Sare Sipal

Correlation of E-cadherin, VEGF, COX-2 expression to prognostic parameters in papillary thyroid carcinoma

Thyroid cancer represents approximately 1% of all human malignancies. papillary thyroid carcinoma (PTC) is the most common malignant tumor of the thyroid gland, accounting for 70-80% of all thyroid cancers. In the US, the incidence of thyroid cancer is 4 per 100,000 individuals. It is two to four times as frequent in women as in men. The development of PTC is influenced by many factors including genetic alterations, growth factors, and physical agents such as radiation. In order to recognize the prognosis for PTC, a lot of clinic and pathological parameters such as; age, tumor size, extra-thyroid tumor spread, lymph node, distant metastases, gender, tumor stage are used. As most of these parameters are subjective, more objective and useful prognostic factors are needed for determining biologic behavior, providing an initial assessment. In this study, we aimed to compare the expressions of COX-2, E-cadherin, VEGF to classical prognostic factors, and to investigate the correlation with prognosis. Operation records from 79 PTC cases were examined retrospectively. In the study, we aimed to investigate the whole tissue by means of stereology method, which is an impartial one, and we indicated the expression COX-2, VEGF, E-cadherin immunohistochemically in 79 resection diagnosed with PTC. We determined correlations between the expressions of COX-2 and VEGF, E-cadherin, and age, gender, and stage.

Incidence and Clinicopathologic Features of Primary Lung Cancer: A North-Eastern Anatolia Region Study in Turkey (2006-2012)

BACKGROUND Lung cancer is the most frequent cancer among men and second highest among women overall, including in Turkey. Cigarette smoking is the most important etiologic factor for the development of cancer in both men and women. OBJECTIVE To determine the lung cancer incidence in Northeastern Anatolia Region of Turkey with a focus on clinical properties, cancer subtypes, the relationships of tumors with cigarette smoking and radiological properties of the lesions. MATERIALS AND METHODS In a retrospective study design, 566 lung cancer cases diagnosed at the Pathology Department of Ataturk University in Erzurum over the last seven years extending from January 2006 to June 2012 were investigated. The results were compared with statistical analyses. RESULTS The most common histopathological subtype of primary bronchogenic carcinoma in our study was found to be the squamous cell carcinoma, 46.1% (261 out of 566), and the second was small cell lung carcinoma 15.7% (89 out of 566). Based on our data, an overall male predominance was noted with a male/female ratio of 6.1/1. While 296 (52.2%) of the patients were found to be smokers at the time of diagnosis, 125 (22.0%) were nonsmokers and 145 (25.6%) were ex-smokers. Smoking status was found to have a strong correlation with primary lung cancer (p <0.05), and there were significant differences between males and females (p<0.001). CONCLUSION Although relative prominence of subtypes of lung cancers differ between Turkish and other populations, lung cancer overall remains as an important health problem in Turkey. Our findings stress the critical need for effective cancer prevention programs such as anti-smoking campaigns.

Rational Roots of Sympathetic Overactivity by Neurogenic Pulmonary Edema Modeling Arising from Sympathyco-Vagal Imbalance in Subarachnoid Hemorrhage: An Experimental Study.

BACKGROUND Autonomous innervations of the lungs are maintained by cervical sympathetic and vagal nerves. Sympathetic overactivity-induced neurogenic pulmonary edema (NPE) is known as a serious complication of subarachnoid hemorrhage, but the rational neuronal mechanism of that overactivity has not yet been clarified fully. The aim of this study was to examine whether there is a relationship between vagal nerve ischemia related sympathetic overactivity and neurogenic pulmonary edema in subarachnoid hemorrhage. METHODS This study was conducted on 27 rabbits. A control group was formed of 5 animals, a sham group of 7 to which saline was administered, and a study group of 15 animals that were injected with homologous arterial blood into the cisterna magna. Electrocardiography and respiratory rhythm parameters were monitored for 3 weeks and the animals were then decapitated. Statistical analysis was made of the numbers of degenerated axons in the pulmonary branches of the vagal nerves, the neuron density of stellate ganglions and the vasospasm index of the pulmonary arteries. RESULTS In the control group, the normal respiration rate was 34 ± 6 bpm, total axon number was 1600 ± 270/mm(2), degenerated axon number was 10 ± 3/mm(2), and vasospasm index was 1.34 ± 0.25. The sham group values were 30 ± 3 bpm, 163 ± 47/mm(2), and 1.95 ± 0.45 and the study group values were 45 ± 8 bpm, 530 ± 92/mm(2), and 2.76 ± 0.83. The mean stellate ganglion neuron density was evaluated as 8.112 ± 1.230/mm(3) in all animals, as 7.420 ± 4.10/mm(3) in animals with slight NPE, and as 12.512 ± 1.236/mm(3) in animals that developed severe NPE. CONCLUSION High neuron density of stellate ganglion may have important roots in sympathetic overactivity-related NPE development in subarachnoid hemorrhage.

Comparative study of three angiotensin II type 1 receptor antagonists in preventing liver fibrosis in diabetic rats: stereology, histopathology, and electron microscopy

The presence of liver disease in patients with progressively worsening insulin resistance may not be recognized until patients develop manifestations of the metabolic syndrome such as diabetes, hypertension, hyperlipidemia, and vascular disease. It was aimed to investigate whether three angiotensin II type 1 receptor antagonists (ARBs) (olmesartan, losartan, and valsartan) had preventive effect against hepatic fibrosis and this was a common characteristic among ARBs. In current study, 25 adult male rats were used and divided into five groups: the non-diabetic healthy group, alloxan induced diabetic (AID) control group, AID losartan group, AID valsartan group and AID olmesartan group. According to numerical density of hepatocytes, significant difference was found between the non-diabetic healthy group and diabetic control group. All treatments groups were significant when compared to diabetic control group. In diabetic control group it was examined swelling, irregular cristae arrangement in some of mitochondria. It was also determined mitochondria membrane degeneration in some areas of section profiles. In diabetic rats treated with losartan group, there were necrotic hepatocytes. In diabetic rats treated with valsartan group, predominantly, findings were similar to losartan group. In diabetic rats treated with olmesertan group, plates of hepatocytes were quite regular. There were hardly necrotic cells. Not only other organelles such as RER, SER and lysosom but also mitochondrial structures had normal appearance. In the diabetic control group electron microscopy revealed edema in both the cytoplasm and perinuclear area and the nuclear membranes appeared damaged. In conclusion, it was established that the most protective ARB the liver in diabetic rats was olmesartan, followed by losartan.

Goseki Grade and Tumour Location Influence Survival of Patients with Gastric Cancer

BACKGROUND Owing to the variability of histopathological features and biological behaviour in gastric carcinoma, a great number of categorisation methods such as classical histopathologic grading, Lauren classification, the TNM staging system and the newly presented Goseki grading method are used by pathologists and other scientists. In our study, we aimed to investigate whether Goseki grade and tumour location have an effects on survival of gastric cancer cases. MATERIALS AND METHODS Eighty-four patients with gastric adenocarcinoma were covered in the investigation. The importance of Goseki grading system and tumour location were analysed in addition to the TNM staging and other conventional prognostic parameters. RESULTS The median survival time in our patients was 35 months (minimum: 5, maximum: 116). According to our findings, there was no relation between survival and tumour size (p=0.192) or classical histological type (p=0.270). In contrast, the Goseki grade and tumour location significantly correlated with survival (p=0.007 and p<0.001, respectively). Additionally, tumours of the intestinal type had a longer median survival time (60.0 months) than diffuse tumours (24.0 months). CONCLUSIONS In addition to the TNM staging system, tumour location and the Goseki grading system may be used as significant prognostic parameters in patients with gastric cancer.

A rare thymoma type presenting as a giant intrathoracic tumor: lipofibroadenoma.

Type B1 thymoma (lipofibroadenoma) is extremely rare. The tumor is characterized by an organoid appearance rich in lymphocytes with medullary differentiation and perivascular spaces. A twenty-three-year-old female patient was admitted to our clinic with complaints of chest pain and dyspnea for six months. Chest computed tomography showed solid and fatty components of masses 21×7 and 5×7 cm with clear borders in the right thoracic cavity. The patient underwent a posterolateral thoracotomy in which the mass, arising from the anterior mediastinum, was resected. Histopathological examination showed that the mass was Type B1 thymoma, and the patient was presented in light of the literature.

Breast lesions with high signal intensity on T1-weighted MR images.

Magnetic resonance imaging of the breast supplies much information concerning the signal characteristics of a lesion. Among these, high signal intensity on non-fat saturated T1-weighted imaging (WI) is a special finding. Such a finding may result from different causes, such as a paramagnetic substance or fatty, bloody or proteinaceous content. In this article, we present hyperintense breast lesions on T1-WI.

A new described mechanisms of intestinal glandular atrophy induced by vagal nerve/Auerbach network degeneration following subarachnoid hemorrhage: The first experimental study

Stress ulcers is a trouble complication of subarachnoid hemorrhage (SAH). Although gastrointestinal ulcerations may be attributed to increased HCL secretion in SAH; the exact mechanism of that complication has not been investigated definitively. We studied if vagal network degeneration may cause intestinal atrophy following SAH. Study was conducted on 25 rabbits, with 5 control group (Group-A), 5 SHAM group (Group-B), and 15 SAH group via injection of autologue blood to cisterna magna. Seven animals followed for seven days (Early Decapitated-Group-C) and eight animals followed 21 days (Late Decapitated-Group-D). The vagal nodosal ganglia (NGs), Auerbach plexuses and goblet cells of duodenums were examined by current stereological methods and compared statistically. The mean numbers of degenerated axon density/mm2 of gastric branches of vagal nerves was 8 ± 2, 34 ± 11, 189 ± 49 and 322 ± 81 in the Group A, B, C, and D respectively. The mean numbers of degenerated neuron density/mm3 of NGs was 5 ± 2, 54 ± 7, 691 ± 87 and 2930 ± 410 in the Group A, B, C, and D respectively. The mean numbers of degenerated Auerbach neurons 2 ± 1, 4 ± 1, 12 ± 3 and 27 ± 5/mm3 in the Group A, B, C, and D respectively. The mean numbers of degenerated goblet cells/mm3 were 4.3 ± 1.02, 11.5 ± 0.26, 143 ± 26 and 937 ± 65 Group A, B, C, and D respectively. Statistical analysis showed that vagal network ischemia could cause intestinal bleeding and so atrophy in SAH progression. Statistical analyses of groups were; Group-D/Group-A < 0.001, Group-D/Group-B < 0.005, Group-C/Group-A < 0.005. Undiscovered effect of ischemic vagal network injuries should be regarded as a major cause of stress ulcerations following SAH which has not been mentioned in the literature.

Predictive Role of the Cervical Sympathetic Trunk Ischemia on Lower Heart Rates in an Experimentally Induced Stenoocclusive Carotid Artery Model by Bilateral Common Carotid Artery Ligation

Bilateral common carotid artery ligation (BCCAL) leads to acute craniocervicocerebral ischemia, retrograde blood flow, increased blood pressure, and significant hemodynamic and histomorphological changes at the posterior cerebral vasculature. We examined the potential relationship between denervation injury following BCCAL-induced cervical sympathetic trunk (CST) ischemia and heart rate after permanent BCCAL. Rabbits (n = 25) were randomly divided into three groups: an unoperated control group (GI, n = 6); a sham-operated control group (GII, n = 6), and an experimental group subjected to BCCAL (GIII, n = 13); and then followed for one month. All animals were then sacrificed and the stellate ganglia (STGs) were examined histologically using stereological methods. The densities of degenerated neurons in the STGs were compared with heart rates and the results were analyzed with the Mann–Whitney U test. The mean normal neuron density in STGs was 10.340 ± 954/mm3 and the degenerated neuron density was 12 ± 3/mm3 in the GI group (p > 0.5). The mean heart rates and degenerated neuron densities of STGs were recorded as 267 ± 19/min and 237 ± 45/mm3 in GII (p < 0.005 for GII vs. GI); and 190 ± 11/min 1421 ± 230/mm3 in GIII (p < 0.0001 for GIII vs. GI and p < 0.005 for GIII vs. GII). An inverse and meaningful association was observed between the heart rate and degenerated neuronal density in the STGs. BCCAL may lead to hazardous histomorphological changes in the CST. A high density of degenerated neurons in the STG may provoke excessive sympathetic hypoactivity-related cardiac damage and bradyarrhythmias after stenoocclusive carotid artery diseases.

Changing Trends in the Incidence of Ovarian Neoplasia and Its Relationship with the Risk Factors: A Report of 311 Cases from North-Eastern Anatolia Region

OBJECTIVE Ovarian cancer is one of the most common and lethal gynecologic malignancy. In Turkey, the 8(th) most commonly seen neoplasm is ovarian cancer. The risk factors of ovarian cancer are menstrual reproductive events including gravida, menarche and menopause status, and life style habits such as cigarette smoking and habitat. In this study we aimed to determine the risk factors leading to ovarian cancer in Turkish women population and show the tumor markers in this population. MATERIALS AND METHODS This study included 311 ovarian neoplasia cases diagnosed at the Pathology Department of Ataturk University in Erzurum over last seven years extending from 2005 to 2013. This study is a retrospective analysis basing on the pathology reports and accesible patient files. Serum tumor markers of the patients were retrospectively reported from their records. Conventional stained preparations existing in our archive examined by two pathologists as well independent of each other, and histopathologic diagnosis and the distribution of the sub-group was revised. RESULTS A total of 311 patients were included in this study in which patients were diagnosed at the Pathology Department of Ataturk University in Erzurum. Serous cystadenoma is the most common ovarian tumor followed by mucinous cystadenoma, germ cell tumors, and dysgerminoma. All of the tumor markers were significantly normal. CONCLUSION Upto our knowledge this was the first epidemiological study in Turkey. Analysis of each countrys statistical information reflecting its own profile is also important. The relationship between the profiles of patients and types of ovarian neoplasia may give an idea about the risk factors of the disease in its region. Additionally, distribution of tumor markers might be considered for the discriminating of the benign or malign characters of the ovarian neoplasia.