Muhan Erkus

NF-KappaB expression correlates with apoptosis and angiogenesis in clear cell renal cell carcinoma tissues

BackgroundClear cell renal cell carcinoma (ccRCC) is the most frequently encountered tumor in the adult kidney. Many factors are known to take part in the development and progression of this tumor. Nuclear factor kappa B (NF-κB) is a family of the genes that includes five members acting in events such as inflammation and apoptosis. In this study, the role of NF-κB (p50 subunit) in ccRCC and its relation to angiogenesis and apoptosis were investigated.MethodsFormalin-fixed and paraffin embedded tissue blocks from 40 patients with ccRCC were studied. Expressions of NF-κB (p50), VEGF, EGFR, bc1-2 and p53 were detected immunohistochemically. The relationship of NF-κB with these markers and clinicopathological findings were evaluated.ResultsThe expression of NF-κB was detected in 35 (85%), VEGF in 37 (92.5%), EGFR in 38 (95%), bc1-2 in 33 (82.5%) and p53 in 13 (32.5%) of 40 ccRCC patients. Statistical analyses revealed a significant relation between NF-κB expression and VEGF (p = 0.001), EGFR (p = 0.004), bc1-2 (p = 0.010) and p53 (p = 0.037). There was no significant correlation between NF-κB and such parameters as tumor grade, stage, age and sex.ConclusionThe results of this study indicated that in ccRCC cases NF-κB was associated with markers of angiogenesis and apoptosis such as VEGF, EGFR, bc1-2 and p53. In addition, the results did not only suggest a close relationship between NF-κB and VEGF, EGFR, bc1-2 and p53 in ccRCC, but also indicate that NF-κB was a potential therapeutic target in the treatment of ccRCC resistant to chemotherapy.

Sclerosing adenosis of the breast: radiologic appearance and efficiency of core needle biopsy.

PURPOSE To examine the mammography and ultrasonography findings of patients who have a final histopathological diagnosis of sclerosing adenosis after breast biopsy, and to evaluate the follow-up results of patients who underwent core needle biopsies. MATERIALS AND METHODS Seventy-six of the 723 patients who underwent breast biopsy in our institution were diagnosed with sclerosing adenosis on histopathological examination. Mammography and ultrasonography findings from these 76 lesions were analyzed retrospectively. Thirty-seven of these lesions were sampled by image-guided core needle biopsy; the remaining lesions were excised surgically. Mammograms and ultrasound images of the lesions were re-evaluated, and the post-biopsy medical records of these patients were evaluated. RESULTS Sclerosing adenosis was the main diagnosis in 41 patients and the complementary diagnosis in 35 patients. Among the first 41 lesions in which sclerosing adenosis was the main diagnosis, there were 18 (44%) mass lesions, 16 (39%) microcalcification clusters, two (5%) lesions with asymmetrical opacity, three (7%) lesions with architectural distortion, and two (5%) lesions with focal acoustical shadowing that was only detected by ultrasonography. No alterations suggesting malignancy were noted during the follow-up examinations of 35 patients who underwent core needle biopsy. CONCLUSION Sclerosing adenosis is a benign proliferative disease of the breast that can be confused with malignancy on clinical, radiological, and even histopathological examination. There is no typical radiological criterion for diagnosis. Core needle biopsy or excisional biopsy can be used, depending on the lesions characteristics. Core needle biopsy can be the first step in the diagnosis of sclerosing adenosis.

The effect of blunt abdominal trauma on appendix vermiformis

Objectives: Trauma and appendicitis are the most common conditions of childhood for which surgical consultation is sought in emergency departments. Occasionally, appendicitis and trauma exist together, which causes an interesting debate whether trauma has led to appendicitis. We aimed to evaluate our patients with traumatic appendicitis and to discuss their properties in the light of the literature. Methods: We retrospectively reviewed the charts of children of blunt abdominal trauma accompanied by appendicitis. Results: Of 29 cases of blunt abdominal trauma that had required surgical exploration, five were found to have gross findings of acute appendicitis and underwent appendicectomy. Appendicitis was confirmed histopathologically. Conclusion: It should be kept in mind that children managed for severe blunt abdominal trauma may develop appendicitis. If clinical outlook suggests appendicitis in cases conservatively managed for blunt abdominal trauma, physical examinations, abdominal ultrasonography and/or abdominal computed tomography should be repeated for diagnosis of traumatic appendicitis. This approach will help to protect the patients against the complications of appendicitis that are likely to develop.

Infantile Amyand's hernia.

The finding of an uninflamed appendix within an inguinal hernia is estimated to be found in approximately 1% of adult inguinal hernia repairs. 1,2 A normal appendix in an inguinal hernia sac is three times more likely to occur in infants than in adults. 3 Acute or perforated appendicitis occurring within an inguinal hernia is a rare event and is known as ‘Amyand’s Hernia’. 1,2,4,5 The first case was reported in 1735 by the surgeon Claudius Amyand. 5 Amyand’s hernia is almost never diagnosed prior to surgery. 1 We present an infant whose appendicitis was found within the inguinal hernia sac in operation, which was performed eight hours following manual reduction of his incarcerated inguinal hernia.

Id-1: Regulator of EGFR and VEGF and potential target for colorectal cancer therapy

BackgroundThe helix-loop-helix transcription factor Id-1 (an inhibitor of differentiation and DNA binding) plays a role in development and progression of many tumours. Id-1 is known to exert its effects on the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor (VEGF). The aim of this study was to reveal whether there was a relationship between Id-1 and EGFR and VEGF in colorectal carcinoma.MethodsTumour and non-tumour tissue specimens from 46 cases of colorectal carcinoma were exposed to immunohistochemical staining for Id-1, EGFR and VEGF. The relationship between the degree of staining and tumour grade, tumour stage and all tumour markers was investigated.ResultsTumour cells showed positive staining for Id-1 in 43 cases (93.5%), for EGFR in 41 cases (89%) and for VEGF in 42 cases (91%). There was a significant relation between the tumour grade and the degree of staining for Id-1, EGFR and VEGF. The relation between the tumour stage and the degree of staining for Id-1, EGFR and VEGF was also significant. There was a significant relation between Id-1 expression and EGFR and VEGF expressions. Non-tumoural tissue specimens were not stained with Id-1 and EGFR antibodies in any of the cases, but stained with VEGF antibody in 3 cases.ConclusionThis study revealed that Id-1, EGFR and VEGF took part in development and progression of colorectal carcinomas and that Id-1 was associated with regulations of EGFR and VEGF. The results of this study support the idea that not only EGFR and VEGF but also Id-1 could be new targets in cancer treatment.

C-reactive protein may be a marker of bacterial translocation in experimental intestinal obstruction.

Background:  C‐reactive protein (CRP) is used as a marker of intestinal ischaemia. This study evaluated whether CRP levels can be used to detect ischaemia‐induced (strangulated) intestinal obstruction and subsequent bacterial translocation.

The effect of fibrin adhesive (Tisseel) on interbody allograft fusion: an experimental study with cats.

Summary Fibrin glue has been promoted for use in many neuro- and orthopaedic surgical procedures. At present, some surgeons make routine use of the adhesive in augmentation of bone grafting operations. However, there is controversy about its effectiveness in augmenting bone graft healing. This study investigated the use of two-component fibrin sealant (Tisseel®, Immuno AG, Vienna, Austria) as an adjunct to graft material in fusion surgery. Twenty-four cats were fused with corticocancellous bone graft, which was taken from a separate cat, across the disc space in the anterior cervical region. In the present experiment, the authors carried out cervical interbody fusions in 24 cats, divided into two groups, to test the usefulness of fibrin glue in fixation of allograft fusions. At surgery, a piece of corticocancellous allograft was placed into the intervertebral disc space at the C5–C6 region, either untreated or locally treated with fibrin adhesive (Tisseel). Fusion mass formation was examined 6 months after the experimental fusion procedure by radiography and computed tomography (CT) scanning and the new bone formed was evaluated histologically. The authors observed that the allograft fusion mass area is more voluminous in the untreated animals in Group I than in the ones augmented with Tisseel, as illustrated by CT measurement (section area and bone density) (p=0.038). Accordingly, histopathological studies demonstrated a reduced vascularization of the graft as well as diminished new bone formation in the animals treated with Tisseel in Group II. The present investigation demonstrates that local fibrin sealing significantly retards the osteogenic fusion in a model of corticocancellous bone grafting in cats. In view of our results it seems that fibrin sealant is not suitable for fixation of bone fragments in anterior cervical fusion.

Correlation of serum trace elements and melatonin levels to radiological, biochemical, and histological assessment of degeneration in patients with intervertebral disc herniation.

The aim of our study was to assess the blood concentrations of some trace elements and melatonin (MLT) in patients with intervertebral disc herniation (IDH) and to investigate the interaction of histological and biochemical degeneration findings with aging. The present study was carried out on 13 subjects (8 women and 5 men) diagnosed with IDH. They were divided into three groups according to their ages. Nighttime serum MLT, zinc (Zn), and magnesium (Mg) levels were determined in all patients. In addition, computed tomography (CT) scan of the brain and magnetic resonance imaging examination of the lumbar spine were obtained in this study. The Zn level and Zn/Mg ratio showed a decline in patients with IDH with aging, whereas the serum Mg level and tissue hydroxyproline content increased. A positive correlation between serum Zn and MLT concentrations was found (r=0.104, p=0.734). In addition, there was a positive correlation between serum Zn level and Zn/Mg ratio (r=0.835 and p<0.01), and a negative correlation between serum Mg level and Zn/Mg ratio (r=−0.571, p<0.05). On CT study, both volume percentage of calcified pineal gland and density of calcification were found to increase progressively with advancing age. The results of semiquantitative evaluation of disc tissues of patients with IDH for histological degeneration findings showed that 66.7% of discs treated had slight degeneration in younger age group, but 75.0% and 100% of discs had moderate or marked degeneration in older age groups. Our data indicated that there is a close relationship between MLT and Zn or Mg levels in the serum samples of patients with IDH, and the levels of these elements might be affected by the presence of degeneration process and serum MLT level, or vice versa.

Changes in Urethral Connective Tissue after Estrogen Replacement Therapy in Ovariectomized Rats

Objective: Genuine stress urinary incontinence is a common problem after the middle age. Various treatment modalities have been tried as a treatment for this entity and estrogens are one of the most common alternatives. Their effects on the urethral mucosa have been described in many studies, while the impact on the urethral connective tissue has been evaluated only in a few reports. In this study, we aimed to investigate the effect of estrogen on urethral connective tissue in ovariectomized rats. Material and Methods: Thirty-six Wistar rats (4 months old, 250-300 g weight) were included in the study. They were organized as group 1 (ovariectomized, n = 10), group 2 (ovariectomized + late estrogen treatment, n = 10), group 3 (ovariectomized + early estrogen treatment, n = 10) and group 4 (sham operated, n = 6). Rats in group 1 were killed 6 weeks after the ovariectomy. Group 2 was ovariectomized 6 weeks before treatment and then received estradiol for 6 weeks. Group 3 was treated with estradiol for 6 weeks immediately after the ovariectomy. After killing the rats, urethral tissues were removed. Quantitative analysis of collagen fiber content was done by computerized image analyzer system in specimens stained with Massons trichrome technique. Results: Percentages of collagen fiber content (mean - standard error of mean) were 58.4 - 5.9% in group 1; 53.3 - 4.8% in group 2; 46.3 - 3.4% in group 3 and 40.2 - 3.2% in group 4. There was not any significant difference among the groups (p > 0.05). Conclusions: Our results suggest that early and late estrogen replacements do not seem to have a discriminating effect on the urethral connective tissue. Further studies are needed to assess the preventive effect of estrogen on urethra.

Sonographic features of histopathologically benign solid breast lesions that have been classified as BI-RADS 4 on sonography

To describe the sonographic (US) features associated with ultrasonography BI‐RADS category 4 lesions that have a benign histopathological outcome.