Fatma Hüsniye Dilek

The effect of lymphatic blockage on the amount of endotoxin in portal circulation, nitric oxide synthesis, and the liver in dogs with peritonitis.

This study was performed to investigate the effect of lymphatic blockage on the amount of endotoxin in portal venous blood, nitric oxide synthesis, the release of aspartate aminotransferase (AST) from the liver, hepatic damage, and survival in an experimental model of dogs with peritonitis. The dogs were divided into a control group (group 1), an unligated thoracic duct peritonitis group (group 2), and a ligated thoracic duct peritonitis group (group 3). Peritoneal fluid and blood from the portal vein and femoral artery were taken for peritoneal culture, endotoxin, and AST assay, respectively, and liver biopsies were performed to assess for hepatic damage and for nitric oxide assay. There was a higher bacteria count in the peritoneal fluid from group 3 than in that from group 2 (P<0.0001). Bacteria grew in all of the blood cultures from the group 2 animals, but growth was seen only in blood cultures from four of the group 3 animals. The levels of endotoxin, nitrite, and AST levels in group 3 were significantly increased in comparison with those in group 2 (P<0.0001). Extensive hepatocellular necrosis with hemorrhage was observed in the livers of the group 3 animals, and all of them died within 48 h. The results of this study suggest that the blockage of lymph flow has a negative effect on liver and survival in dogs with peritonitis, and that hepatic damage is directly related to the amount of endotoxin to which the liver is exposed.

Five methods for detection of Helicobacter pylori in the Turkish population

AIM To compare culture analysis, Helicobacter pylori (H. pylori) stool antigen (HpSA) test, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) for H. pylori detection. METHODS One hundred and thirty-two consecutive adult dyspeptic patients receiving diagnostic endoscopy at the department of gastroenterology were enrolled in this study. Culture and histological examination were performed on biopsy specimens. PCR and FISH tests were applied to histopathological samples. Stool samples that were simultaneously collected were tested for the H. pylori antigen using the HpSA test and bacterial DNA using stool PCR. RESULTS H. pylori was positively identified by histological examination in 85/132 (64.4%) of the patients, while positive samples were found in 56 (42.4%), 64 (48.5%), 98 (74.2%), 28 (21.2%) and 81 (61.4%) of the patients by culture, HpSA, PCR, stool PCR and FISH methods, respectively. The results of the culture, biopsy PCR, HpSA and FISH tests, with the exception of the stool PCR, were found to correlate with the histological examination as a gold standard. CONCLUSION The HpSA test is a rapid, simple, and noninvasive test for monitoring therapy. FISH is an accurate, rapid, cost-effective, and easy-to-use test for H. pylori detection.

E-cadherin, β-catenin adhesion complex and relation to matrilysin expression in pT3 rectosigmoid cancers

E-cadherin/beta-catenin complex has a critical role in cell-cell adhesion. beta-Catenin is a critical component of the highly conserved Wnt signaling pathway that regulates cell proliferation and differentiation. Wnt signaling leads to the stabilization of cytosolic beta-catenin and to translocation to the nucleus, where it binds with T-cell factor and promotes the transcription and changes in target gene expression, including matrix metalloproteinases. In this study, we analyzed paraffin-embedded specimens from 42 patients with pT3 rectosigmoid cancer for E-cadherin, beta-catenin, and matrix metalloproteinase-7(MMP-7, matrilysin) expression using immunohistochemistry. Seventy-four and 79% of tumors expressed beta-catenin and E-cadherin, respectively. Nuclear expression of beta-catenin was detected only in 26.1% of tumors. Forty-five percent of the rectosigmoid cancers showed strong expression of MMP-7. It was revealed that membranous or cytoplasmic beta-catenin expression was significantly related to E-cadherin and MMP-7 expression. No significant association was seen between E-cadherin, beta-catenin, or MMP-7 expression and some clinicopathologic features. Our results may contribute to the functional interaction between beta-catenin and MMP-7. Further studies on Wnt/beta-catenin and MMP-7 gene activity and protein expression are necessary to better understand the pathogenesis of colorectal carcinoma.

Mucin production in carcinomas of the uterine cervix

The histological types of the cervical carcinoma effect the incidence, prognosis and the treatment methods. One hundred and eighty-seven cases selected randomly among the cervical carcinoma were stained with mucicarmen, alcian blue, PAS, and PAS with diastase to identify the presence of intracellular mucin. One hundred and seventy-two squamous carcinoma were examined and 27.3% (47 cases) of them were shown to contain some degree intracellular mucin (nine cases which were originally diagnosed squamous carcinoma after the application of mucin stains to the tumors, reclassified as adenosquamous carcinoma because of demonstrated widespread intracellular mucus). Of the 14 adenocarcinomas, 13 were mucin positive. Mucin-positive tumors (independent of histological type) had metastasized to the lymph nodes in 23 of 60 cases (38.3%), in contrast to mucin-negative tumors which had metastasized in 24 of 127 cases (18.9%). The application of mucin stains can assist in the classification of poorly differentiated lesions as well as help in the planning of management and in the prognosis.

Prevalence of cagA and vacA genotypes of Helicobacter pylori isolated from Turkish patients with active or non-active chronic gastritis

Abstract Several virulence factors of Helicobacter pylori may contribute to gastric mucosal damage. In this study, the prevalence of cagA and vacA genotypes of H. pylori was examined in different patterns of chronic gastritis. Oesophagogastroendoscopy was performed in 147 dyspeptic patients. Antrum biopsies were obtained for isolation of H. pylori and for histopathological assessment. H. pylori vacAs1 and cagA genes were directly genotyped in the gastric biopsy specimens by polymerase chain reaction (PCR). A total of 102 dyspeptic patients, all H. pylori-positive by PCR, were included in the study. Of these, 59 had active chronic gastritis and 37 had non-active chronic gastritis. The prevalence of cagA and vacAs1 was higher among patients with active chronic gastritis than among those with non-active chronic gastritis (45.8% vs 21.6% (p = 0.02) and 78.0% vs 40.5% (p < 0.001), respectively). In conclusion, both cagA and vacAs1 genotypes are associated with the activity of chronic gastritis.

Expression of cyclooxygenase-1 and 2 in chronic tonsillitis

OBJECTIVES Prostaglandins are critical mediators of inflammation and affect both humoral and cell-mediated immune responses. Recent findings show that T and B cells express COX-2 upon activation. The purpose of this study is to investigate the potential occurrence of COX-1 and COX-2 immunoreactivity in cases of chronic tonsillitis and to determine the sites of their expression. In addition, their expression in adult patients is compared with that in child patients. MATERIALS AND METHODS Immunohistochemical techniques were used to evaluate the expression of the enzymes COX-1 and COX-2, in chronic tonsillitis tissue specimens from adults (n = 15) and children (n = 15). RESULTS There was no staining in surface epithelium or reticulated crypt epithelium. COX-1 and COX-2 expressions were observed mainly in the intraepithelial lymphoid cells in reticulated crypt epithelium and subepithelial cells. Also, COX-1 and COX-2 stained cells were found in the germinal center. There was no difference of the expressions of COX-1 and COX-2 among adults and children. The only significant difference noted between the adults and children was that, the adults had rich subepithelial plasma cells. CONCLUSION Activated B and T cells express COX-1 and COX-2 in paraffin-embedded tissue sections of chronic tonsillitis. Further studies need to be performed to elucidate expression of COX enzymes and their immunologic role in tonsil diseases. They will play an important role in the treatment of chronic tonsillitis. Additional studies are warranted to study the effects of NSAIDs and selective COX-2 inhibitors in chronic tonsillitis.

Comparison of FISH, RFLP and agar dilution methods for testing clarithromycin resistance of Helicobacter pylori

BACKGROUND/AIMS Clarithromycin resistance is an important factor of Helicobacter pylori (H. pylori) eradication failure in adults and children. There are some tests to determine resistance such as restriction fragment length polimorphism (RFLP), fluorescence in situ hibridisation (FISH), PCR and (culture) agar dilution. Clarithromycin resistance is reported between 16.8%-48.2% in Turkey using PCR, 18% in Japan using RFLP. The aim of the study is to compare the efficacy of FISH, RFLP and culture. MATERIALS AND METHODS Patients with gastric complaint underwent endoscopic examination. H. pylori status of all patients was tested with urea breath test. Gastric biopsy samples obtained from adult patients and children were studied. Each tissue was analised with FISH, PCR-RFLP anda gar dilution. RESULTS A total 100 patients were positive by UBT and histology for H. pylori. Tissues from 89 adults and 11 children were evaluated. According to FISH and RFLP clarithromycin resistance was 26% and 16% respectively. Among 100 patients H. pylori was cultured in 52 tissue samples, among these samples 7 were resistant to clarithromycin. There was strong correlation between the results of FISH and RFLP; RFLP and culture; and FISH and culture. CONCLUSION There is a high ratio of clarithromycin resistance in the studied population. All 3 tests are valuable, but FISH seems to be more sensitive among these tests. We suggest FISH should be used for detecting clarithromycin resistance among H. pylori infected patients before eradication therapy.

Effects of Octenidine HCl on Liver Tissue: Could It Be an Alternative Scolicidal for Hidatid Disease?

Octenidine HCl is new topical antiseptic solution for wounds and abdominal washing that has been found to be highly effective for inactivating scolices in an in vitro study. However, the effects of octenidine HCl on the liver are not yet known. The aim of this study was to determine if there are any histopathologic changes after injecting octenidine HCl into the liver. A group of 50 male Sprague-Dawley rats were included in the study and randomly divided into five groups of 10 rats each, as follows: sham group; 0.09% NaCl group; 20% NaCl group; undiluted octenidine HCl group; 1% octenidine HCl group. The scolicidal agents (0.3 ml) were directly injected into the left lobe of the liver (except in the sham group). At 3 and 7 days after the injection, the rats were sacrificed, and the left lobe of the liver was harvested. Liver tissue was scored for degree of necrosis and the diameter of the necrosis examined under light microscopy. The highest scores were found in the undiluted octenidine HCl group, although a similar effect was observed in the 20% NaCl group. There was no necrosis in the sham group, the 0.09% NaCl group, or the 1% octenidine HCl group. All of the injury was coagulation-type necrosis. No mortality was observed throughout the study. The 1% octenidine HCl solution could thus be used as a scolicidal agent in liver tissue, whereas the undiluted form of octenidine and 20% NaCl solutions were shown to cause necrosis when directly injected into liver tissue in our animal model.

Striking Multiple Primary Tumors that underwent Whipple Procedure due to Periampullary Carcinoma: An Analysis of 21 Cases

Introduction The term multiple primary tumor (MPT) is used to describe cases where two or more primary tumors show no histopathological similarities in between. Multiple primary tumor cases have begun to increase in recent years as a result of the increase in life expectancy because of the increase in life standards and progress in diagnostic methods. In this study, MPT cases with periampullary tumors that underwent Whipple procedure were discussed in the light of literature data. Materials and methods The patient files of 223 cases with periampullary tumors that underwent Whipple procedure in our hospital during the last 6 years were examined retrospectively. More than one primary tumor was detected in 21 patients. Results Periampullary carcinomas were detected as a second primary tumor in 18 patients. First primary tumor was periampullary carcinoma in 3 patients that underwent Whipple procedure. After the Whipple procedure, 5 patients died due to early complications in the first 30 days and 6 patients died due to metastases and additional problems that developed during follow-up. Discussion The incidence of MPT has been reported as 0.7 to 14.5% in the literature. Most of them are multiple primary case presentations. In patient management, it is recommended that each tumor should be evaluated independently of its own characteristics, and treatment and follow-up should be planned accordingly. Conclusion The MPT cases are increasing. The possibility of MPT as well as metastasis should be kept in mind during the evaluation of tumor foci seen during diagnosis and follow-up of patients. The characteristics of each tumor, survival, and prognosis should be evaluated separately and the most appropriate treatment should be offered to the patient. It is recommended that synchronic primary tumors which are considered to be surgically resectable without metastasis should be removed in the same session. How to cite this article: Dilek ON, Ozsay O, Karaisli S, Gür EÖ, Er A, Haciyanli SG, Kar H, Dilek FH. Striking Multiple Primary Tumors that underwent Whipple Procedure due to Periampullary Carcinoma: An Analysis of 21 Cases. Euroasian J Hepato-Gastroenterol 2018;8(1):1-5.

Proliferatif Fasiitis: Bir Olgu Sunumu

Proliferatif fasiitis, fasialari ve subkutanoz dokuyu tutan, sik gorulmeyen benign, bir bag doku lezyonudur. Genellikle yetiskinlerde, erkek ve kadinlarda esit oranda, 40-70 yas arasinda sik gorulur. Ozellikle on kol ve uyluk olmak uzere ekstremitelerde sik yerlesir. Histopatolojik olarak lezyon fibroblast benzeri hucreler ile ganglion benzeri buyuk dev hucrelerden olusur. Klinik olarak hizli buyumesi, infiltratif buyume paterni, hucreden zengin olmasi, mitoz oraninin yuksek olabilmesi, dev hucrelerin varligi nedeniyle malign mezenkimal tumorlerle karisabilmektedir. Kirk bes yasinda erkek hastanin gogus duvari uzerinde saptanan bir kitle proliferatif fasiitis tanisi aldi. Immunhistokimyasal olarak duz kas aktini, CD68, S-100 proteini ve CD34 ile boyanma izlenmedi. Spindle ve dev hucreler vimentin ile pozitif reaksiyon verdi