Abdullah Haholu

HLA-G in Testicular Germ Cell Tumors

Background: HLA-G is a non-classical major histocompatibility complex class I molecule. HLA-G expression has been found in various types of solid and hematological malignancies. It is also expressed in normal testicular and epididymal tissue. However, expression of HLA-G in testicular germ cell tumors has not been extensively studied. The aim of this study was to investigate whether HLA-G protein is present in different components of testicular germ cell tumors. Patients and Methods: 34 testicular cancer patients, for whom tumor tissue was available, were included in the study. Immunohistochemical staining was performed on tissue sections from formalin-fixed, paraffin-embedded tissue samples. Results: 7 (20.6%) patients had positive HLA-G staining in at least 1 component of the tumor sample. In 3 of 7 patients with intratubular germ cell neoplasia, staining with HLA-G was seen in this component. All of the choriocarcinoma components were strongly positive, and about 40% of teratoma components had immunopositivity. The components of seminoma and embryonal carcinoma, and most yolk sac tumors were negative. HLA-G immuno-positivity was not associated with tumor size, retroperitoneal lymph node involvement, distant metastasis, or relapse/refractory status. Conclusion: This study demonstrated that testicular choriocarcinoma and some teratomas express HLA-G, but not seminoma, embryonal carcinoma, and yolk sac tumors.

Prefabrication of vascularized bone graft using an interconnected porous calcium hydroxyapatite ceramic in presence of vascular endothelial growth factor and bone marrow mesenchymal stem cells: Experimental study in rats

Objectives: The purpose of this experimental pilot study was to create a prefabricated vascularized bone graft using interconnected porous calcium hydroxyapatite ceramic (PCHC) block by combining vascular bundle implantation, rat bone marrow mesenchymal stem cells and administration of vascular endothelial growth factor (VEGF) in a rat model. Materials and Methods: Sixty male Sprague-Dawley rats were used. Experimental animals were divided into six groups, each of which comprised 10 rats. The PCHC blocks were implanted in the medial thigh region in groups I, III, and V without vascular bundle implantation. The PCHC blocks were vascularized by the superficial inferior epigastric artery and vein in groups II, IV and VI. These vessels were passed through the hole of the PCHC blocks. Mesenchymal stem cells were administered into the PCHC in groups III, IV, V and VI. In addition, both mesenchymal stem cells and VEGF were administered in group V and VI. The presence and density of any new bone formation and neovascularization from the vascular bundle was evaluated by X-ray, microangiography, scintigraphy, biochemical analysis and histomorphometry. Results: The newly formed vessels and bone formations were significantly greater in group VI, in which both mesenchymal stem cells and VEGF were applied. Conclusion: This preliminary study suggests that: Both mesenchymal stem cells and VEGF provide vascularized bone prefabrication by enhancing neovascularization and osteogenesis in a shorter time compared to only VEGF application.

Malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously: A case report

Malignant melanoma can be successfully treated when it is identified in its early stages, but the disease is associated with a poor prognosis when it is detected in an advanced stage. Papillary thyroid carcinoma is a thyroid cancer that has a good prognosis. The present study reports a rare case of malignant melanoma and papillary thyroid carcinoma that were diagnosed concurrently and treated simultaneously. The present patient was a 37-year-old male, in whom examination of a skin biopsy that was obtained from a lesion in the right retroauricular region revealed the lesion to be consistent with malignant melanoma. The patient underwent radical neck dissection upon the detection of malignant melanoma metastasis to the sentinel lymph node. Metastases of papillary thyroid carcinoma were detected in four out of 38 lymph nodes. The patient was then diagnosed with papillary thyroid carcinoma and underwent total thyroidectomy. The patient was administered with high-dose followed by moderate-dose interferon-α therapy for the treatment of malignant melanoma. The patient also received concurrent radioactive iodine therapy for the treatment of papillary thyroid carcinoma, at the same time as the interferon therapy. The two primary tumors of the patient were treated successfully. During therapy, no serious side-effects were observed, with the exception of fever caused by high-dose interferon therapy. Malignant melanoma and papillary thyroid carcinoma may occur concurrently, although this is rarely observed. The present study reports a rare case that demonstrates that the two tumors can be successfully treated simultaneously.

Differential diagnosis of cervical lymphadenitis mimicking malignancy due to tularemia: Our experiences

BACKGROUND Tularemia is a disease caused by a Gram-negative coccobacillus Francisella tularensis. This bacterium may cause different types of clinical pictures owing to acquisition route and entrance site, such as ulceroglandular, oropharyngeal, glandular, pneumonic, typhoid and ocular forms. Oropharyngeal tularemia (OPT) is the most common form of tularemia in some regions. OPT may cause tonsillopharyngitis followed by cervical lymphadenopathies (LAPs). Without treatment LAP may persist for several months and may mimic other diseases causing cervical LAPs. MATERIALS AND METHODS A total of six cases of OPT, five male and one female, between 21 and 31 years old, diagnosed serologically and clinically recorded in GATA Haydarpasa Training Hospital were included in this study. Detailed story including the region they lived for last 6 months, their occupation, family and neighborhood story with similar complaints were obtained. Patient data were also obtained from manually written patients files and electronical patient file system. Formalin fixed paraffin embedded tissue blocks of all biopsy material were submitted for polymerase chain reaction (PCR) study for F. tularensis. RESULTS A total of six cases with head and neck mass following a story of tonsillopharyngitis admitted to different clinics including infectious diseases, ear-nose-throat and internal medicine in our tertiary care hospital. Physical examination revealed immobile, hard, conglomerated unilateral cervical lymphadenopathy in all cases. Histopathological examination revealed granulomatous inflammation in four cases. Acute suppurative inflammatory changes were also seen in two cases. Large necrotic areas mimicking casseifying necrosis were seen in two cases. PCR amplification of F. tularensis genom from isolated deoxyribonucleic acids was successful in five cases. CONCLUSION Tularemia should be kept in mind in patients with tonsillopharyngitis not responding to penicillins and beta lactam antibiotics. Furthermore, persisting LAPs mimicking tumor with or without the story of previously experienced sore throat or tonsillopharyngitis in past few days or weeks should be evaluated for glandular or OPT. At this point, easily applicable serological tests such as tularemia micro-agglutination tests will confirm the diagnosis of OPT. However, if lymph node were already sampled to exclude especially malignancy or T cell lymphoma, tularemia PCR test may be used to make a certain diagnosis.

Basal cell adenocarcinoma of the parotid gland detected in a patient with breast cancer

Basal cell adenocarcinoma (BCAC) is a rare tumour of the salivary glands and often associated with a good prognosis. The present case had BCAC of the parotid gland as the second primary tumour in addition to breast cancer. The patient was a 66-year-old woman who underwent mastectomy due to breast cancer. She then underwent adjuvant chemotherapy and adjuvant hormone therapy. After 4 years of disease-free follow-up, the patient presented with a swelling on the left cheek. The examination of the biopsy specimen revealed BCAC of the parotid gland. The patient then underwent left parathyroidectomy plus left neck dissection. Adjuvant radiotherapy was performed. Despite the therapy, the patient developed four local recurrences within 1 year, and then developed metastasis to the pleura. A swelling in the parotid gland in a patient with breast cancer should be carefully screened for the presence of a second primary tumour.

Efficiency of quantification of cardiac electrical heterogeneity: via QT dispersion, transmural dispersion, or both

LETTER TO THE EDITOR We read with great interest the article entitled ‘A 24-hour ambulatory ECG monitoring in assessment of QT interval duration and dispersion in rowers with physiological myocardial hypertrophy’ by Lutfullin IY et al. [1] published in the Biology of Sport journal. In the study, the effects of myocardial hypertrophy on cardiac repolarization parameters were investigated in endurance athletes using both 12-lead ECG and 24-hour ECG monitoring. In the conclusion of the article, it was stated that myocardial hypertrophy observed in athletes does not lead to an increase in corrected QT interval (QTIc) duration, QT dispersion (QTd) or corrected QT dispersion (QTcd). QT interval (QTI) duration was found to be increased in athletes with myocardial hypertrophy, but it was attributed to the increased vagal tone of the endurance athletes. Regular intensive training may lead to cardiac hypertrophy known as athlete’s heart. Athlete’s heart is associated with alterations in cardiac structure and electrophysiological properties [2]. As expected, heterogeneity in the duration of the ventricular repolarization phase leading to arrhythmias may also be seen in athlete’s heart. As used in this study, QTd is the most frequently used parameter to detect ventricular inhomogeneity. However, as also mentioned in this article, varying results have been reported in the studies related to QTI [3]. This may be due to the technical limitations in the QTI measurement. QTI can be measured either manually or automatically. It is well known that the reproducibility of QTI measurements is low in both manual and automatic measurements [4] Additionally, in manual measurements, interand intra-observer variability of QTd is very high [3]. Quantifying the inhomogeneity of the myocardium, transmural dispersion of repolarization (TDR) has also been used since the beginning of the 2000s in addition to QTd [5] There are three cell types having different electrophysiological properties in the ventricuEfficiency of quantification of cardiac electrical heterogeneity: via QT dispersion, transmural dispersion, or both

P-0010GSTM1 AND GSTT1 POLYMORPHISM IN TURKISH GASTRIC CANCER PATIENTS

Background: The glutathione S-transferases (GST) are a family of enzymes catalyzing reactions in detoxification of endogenous and xenobiotic substrates including carcinogens. GSTT1 and GSTM1 genes are polymorphic in human. The relations between dysfunction of GST, polymorphism of some GST genes and cancer have been reported. In this study, we aimed to investigate the distribution of GSTT1 and GSTM1 polymorphisms in Turkish gastric cancer patients. Methods: A case-control study was conducted. Fifty patients with gastric adenocarcinoma and 57 healthy subjects were included in the study. DNAwas extracted from peripheral venous blood of control subjects and from the paraffin blocks of cancer cases. GSTT1 and GSTM1 genes genotyping was performed with duplex polymerase-chain-reaction.

Coronary pseudoaneurysm and superior vena cava occlusion in a young patient with multicentric Castleman's disease and antiphospholipid antibody positivity.

Castleman disease is a non-malignant proliferative disease of the lymphoid system. It can be unicentric or multicentric. In this report, we present a case of multicentric Castleman disease to which coronary artery pseudoaneurysm, vena cava superior occlusion, and antiphospholipid antibody positivity was accompanying.