Erdinc Serin

Is Only Perianal Anesthesia with Lidocaine-Prilocaine Cream Sufficient to Decrease the Pain during Transrectal Ultrasound-Guided Prostate Biopsy? A Prospective Randomized Study

Aims: To determine the optimal place to apply the local anesthetic agent and to investigate the efficacy of lidocaine-prilocaine cream on the perianal and intrarectal region during prostate biopsy. Methods: The study included 80 patients. Patients were randomized into four groups: group 1 served as the control group and was administered no anesthesia; group 2 received 5 ml lidocaine-prilocaine cream perianally; group 3 received 5 ml lidocaine-prilocaine cream intrarectally, and group 4 received lidocaine-prilocaine cream perianally and intrarectally. Pain scores during probe insertion, biopsy procedure, and the overall pain score were assessed. Mean pain scores in each group were compared statistically. Results: In group 1, the mean pain score was significantly higher during probe insertion than that during biopsy (p < 0.001). For the mean overall pain scores, there was no significant difference between groups 1 and 3 (p = 0.942), but the results of group 1 were statistically different from groups 2 (p = 0.001) and 4 (p < 0.001). When we compared the biopsy pain scores, there was no significant difference among the groups (p > 0.05). During probe insertion, subjects in groups 2 and 4 reported significantly lower pain scores than the control group (p = 0.002, p = 0.001, respectively). Conclusions: Perianal anesthesia with lidocaine-prilocaine cream may solely be sufficient to decrease the pain during prostate biopsy.

Effects of Photoperiod and Food Availability on Growth, Leptin, Sexual Maturation and Maintenance in the Mongolian Gerbils ( Meriones unguiculatus )

Abstract Reproductive activity of Mongolian gerbils is regulated by photoperiod nevertheless body weight regulation is controlled without ambient photoperiod. Food intake is a major factor affecting rodent reproductive efficiency. Leptin is a hormone secreted by adipose tissue and modulates food intake, energy expenditure and body fat stores. In this study we studied the interaction of photoperiod and food availability on growth, sexual maturation and leptin concentration in the male and female gerbils. Gerbils were gestated and reared in either 14L:10D or 2L:22D. At weaning, gerbils were housed individually and divided into three groups: fed ad libitum, fed 80% of ad libitum or fed 60% of ad libitum. Body weights were recorded at weaning and every week thereafter. After twelve weeks of treatment, animals were sacrificed and testes and uterine weights were determined and blood was collected for leptin measurement. Food restriction reduced body weight and inhibited reproductive development. Absolute paired testis weights were similar in ad lib and 80% of ad lib groups but significantly different compared with the 60% of ad lib group in both photoperiods. Body weights were also directly dependent upon the level of food restriction. Uterine mass was only affected in the 60% of ad lib group in 14L but both food restriction levels significantly affected the uterine weights in 2L. Significant variations were found in leptin profiles. Leptin concentration was highest in ad lib and 80% of ad lib groups and lowest in 60% of ad lib groups. These results suggest that the reproductive activity of Mongolian gerbils is sensitive to food intake and multiple potential environmental cues (e.g., food availability, temperature) can be utilized.

Reliability of the 34βE12, keratin 5/6, p63, bcl-2, and AMACR in the diagnosis of prostate carcinoma.

OBJECTIVE In this study, we aimed to investigate which basal cell marker should be used with α-methylacyl coenzyme A racemase (AMACR) to increase diagnostic accuracy in the diagnosis of prostate carcinoma. MATERIALS AND METHODS A total of 98 cases of prostate biopsy, comprising 65 cases with prostate adenocarcinoma and 33 cases without adenocarcinoma, were included in this study. Prostate-specific antigen (PSA) serum levels before biopsies were obtained. The number of cores with malignant glands and Gleason scores for each case were determined. Paraffin sections were stained immunohistochemically with 34βE12, keratin 5/6, p63, bcl-2, and AMACR. RESULTS According to staining pattern, extensiveness, and intensity of basal cell markers in benign glands, 34βE12 gave the best results. As negative markers for prostate adenocarcinoma, the best markers were p63 and 34βE12. According to the AUC values in ROC curves for both extensiveness and intensity, the arrangement from the best to the worst was 34βE12, p63, bcl-2, and keratin 5/6. The 34βE12 had the best sensitivity and specificity values (95% and 98%, respectively). Staining extensiveness and intensity of keratin 5/6 in malignant glands, and those of bcl-2 in benign glands had statistically significant positive correlation with serum PSA levels. Even though AMACR is a negative marker for benignity, some of the benign glands also had positive immune reaction with AMACR. However, AMACR positivity was usually focal and weak. Nevertheless, intensively stained subjects were also present. No correlation was present between AMACR and basal cell markers. CONCLUSIONS As a result, we suggest that keratin 5/6 and bcl-2 should not be used to identify benign glands in prostate biopsy since they show high positivity in malignant glands and high negativity in benign glands. 34βE12 should be the first choice as a basal cell marker. p63 can be used together with 34βE12, but it may not give additional diagnostic information. When we evaluated the correlation of basal cell markers, we did not find any complementary staining results among basal cell markers. Our study showed that 34βE12 is the most appropriate negative marker to combine with AMACR as a positive marker for the diagnosis of prostate adenocarcinoma.

Effect of Tube Filling Order on Specific Coagulation Parameters in Healthy Subjects

Background: In this study, the authors attempted to determine if there was any effect of tube filling order on both routine (prothrombin time [PT], activated partial thromboplastin time [APTT], and fibrinogen) and specific coagulation parameters (protein S, protein C, antithrombin III, factor V Leiden, plasminogen, and D-dimer). Methods: Fifty-seven consecutive patients having coagulation parameters within the reference range (mean age ±SD, 32.14±5.59 years) were included in the study. In drawing blood, the first 2 tubes were 3.2% citrated coagulation tubes. Routine and specific coagulation parameters were studied on both tubes, and the results were compared using a paired sample t-test. Results: The comparison of all parameters revealed statistically-insignificant results. The difference in the levels of protein C between the 2 tubes approached significance (P=0.053). Conclusion: This study has shown some evidence that tube filling order in healthy subjects does not play a significant role on routine and specific coagulation parameters. Received 3.8.07 | Revisions Received 7.3.07 | Accepted 7.18.07

The effect of pinealectomy and leptin hormone on the proliferation and apoptosis activation in Syrian hamster testis in different photoperiods

The effects of pinealectomy and leptin hormone on proliferative and apoptotic processes in the epithelia of testicular seminiferous tubules of Syrian hamsters have been investigated. Proliferative and apoptotic processes were assessed semi-quantitatively by proliferating cell nuclear antigen (PCNA) and caspase-3 immune stainings. Animals used in the study were divided into four groups; control, pinealectomy (PinX), leptin-treated (10 microg/mL/day/kg body weight, intraperitoneally) and pinealectomy + leptin groups. Half of the hamsters in each group were exposed to short and the other half to long photoperiods for 8 weeks. In short photoperiod, PCNA activity especially in spermatogonia was significantly higher in the pinealectomy and leptin-treated groups compared with the control group. Histological score (HSCORE) value of PCNA in the PinX + leptin group was lower than those of PinX and leptin-treated groups. HSCORE value of caspase-3 in PinX and PinX + leptin groups was increased. In the long photoperiod, PCNA activation in the PinX group was significantly lower than the control group while the differences between the controls and other groups were not significant. The difference between the increases in caspase-3 activity in the PinX and control groups was significant. Thus, it was observed that photoperiods had no effect on the proliferation activity in the control groups. The inhibiting effect of short photoperiod on testis was not observed throughout 8 weeks. PinX eliminated the inhibiting effect of short photoperiod but did not alter the stimulating effect of long photoperiod. Leptin did not show any effect in long photoperiod but decreased proliferation by stimulating melatonin in short photoperiod.

Cellular Immune Response in Patients with Chronic Plaque Type Psoriasis: Evaluation of Serum Neopterin, Procalcitonin, Anti-Streptolysin O and C Reactive Protein Levels

Background: Psoriasis is characterized by T-cell mediated hyperproliferation of keratinocytes initiated by antigen presenting cells on the skin. Environmental factors including β hemolytic streptococcus infections and multiple genetic components may be responsible for the pathogenesis of the disease. However the antigen which initiates the immunologic reactions has not yet been known. We aimed to evaluate the relationship between streptococcal as well as other bacterial infections and psoriasis via measurement of some infection markers. Materials and methods: The study included 40 patients with exacerbations of chronic plaque type psoriasis lesions and 40 healthy individuals. Disease activity in study group was determined according to the score of psoriasis area and severity index. Antistreptolysin O, C-reactive protein, procalcitonin and neopterin levels of patients with psoriasis were compared to those of control subjects. Results: The levels of procalcitonin (p=0.002) and neopterin (p=0.001) in patients with psoriasis were significantly higher than those in control subjects. Additionally, there was significant correlation between psoriasis area and severity index scores and neopterin (p< 0.001) as well as C-reactive protein (p=0.006) levels. However ASO levels in patients with psoriasis did not differ significantly from those in control subjects (p=0.86). Conclusions: Significant increased levels of serum procalcitonin during exacerbation period of chronic plaque type psoriasis may be resulted from the presence of a bacterial antigenic stimulus and significant elevated levels of neopterin may indicate elevated cellular immune system activity following bacterial antigenic stimulation. However, absence of significant elevated antistreptolysin O levels indicates the possible role of bacterial infections in the pathogenesis of psoriasis rather than streptococcal infections.