. Poorly differentiated SLCT was diagnosed with the consideration of both histopathologic and immunhistochemical findings. Poorly differantiated SLCT are unusual sex cord stromal neoplasms of ovary of which differantial diagnosis should include spindle cell neoplasms.

The aim of the study was to evaluate the effects of selenium (Se) on ischemia/reperfusion (I/R) injury in rat ovaries.Thirty-five female Sprague-Dawley rats were randomly divided into 5 groups (n = 7): sham (S), I/R1, I/R2, Se1, and Se2. In the I/R1 and Se1 groups, 4 hours of ischemia was followed by 6 hours of reperfusion, and in the I/R2 and Se2 groups, 4 hours of ischemia was followed by 12 hours of reperfusion. In the Se groups, 30 minutes before reperfusion, a single dose of 0.2 mg/kg Se was administered intraperitoneally. The ovarian tissue levels of malondialdehyde (MDA) and nitric oxide (NO), and the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured biochemically. Tissue damage to ovarian tissue was scored by histopathologic examination.The I/R groups had significantly higher MDA levels and lower CAT, SOD, and GPx activities than the sham group (P.05). Although NO levels were significantly higher in the I/R1 group than in the sham group (P.05), the NO levels in the I/R2 and sham groups were similar. Selenium pretreatment significantly lowered tissue MDA and NO levels and increased tissue SOD and GPx activities in the Se groups, compared with those in the I/R groups (P.05). Catalase activities were significantly higher in the Se2 group than in the I/R2 group (P.05). Catalase activities were higher in the Se1 group than in the I/R1 group, but the difference was not statistically significant. Treatment with Se significantly decreased the ovarian tissue damage scores in the Se2 group compared with those in the I/R2 group (P.05).Selenium is effective in preventing tissue damage induced by I/R in rat ovaries.

Xanthogranulomatous pyelonephritis (XGP) is an uncommon and aggressive form of inflammation of the renal parenchyma particularly resulting in diffuse renal destruction. A previously healthy 25-year-old woman was admitted to our clinic with right flank pain of sudden onset, nausea and high fever. Computed tomography revealed a mass (12 x 7 cm in diameter) around the right kidney with extension to pelvis and paravertebral space. Flank incision was made urgently and a very large perirenal haematoma and abscess formation were found caused by the rupture located at the posterior side of the right kidney. A right nephrectomy was performed and abscess material was evacuated from the perirenal area. XGP was diagnosed by histopathologic examination of the resected kidney. Although XGP regularly demonstrates a gradual progression and presents with nonspecific symptoms, the situation may appear with complications as in our case. Our patient presented with renal rupture and perirenal abscess extending to the pelvis and paravertebral space. To the best of our knowledge, this is the first report of XGP presenting with spontaneous renal rupture in the English literature.

Ependymomas commonly arise in the central nervous system. Extraneural presentation is quite rare. Herein, we describe a primary extraneural ependymoma in a young female. The mass was located in the right inguinal area. The cut surface of the 7.5 mm × 6.5 mm × 4.5 mm sized tumor was brownish-yellow in color. Histologically, it was hypercellular exhibiting pseudorosette or rosette formations and some papillary structures. Mitosis was counted as high as 10 per 10 high power fields. Neither necrosis nor vascular endothelial proliferation within the tumor was observed. Tumor cells showed strong glial fibrillary acidic protein immunoreactivity. On epithelial membrane antigen, intracytoplasmic dot-like immunostaining was observed. This is the first report presenting a primary extraneural anaplastic ependymoma arising in the inguinal subcutaneous region.

Inflammatory fibroid polyp (Vanek-s tumor) is a rare benign polypoid lesion of the gastrointestinal tract. It often varies between 1-3 cm in diameter. It is usually seen in 60-70 years. Microscopically, proliferate spindle cells which localized around the vessels concentrically and eosinophil-rich inflammatory infiltrate are seen. In the differential diagnosis, many benign mesenchymal tumors of gastrointestinal tract, especially gastrointestinal stromal tumor, should be considered. 70 year old male patient, admitted with epigastric pain, nausea, fever after eating, had normal laboratory values except anemia. Contrast-enhanced computed tomography revealed a polypoid mass about 4 cm in diameter in the cardia and he was operated on suspicion of gastrointestinal stromal tumor. In the microscopic examination of excision material, numerous small and large vein structures, spindle cell proliferation and eosinophil-rich inflammatory infiltrate were observed. Immunohistochemically, CD117, CD34, smooth muscle actin, desmin, S-100, cytokeratin, DOG 1 were negative, Vimentin was strongly positive and Ki-67 proliferation index was 2%. The diagnose was -inflammatory fibroid polyp-. The case is presented because of the unusually localization, large diameter, its rare occurrence and the potential risk of confusion with gastrointestinal stromal tumor.

Aspergillus fungi can cause serious infections, including intra-abdominal infection, particularly in patients with compromised immune system. Described in the present report is case of 46-year-old female patient who had undergone laparoscopic cholecystectomy (LC) at another healthcare facility. In early postoperative period, she had increasing complaints of swelling, nausea, and vomiting. On postoperative 19th day, she was referred to our clinic with diagnosis of acute abdomen. Surgery was performed with suspected possibility of bile leakage. However, pathological examination of soft, yellow-green mass found in subhepatic space determined it was fungus ball caused by fungi of the genus Aspergillus. Patient was diagnosed postoperative intra-abdominal aspergillosis (IAA).

Background This experiment was performed to compare the effects of Phenytoin (PHT) and Hypericin (HP) cream on healing of burn wounds in rats. Material and methods Twenty rats were divided into 3 groups and second-degree burn wounds were created. The burn wounds in the first, second, and third groups were covered twice daily with PHT cream, HP cream, and saline (control), respectively. At the end of days 3, 7, 14, and 21, full-thickness skin biopsies were done for histopathologic and immunohistochemical analyses. Results Histopathologic evaluations at the 14th day showed that re-epithelialization scores were greater in the HP group than the PHT group, but on day 21, re-epithelialization scores were higher in the PHT group than the HP group. Collagen content on days 3 and 14 in the PHT group was found to be higher than in the HP group. Well-vascularized granulation tissue on day 7 in the PHT group was higher than in other groups. HP and PHT groups had a significant increase in VEGF and TGF-b expression in burn wound healing area compared to the control group on all days. Conclusions Topical application of HP can promote re-epithelialization in burn wounds to shorten the wound healing time for superficial burns. Phenytoin, on the other hand, contributes to healing by increasing vascularized granulation tissue and collagen synthesis through re-epithelialization. The increased VEGF and TGF-b expression following PHT and HP treatment strongly indicate that PHT and HP treatment promotes VEGF and TGF-b production and action in the burn wound area.

Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically. Lymphangiomatous polyps of the palatine tonsils are uncommon hamartomatous proliferations that could be clinically misdiagnosed as malignant neoplasms. These polyps consist of dilated lymphatic vessels located inside fibrous and/or adipose tissue. In this paper, a 27-year-old man who presented to the outpatient clinic with a complaint of dysphagia is presented. On physical examination, the patient had a smooth, polypoid mass extending from the posterior section of the right palatine tonsil into the oropharynx. The patient underwent right tonsillectomy. histopathological examination of the specimen showed typical features of a lymphangiomatous polyp of the tonsil. The case is reported with the accompanying literature to avoid the possibility of misdiagnosing it as a malignant lesion clinically.

The aim of this study was to analyze the effect of dexketoprofen trometamol, a non-steroidal anti-inflammatory drug, on fracture healing.Closed tibia fracture was created in the right tibia of 60 male Wistar albino rats. Fixation was achieved by closed reduction and 0.5 mm intramedullary nails. Intramuscular dexketoprofen trometamol was administered at a dose of 5 mg/kg daily to the 30 rats in the study group. Rats were sacrificed in groups of 10 at the 2nd, 4th, and 6th weeks following the fracture. Fracture healing was compared mechanically, radiologically, and histopathologically between the groups.There was no statistically significant difference between the study and control groups in terms of mean values of radiological or histopathological scores at the 2nd, 4th and 6th weeks (p0.05). Biomechanical evaluation could not be conducted in all rats in the study and control groups at the 2nd week due to early stage fracture healing. Mean biomechanical examination values were not statistically significant at the 4th and 6th weeks between the study and control groups (p0.05).No radiological, biomechanical, and histological effects were detected in the healing of closed fractures of the tibia fixed with intramedullary nail with the long-term use of dexketoprofen trometamol. Dexketoprofen trometamol may be used in patients undergoing surgical fixation for traumatic fractures, taking into account other drugs administered together.

Primary malignant melanoma of the bladder is very rare. Rather than being a primary lesion, malignant melanomas of the bladder are more commonly metastatic lesions. The histopathological appearance largely does not differ from that of melanoma at other body sites. It is often difficult to discriminate whether a bladder melanoma is primary or metastatic. Therefore, a careful review of histological features and performing necessary immunohistochemical staining procedures for S-100 protein and HMB-45 are very important in achieving a correct diagnosis. We report a case of hypomelanotic malignant melanoma of the bladder. Despite the variety of therapies available for primary melanomas of the bladder, the prognosis is still poor. © 2014 Canadian Urological Association.

To evaluate the accuracy of imprint cytology of core needle biopsy specimens in the diagnosis of prostate cancer.Between December 24, 2011 and May 9, 2013, patients with an abnormal DRE and/or serum PSA level of2.5 ng/mL underwent transrectal prostate needle biopsy. Samples with positive imprint cytology but negative initial histologic exam underwent repeat sectioning and histological examination.1,262 transrectal prostate needle biopsy specimens were evaluated from 100 patients. Malignant imprint cytology was found in 236 specimens (18.7%), 197 (15.6%) of which were confirmed by histologic examination, giving an initial 3.1% (n = 39) rate of discrepant results by imprint cytology. Upon repeat sectioning and histologic examination of these 39 biopsy samples, 14 (1.1% of the original specimens) were then diagnosed as malignant, 3 (0.2%) as atypical small acinar proliferation (ASAP), and 5 (0.4%) as high-grade prostatic intraepithelial neoplasia (HGPIN). Overall, 964 (76.4%) specimens were negative for malignancy by imprint cytology. Seven (0.6%) specimens were benign by cytology but malignant cells were found on histological evaluation. On imprint cytology examination, nonmalignant but abnormal findings were seen in 62 specimens (4.9%). These were all due to benign processes. After reexamination, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate of imprint preparations were 98.1, 96.9, 98.4, 92.8, 99.3, 1.6, 3.1%, respectively.Imprint cytology is valuable tool for evaluating TRUS-guided core needle biopsy specimens from the prostate. Use of imprint cytology in combination with histopathology increases diagnostic accuracy when compared with histopathologic assessment alone.

Objective Subepidermal bullous lesions and toxic epidermal necrolysis-like (TEN-like) lesions can occur in patients with systemic lupus erythematosus (SLE). In this report, we describe a case of a patient previously diagnosed with SLE who experienced TEN-like skin lesions with unusual subacute progression in the context of the current literature. Methods We present a recent case of TEN-like lupus erythematosus and review of studies published in English identifying SLE cases mimicking TEN, accessed via PubMed and Google Scholar databases. The keywords used in the search were: TEN, SLE, TEN-like SLE, and TEN-like lesions. The search covered all articles from January 1980 to November 2011. Results A 52-year-old male presented with fatigue, weakness, and weight loss (23 kg in two months). Skin redness started across nose and cheeks six months before admission. Bilateral pleural effusions were observed in a thorax tomography taken in the referral hospital two months prior to admission. Because of articular involvement, antinuclear antibody (ANA), and anti-dsDNA positivity, the patient was diagnosed with SLE. We initiated a punch skin biopsy, and the findings were consistent with Stevens-Johnson syndrome. There was marked basal layer necrosis in the epidermis, and there was predominantly lymphohistiocytic infiltrate in the dermis. A total of 22 cases, including our case, with TEN-like lupus erythematosus were reported in the literature. In addition, cutaneous lupus had positive ANAs in 18 of 22 patients (81.8%). The patients were aged 12 to 76 years; 21 cases were women and only one patient was male. Discussion Skin involvement, including the rare variant of TEN-like acute cutaneous SLE, is very common among SLE patients. The acute syndrome of pan-epidermolysis or apoptotic pan-epidermolysis may become a useful designation when considering a clinical diagnosis of drug-induced TEN or SLE. Further studies are required to verify our findings.

Adrenal myelolipoma is a rare benign tumour. This tumour is generally considered as a type of hormonally inactive neoplasm, which is composed of mature adipose tissue and normal haematopoietic cells. Rarely adrenal myelolipoma and adrenal cortical adenoma could be found together in the same gland. Due to myelolipoma9s asymptomatic character, it is generally diagnosed incidentally. In fact, myelolipoma can now be easily detected because of improved techniques such as ultrasound, CT and MRI and widespread use of imaging. Because of this a 66-year-old male patient with abdominal pain, proved that adrenal myelolipoma and non-functional adrenal cortical adenoma are rare in the same gland. The case presented here deals with different outcome which is rare in the literature.

Recent studies have demonstrated a role for calcium channel blocking agents in the treatment of persistent hyperinsulinemic hypoglycemia of newborns. We report a newborn infant with persistent hyperinsulinemic hypoglycemia whom we successfully treated with oral nifedipine alone after surgical therapies. A 4-day-old male infant was referred with intractable hypoglycemia and seziures. Normoglycaemia could be maintained only by the intravenous infusion of glucose at a rate of 20 mg/kg per minute. Persistent hyperinsulinemic hypoglycemia of newborn was diagnosed from an inappropriately raised plasma insulin concentration (44 mU/L) at the time of hypoglycemia. Medical treatments led to only a mild reduction in the intravenous glucose requirement; an 85-90% pancreatectomy was performed and histological "diffuse nesidioblastosis" was confirmed. However, despite all the medical treatments after the first pancreatectomy, the hyperinsulinemic hypoglycemia persisted and a second 95% pancreatectomy was performed. After the second pancreatectomy, persistent hyperinsulinemic hypoglycemia was treated with somatostatin and diazoxide, but led to no reduction in the intravenous glucose requirement. We report the case of an infant who had persistent hypoglycemia after two subtotal pancreatic resections but subsequently became normoglycemic on treatment with nifedipine (2 mg/kg per day). The patient was discharged home on oral nifedipine. Calcium channel blocking agents cuold be used with efficacy and safety in recurrent persistent hyperinsulinemic hypoglycemia.