Mikdat Bozer

Four mucinous cystadenoma of the appendix treated by different approaches.

Appendiceal mucocele is a rare clinical entity characterized by dilatation of the appendiceal lumen due to abnormal mucinous secretion. It may be of inflammatory or tumoral origin. It may occur as a result of mucoceles, mucosal hyperplasia, mucinous cystadenoma or mucinous cystadenocarcinoma. Mucinous cystadenoma of the appendix is the most common form, although it manifests itself in many different clinical presentations. It is detected in 0.6% of appendectomy specimens. Preoperative diagnosis is difficult, and it is often detected at laparotomy. Despite existing reservations due to the risk of rupture, laparoscopic surgery is gaining acceptance. Although there is no consensus on the choice of surgery, either appendectomy or right hemicolectomy is applied. In this article, we discussed four patients with appendix mucinous cystadenoma where different surgical methods were applied in light of the literature.

Differentially regulated ADAMTS1, 8, 9, and 18 in pancreas adenocarcinoma

Introduction Despite recent diagnostic and therapeutic improvements, pancreas cancer remains one of the highly lethal cancers. The extracellular matrix (ECM) is a physiological barrier that limits the spread of cancer cells into surrounding tissues and distant organs. Disintegrin and metalloprotease with thrombospondin motifs (ADAMTS) is a family of 19 proteases, which is involved in various biological processes such as ECM remodelling and anti-angiogenesis. Aim To investigate the expression of ADAMTS1, 8, 9, and 18 proteinases in pancreas adenocarcinoma and its nodal metastasis. Material and methods The immunostaining status of ADAMTS1, 8, 9, and 18 were investigated in formalin-fixed paraffin-embedded samples of 25 patients who underwent pancreaticoduodenectomy for an adenocarcinoma located at the head of the pancreas. Results In semi-quantitive grading pathologically, ADAMTS1, 8, 9, and 18 were found to be highly stained in all cancerous pancreas samples compared with normal pancreas. In addition, the immune positivity of ADAMTS1, 9, and 18 was found to be higher in metastatic lymph nodes than in non-metastatic lymph tissue. Tumour size was correlated with ADAMTS9 and 18 expressions in cancerous pancreas. Conclusions According to the data obtained from the study, we suggest that these four ADAMTSs may have significant roles in the tumorigenesis and nodal spread of pancreas adenocarcinoma.

Male Breast Cancer

Male breast cancer (MBC) is a rare disease, accounting for less than 1% of all breast cancer diagnoses worldwide. Although breast carcinomas share certain characteristics in both genders, there are notable differences. Most studies on men with breast cancer are very small. Thus, most data on male breast cancer are derived from studies on females. However, when a number of these small studies are grouped together, we can learn more from them. This review emphasizes the incidence, etiology, clinical features, diagnosis, treatment, pathology, survival, and prognostic factors related to MBC.

Gastrointestinal Stromal Tumor with Mesenteric Localization Fistulized to Proximal Jejunum Causing Massive Rectal Bleeding

DOI: 10.4328/JCAM.4582 Received: 24.04.2016 Accepted: 10.05.2016 Printed: 01.04.2016 J Clin Anal Med 2016;7(suppl 2): 180-2 Corresponding Author: Mehmet Tolga Kafadar, Department of General Surgery, Turgut Özal University Faculty of Medicine, 06510, Ankara, Turkey. T.: +90 3122035555 F.: +90 3122213670 E-Mail: drtolgakafadar@hotmail.com Özet Gastrointestinal stromal tümörler (GİST) gastrointestinal sistemin en yaygın mezenkimal tümörleridir. Epitelyal olmayan bu tümörler gastrointestinal traktus duvarının muskularis propria tabakasından çıkarlar. En sık lokalizasyonu mide ve ince barsaklardır. Nadiren gastrointestinal sistem ile bağlantısız olarak retroperitonda veya abdomende ortaya çıkabilirler. Sıklıkla gastrointestinal sistem hastalıklarının endoskopik ve radyolojik incelemelerinde veya hemoraji, obstrüksiyon ve organ perforasyonu gibi acil durumların cerrahi tedavisi sırasında, tesadüfen tanı konur. Bu yazıda proksimal jejunuma fistülize, nadir lokalizasyonuyla masif rektal kanamaya yol açan 59 yaşında bir GİST olgusu sunuldu. Histopatolojik inceleme ile kesin tanı alan olguya, total kitle eksizyonu ile birlikte yaklaşık 20 cm jejunum rezeksiyonu yapıldı.Aim: Our aim was to find out whether placement of the embryo transfer catheter guide through the cervical canal at the time of embryo expulsion influences pregnancy rates. Material and Method: We retrospectively com pared in vitro fertilization (IVF) outcomes related to the placement of the embryo transfer catheter guide through the cervix. Subjects were divided into two groups: embryo transfers (ET) performed with the inner catheter alone through the cervical canal (n=55, Group 1) and transfers performed with the double catheter set through the cervix (n=58, Group 2). Results: A total of 113 ETs were carried out in women undergoing IVF treatment. Although the pregnancy ratio seemed to be higher among the transfers carried out with the inner catheter alone inserted through the cervix, no statistically significance for this was detected (odds ratio: 1.644, 95% confidence bound, p>0.05). Discussion: Placement of the catheter guide through the cervical canal at the time of embryo expulsion may not have any effect on the IVF-ET outcome.

Role of ING Family Tumor Suppressors in Breast Cancer

Today cancer is one of the leading diseases, which treat human life and enormous efforts are being done for its eradication. Currently many cancer types including breast cancer are treated by extensive surgery as well as chemo-radiotherapy. These treatment modalities usually present extensive damage to the patient both anatomically, physiologically and psychologically. In addition, chemo-radiotherapy shows extreme side effects of the other system in the body and their efficiencies are quite limited especially in disseminated metastatic cases. Recent developments and progress in human genome technology provided us to develop novel therapeutic methods. This progress also provided novel biomarkers, which early diagnose the cancer and predict the sensitivity of the current chemo-radiation therapies. Tight control by various regulatory mechanisms is applied on cell proliferation and growth in normal cells. However, certain genetic and epigenetic alterations permit the normal cells to avoid these mechanisms allowing indefinite cellular activities. Cancer is basically a genetic disease. The collection of genetic and epigenetic alterations of multiple genes and chromosomes lead to the development of cancer. In this regard, two major groups of tumorassociated genes, oncogenes and tumor suppressor genes (TSGs), have been implicated in the carcinogenic process (Figure 1). TSGs have been defined as genetic elements whose loss or mutational inactivation allows cell to display one or more phenotypes of neoplastic growth [1]. TSG protein products are known to be involved in negative regulation of the cell cycle and proliferation and induction of apoptosis by different mechanisms. Thus inactivation of TSGs is one of the crucial steps during carcinogenetic process. In this process according to Knudson two-hit hypothesis for inactivation of TSGs [2], the deletion of targeted chromosomal regions (location of TSGs) eliminates one allele, while inactivating events (mutation, deletion, or epigenetic events such as promoter hypermethylation) affect the other allele of a concerning TSG [2]. The detection of frequent loss of heterozygosity (LOH) in a chromosomal locus is considered to be critical evidence for the localization of a TSG.