Adem Arslan

The effect of urokinase in preventing the formation of epidural fibrosis and/or leptomeningeal arachnoiditis

BACKGROUND Epidural fibrosis and leptomeningeal adhesion formation are among the common causes of failed back surgery syndrome. Urokinase has been commonly used in treating aneurysmal subarachnoid hemorrhage and intracerebral hematoma. METHODS In a rat model, the potential of local urokinase in preventing the production of epidural fibrosis due to bleeding was investigated. RESULTS A reduction of approximately 48% in leptomeningeal adhesion formation with the use of urokinase was demonstrated. Adhesion score was 2.300 in the control group and 0.700 in the urokinase treated group on day 42 of the postoperative period. CONCLUSIONS It can be concluded that urokinase has the important effect of preventing the formation of leptomeningeal adhesion, but many more extensive studies clearly need to be done before such material can be clinically used.

Diffuse lipomatosis of thyroid gland

A case of diffuse lipomatosis of the thyroid gland is presented. Previously documented cases of this rare disorder are reviewed. Diffuse lipomatosis of the thyroid, amyloid goiter with adipose tissue, and the relationship between lipomatosis and adenolipoma are discussed.

Schwannoma of the larynx: case report.

Abstract Neurogenous tumours of the larynx are extremely uncommon. We present a rare case of schwannoma of the larynx. Clinical findings are presented together with computed tomography (CT) and magnetic resonance images. The tumour was located in the right aryepiglottic fold of the larynx. CT showed a well defined and hypodense mass extending from the right aryepiglottic fold to the right vocal cord. The patient underwent an excision of the mass through a lateral thyrotomy and the tumour was completely removed. The diagnosis and treatment of this tumour are discussed.

Value of Tenascin-C content and association with clinicopathological parameters in uterine cervical lesions

To determine whether the content of the matrix protein tenascin‐C (Tn‐C) is of diagnostic or prognostic value in cervical lesions, we evaluated increases in Tn‐C immunoreactivity in 80 formalin‐fixed, paraffin‐embedded biopsies and surgical specimens of the uterine cervix. Tn‐C content in the basement membrane zone and in the stroma was graded and compared to some prognostic parameters. In the normal cervix, Tn‐C formed a thin continuous band. In cervicitis, Tn‐C bands thickened in the basement membrane zone and the adjacent stroma in the form of thin filaments. In 30 squamous intraepithelial lesions (SILs) of various grades, Tn‐C bands were either slightly (1+) or moderately (2+) thickened in the basement membrane zone, while slight stromal Tn‐C immunoreactivity in the form of thin bands was observed in 12 cases, regardless of grade and inflammatory stromal reaction. In invasive carcinoma, Tn‐C content was markedly increased in the stroma and around the invasive nests of tumors. The intensity of Tn‐C immunoreactivity was significantly higher in grade I tumors than in others (p < 0.04). The intensity of increase in Tn‐C immunoreactivity was 10.5‐fold (95% CI 3.39–32.5) higher in invasive cervical carcinomas than in others (cervicitis, low‐grade SIL and high‐grade SIL) (p = 0.0001). A significant correlation was found between weak Tn‐C immunoreactivity and lymphatic space invasion (p = 0.001), lymph node metastasis (p = 0.01), desmoplastic stromal component (p = 0.0001) and stromal inflammation (p = 0.002). In conclusion, increase in Tn‐C immunoreactivity may be of value in the assessment of noninvasive and invasive cervical lesions and the appearance of Tn‐C may be an indicator of adequate biologic defense in cervical cancer patients.

Prognostic Value of PCNA and Mutant p53 Expression in Laryngeal Squamous Cell Carcinoma

The objective of this study was to investigate the prognostic significance of p53, and proliferative cell nuclear antigen (PCNA) in laryngeal squamous cell carcinoma (LSCC). Sixty pathologic specimens from the patients with LSCC were examined for the expression of the p53 and PCNA, with complete follow-up data. Sixty-three percent of the cases displayed nuclear p53 overexpression. There was a correlation between p53 overexpression and histological grades (p = 0.03), and localization site (p = 0.05). Median of PCNA index was 42.2 (range 5.9 to 85.2). There was no difference between the p53 overexpression group and the normal group in proliferative activity determined by PCNA (p = 0.73). In univariate analyses, localization site, grade, stage, invasion pattern, lymph node status, were significant factors in estimating disease free survival (DFS). Grade was the most important factor affecting recurrence (p = 0.002). In multivariate analyses, grade was the only significant predictor for DFS (p = 0.001). Grade (p = 0.001) and invasion pattern (p = 0.03) were found to be significant predictors of overall survival. In conclusion, the histological grade was the most reliable important prognostic factor. Further studies are necessary to facilitate understanding of the mechanisms of laryngeal carcinogenesis.

Does the analysis based on a histological and immunohistochemical grading system in the model of BDL kidney allow the quantification of the degree of injury

The aim of this study is to evaluate histopathological findings induced by NΩ‐nitro‐L‐arginine methyl ester (L‐NAME) and molsidomine (MOL) on the kidney of bile duct ligated rats. Forty Sprague–Dawley rats, each weighing 125 to 140 g, were included in the study. Extent of histological glomerular injury scores (GIS), arterial injury scores (AIS), and tubulointerstitial injury scores (TIS) in each animal were graded. Alpha‐smooth muscle actin (α‐SMA), tenascin, lectin (Ulex europaeus agglutinin‐1), and vimentin were used to determine extent of the injury. The cholestasis was evidenced by a significant increase in the levels of serum total bilirubin in BDL rats (p < 0.01). Malondialdeyde MDA levels increased by the bile duct ligation (BDL) to 12.10 ± 0.45. This value was significantly higher than the other groups (p < 0.01). Changes in the BDL kidney were marked at 7 days after surgery. GIS were observed to have the highest score, especially at juxtamedullary region in BDL/L‐NAME rats, and AIS were also the highest score in this region. These observations were lower in BDL/MOL rats. There is a correlation between GIS and AIS scores (r = .2, p < .01). TIS revealed that BDL/L‐NAME rats were significantly more damage than rats in the other groups (p < .001). MOL‐treated rats showed considerably fewer lesions in the tubules and interstitium (p < .001). The tubular injuries observed in BDL and BDL/L‐NAME rats were significantly attenuated by MOL treatment. Lectin was more and extensively stained in tubular epithelia of the BDL/L‐NAME group than in the other (p < .05). Expression of tenascin in tubular epithelia was significantly higher in BDL and BDL/L‐NAME as compared with controls (p < .01). Fibrous tissue was only observed in the BDL and BDL/L‐NAME group. These areas were weakly stained with vimentin. α‐SMA staining was more reduced in the L‐NAME‐treated arterioles than in BDL/MOL (p < .05). In conclusion, the analysis of cell injury based on a histological grading system in the model of BDL kidney allows the quantification of the degree of injury.

Spinal intradural neuroepithelial cyst associated with multiple congenital anomalies in a child

A case of spinal intradural neuroepithelial cyst is presented. The patient, who had thoracolumbar hypertrichosis, underwent magnetic resonance imaging which demonstrated a cystic lesion within spinal canal. The cystic lesion was removed surgically. Histological study proved it to be a neuroepithelial cyst. Spinal intradural neuroepithelial cyst associated with other congenital malformations is a rare condition.

Follow-up results of cervical tuberculous lymphadenitis

Abstract Problem: To investigate the efficacy of medical antituberculous treatment in patients with tuberculous cervical lymphadenitis without pulmonary tuberculosis. Methods: We followed 46 patients with tuberculous cervical lymphadenitis who were treated at Dicle University, Diyarbakir, Turkey between 1996 and 2001. Mean age at presentation was 32.2 ± 14.9. Diagnosis was based on clinical findings, results of the PPD tests (Mantoux test) and histopathologic appearance of caseating granuloma, which was consistent with tuberculosis in all cases. The chief complaint was a cervical mass localized mostly to the posterior cervical and/or submandibular regions. Treatment included standard antituberculous medications including isoniasid, rifampisin, and etambutol. Treatment period was between 9 and 12 months with a mean of 7.8 months. During follow-up, excisional biopsy was performed when the lymphadenopathy was bigger than 1 cm in diameter. Results: After clinical and histopathological evaluation, recurrent disease was observed in 8 patients (17 %). Lymphadenopathy was detected in the cervical region (6 patients) mesentery (1 patient) and spleen (1 patient). Cervical excisional biopsy was consistent with tuberculosis in these 6 patients. Conclusion: Patients with tuberculous cervical lymphadenitis should have follow-ups regularly. When there is no cure, the treatment period should be extended to eradicate the disease and other treatment alternatives such as surgery should be kept in mind. Significance: Mycobacterial infections have been shown to be increasing in number worldwide. Standard anti-tuberculous drugs are used for medical treatment. Anti-tuberculous drug resistance is also becoming more frequent. Support: None reported.