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INTRODUCTION: Systemic lupus erythematosus is an autoimmune disease that may affect almost all organ systems. Renal involvement is the most significant prognostic factor. Renal biopsy findings play an important role in treatment decision. Ki-67 is a monoclonal antibody that is only found in proliferative cells. This study aimed to investigate the proliferative activity in renal biopsy specimens of patients with lupus nephritis using the Ki-67 monoclonal antibody, and to compare the proliferative index between different subgroups of patients. MATERIALS AND METHODS: Renal biopsy specimens of 29 patients with systemic lupus erythematosus were retrospectively evaluated. Type of lupus nephritis and activity and chronicity indexes were determined. Ki-67 immunostaining was performed. For each patient, 1000 cells were counted and the number of Ki-67 positive cells was determined. The Ki-67 activity index was compared between different subgroups of lupus nephritis and correlated with systemic lupus erythematosus disease activity index, serum creatinine, proteinuria, anticardiolipin antibodies, and complement levels. RESULTS: A positive correlation between Ki-67 proliferation index, serum creatinine levels, and systemic lupus erythematosus disease activity index were found. Although conventional activity indexes were low, in 3 of 9 patients with class II lupus nephritis, Ki-67 proliferation indexes were high, indicating proliferation. CONCLUSIONS: Ki-67 can be used as a proliferation marker in renal biopsy specimens for patients diagnosed with systemic lupus erythematosus.
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Proliferación Celular , Antígeno Ki-67/análisis , Riñón/química , Riñón/patología , Mastocitosis Sistémica/metabolismo , Mastocitosis Sistémica/patología , Adolescente , Adulto , Anticuerpos Anticardiolipina/sangre , Biomarcadores/análisis , Biopsia , Proteínas del Sistema Complemento/análisis , Creatinina/sangre , Femenino , Humanos , Inmunohistoquímica , Masculino , Mastocitosis Sistémica/sangre , Mastocitosis Sistémica/complicaciones , Mastocitosis Sistémica/inmunología , Valor Predictivo de las Pruebas , Proteinuria/etiología , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Cytology plays an important role in the preoperative assessment of many cancers. It is used as a first-line pathological investigation in both screening and diagnostic purposes. AIMS: To determine the diagnostic value and accuracy of touch imprint cytology (TIC) smear of prostate core needle biopsy (CNB) specimens in the diagnosis of prostate carcinoma. MATERIALS AND METHODS: One hundred and twenty-one patients had ultrasound-guided transrectal prostate CNB. A total of 1210 TIC smears were prepared from all CNB specimens. RESULTS: Diagnoses of 1210 TIC smears were compared with the histopathological findings of the CNB specimens. One hundred and seventy (14%) TIC smears were found positive for malignancy, 35 (2.9%) were diagnosed as suspicious for malignancy and 1005 (83.1%) were found negative for malignancy. Twenty-five of 35 suspicious imprints and 150 of 170 malignant smears were confirmed to be malignant on histopathological evaluation. Although 20 malignant TIC smears were defined as benign in standard histological preparations, 10 of them had definitive diagnosis of malignancy following extensive serial sectioning. Last of all, there were 10 false-positive cytology results. Moreover, 10 of the 35 suspected TIC smears were false negative when compared with the histopathological diagnosis. The sensitivity, specificity, positive predictive value and negative predictive value of touch imprint smear results were 100%, 98%, 90.2% and 100%, respectively. CONCLUSIONS: TIC smears can provide an immediate and reliable cytological diagnosis of prostate carcinoma. It may clearly help the rapid detection of carcinoma, particularly in highly suspected cases that had negative routine biopsy results for malignancy with abnormal serum prostate specific antigen (PSA) levels and atypical digital rectal examination.
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BACKGROUND: To investigate the role of maspin expression in the progression of gastrointestinal stromal tumors, and its value as a prognostic indicator. METHODS: In the study 54 patients with GIST diagnosis were included in Uludag University of Faculty of Medicine, Department of Pathology between 1997-2007. The expression of maspin in 54 cases of gastrointestinal stromal tumor was detected by immunohistochemistry and compared with the clinicopathologic tumor parameters. RESULTS: The positive expression rates for maspin in the GISTs were 66.6% (36 of 54 cases). Maspin overexpression was detected in 9 of 29 high risk tumors (31%) and was significantly higher in very low/low (78.6%) and intermediate-risk tumors (63.6%) than high-risk tumors. CONCLUSIONS: Maspin expression might be an important factor in tumor progression and patient prognosis in GIST. In the future, larger series may be studied to examine the prognostic significance of maspin in GISTs and, of course, maspin expression may be studied in different mesenchymal tumors.
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Biomarcadores de Tumor/metabolismo , Tumores del Estroma Gastrointestinal/metabolismo , Serpinas/metabolismo , Adolescente , Adulto , Anciano , Progresión de la Enfermedad , Femenino , Tumores del Estroma Gastrointestinal/patología , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Factores de Riesgo , Tasa de Supervivencia , Adulto JovenRESUMEN
BACKGROUND: Citicoline has been shown to have beneficial effects in a variety of CNS injury models. The aim of this study was to test the effects of citicoline on nerve regeneration and scarring in a rat model of peripheral nerve surgery. METHODS: Seventy adult Sprague-Dawley rats underwent a surgical procedure involving right sciatic nerve section and epineural suturing. Rats were assigned to the control or experiment groups to receive a topical application of 0.4 mL of saline or 0.4 mL (100 micromol/L) of citicoline, respectively. Macroscopic, histological, functional, and electromyographic assessments of nerves were performed 4 to 12 weeks after surgery. RESULTS: In the control versus citicoline-treated rats, SFI was -90 +/- 1 versus -84 +/- 1 (P < .001), -76 +/- 4 versus -61 +/- 3 (P < .001), and -66 +/- 2 versus -46 +/- 3 (P < .001) at 4, 8, and 12 weeks after surgery, respectively. At 12 weeks after surgery, axon count and diameter were 16400 +/- 600 number/mm(2) and 5.47 +/- 0.25 microm versus 22250 +/- 660 number/mm(2) (P < .001) and 6.65 +/- 0.28 microm (P < .01) in the control and citicoline-treated groups, respectively. In citicoline-treated rats, histomorphological axonal organization score at the repair site was (3.4 +/- 0.1) significantly better than that in controls (2.6 +/- 0.3) (P < .001). Peripheral nerve regeneration evaluated by EMG at 12 weeks after surgery showed significantly better results in the citicoline group (P < .05). Nerves treated with citicoline demonstrated reduced scarring at the repair site (P < .001). CONCLUSION: Our results demonstrate that citicoline promotes regeneration of peripheral nerves subjected to immediate section suturing type surgery and reduces postoperative scarring.
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Citidina Difosfato Colina/farmacología , Regeneración Nerviosa/efectos de los fármacos , Nootrópicos/farmacología , Recuperación de la Función/efectos de los fármacos , Nervio Ciático/lesiones , Animales , Axones/patología , Axones/fisiología , Cicatriz/prevención & control , Tejido Conectivo/patología , Modelos Animales de Enfermedad , Electromiografía , Femenino , Complicaciones Posoperatorias/prevención & control , Ratas , Ratas Sprague-Dawley , Nervio Ciático/patología , Nervio Ciático/fisiología , Nervio Ciático/cirugíaAsunto(s)
Ganglioneuroblastoma/complicaciones , Hematuria/etiología , Neoplasias Renales/complicaciones , Ganglioneuroblastoma/diagnóstico , Ganglioneuroblastoma/cirugía , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Nefrectomía , Resultado del TratamientoRESUMEN
BACKGROUND/AIMS: The purpose of this study was to determine predictors of survival after resection for periampullary neoplasms. METHODOLOGY: In this study, we reevaluated our 17 cases of this type tumor which we had reported as periampullar site tumors, in advanced stages with undetermined localization, in our pathology department of the Uludag University faculty of medicine. RESULTS: Six of our cases were female, and 11 were male with a mean age of 60.6 years (range 31-77). Their main complaints were loss of weight, anorexia, jaundice and fatigue. Physical and endoscopic examination of these patients revealed periampullary mass and Whipple operations were performed on all of them. Histopathologic examinations of these tumors revealed adenocarcinoma in 15, small cell (neuroendocrin) carcinoma in two. All were in the advanced stages. Eight of them were alive and free of disease after 1.5- to 20-month follow-ups, while ten died because of disease. CONCLUSIONS: Periampullary carcinoma is a problem with increasing clinical significance. Tumor size, tumor type and differentiation, lymph node status appears to be prognostic markers.
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Ampolla Hepatopancreática/cirugía , Carcinoma/mortalidad , Carcinoma/cirugía , Neoplasias Duodenales/mortalidad , Neoplasias Duodenales/cirugía , Adulto , Anciano , Ampolla Hepatopancreática/patología , Carcinoma/patología , Neoplasias Duodenales/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Análisis de SupervivenciaRESUMEN
BACKGROUND/AIMS: Gastrointestinal stromal tumors (GIST) are mesenchymal tumors originating from the gastrointestinal canal wall. Although a number of studies are performed concerning prognostic factors, no indicators of recurrence or metastasis could be established. In this study we assessed the prognostic value of MIB-1 proliferative index (PI) in GIST, and whether there was a relationship to any other clinicopathological findings. METHODOLOGY: In the study 37 patients with GIST diagnosis were included. The cases were classified as low, intermediate, and high risk groups according to tumor size and mitotic activity. The average PI of 10% in high risk group was set as the cut-off value. RESULTS: Of all the cases, those with a MIB-1 PI over the cut-off value had a significantly shorter survival (Log-rank test, p < 0.05). Likewise cases with small bowel tumors with a MIB-1 PI over the cut-off value had a significantly shorter survival (Log-rank test, p < 0.05). A statistically significant negative correlation was found between presence of necrosis and survival using McPearson correlation test (p < 0.01). CONCLUSIONS: MIB-1 PI and presence of necrosis are possible indicators of prognosis especially in GIST cases of the small bowel.
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División Celular/fisiología , Tumores del Estroma Gastrointestinal/patología , Antígeno Ki-67/análisis , Índice Mitótico , Adolescente , Adulto , Anciano , Biopsia , Femenino , Tumores del Estroma Gastrointestinal/mortalidad , Tumores del Estroma Gastrointestinal/cirugía , Humanos , Técnicas para Inmunoenzimas , Mucosa Intestinal/patología , Mucosa Intestinal/cirugía , Masculino , Persona de Mediana Edad , Pronóstico , Análisis de SupervivenciaRESUMEN
Studies performed recently have determined that aldosterone has not only a major role in electrolyte and water balance and K excretion, but it also modulates myofibroblast growth in the heart and blood vessels and causes fibrosis. This study investigated the effects of aldosterone blockers in rats with anti-thy 1.1 nephritis, both on proliferation and fibrosis, by comparing it to an angiotensin receptor inhibitor valsartan. Rats with anti-thy 1.1 nephritis were randomly allocated to one of the three following groups of treatment: the control group (group 1); those treated with the aldosterone receptor blocker spironolactone (group 2); and those treated with the ATRB valsartan (group 3). On day 7, the parameters of glomerular fibrosis [transforming growth factor beta, TGF staining areas %], proliferation (Ki-67), and renal damage scores were determined. The TGF-beta and Ki-67 levels of control group were significantly more than the other two groups (p<0.01). The TGF staining areas percentages were significantly decreased compared to control group. The artery, glomerular, and renal injury scores evaluated between the groups were found to be significantly decreased compared to control group. In line with previous studies, this study found that in anti-thy 1.1 mesangioproliferative glomerulonephritis, aldosterone blockage affected proliferation and fibrosis.
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Aldosterona/metabolismo , Proliferación Celular/efectos de los fármacos , Diuréticos/farmacología , Fibrosis/prevención & control , Glomerulonefritis Membranoproliferativa/metabolismo , Antagonistas de Receptores de Mineralocorticoides/farmacología , Espironolactona/farmacología , Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Animales , Antihipertensivos/farmacología , Modelos Animales de Enfermedad , Fibrosis/patología , Glomerulonefritis Membranoproliferativa/patología , Glomerulonefritis Membranoproliferativa/fisiopatología , Antígeno Ki-67/metabolismo , Riñón/efectos de los fármacos , Riñón/metabolismo , Riñón/patología , Ratas , Ratas Sprague-Dawley , Tetrazoles/farmacología , Factor de Crecimiento Transformador beta/metabolismo , Valina/análogos & derivados , Valina/farmacología , ValsartánRESUMEN
Although the association and causality between chronic inflammatory states and systemic AA amyloidosis have been well established, the evidence linking solid malignancies to reactive AA amyloidosis is scarce. Here, a case of diagnosed AA amyloidosis associated with synchronous carcinomas of stomach and bladder complicated with nephrotic syndrome and renal failure is reported.
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Amiloidosis/etiología , Neoplasias Primarias Múltiples/complicaciones , Síndrome Nefrótico/etiología , Insuficiencia Renal/etiología , Adenocarcinoma/complicaciones , Adenocarcinoma/diagnóstico , Anciano , Amiloidosis/diagnóstico , Carcinoma de Células Transicionales/complicaciones , Carcinoma de Células Transicionales/diagnóstico , Resultado Fatal , Humanos , Masculino , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/diagnóstico , Neoplasias de la Vejiga Urinaria/complicaciones , Neoplasias de la Vejiga Urinaria/diagnósticoRESUMEN
The aim of this experimental study was to evaluate the effects of end-to-side coaptation of the proximal end of a severed nerve to the same intact nerve, in addition to traditional end-to-side coaptation of the distal end, with an aim to use the intact nerve as a nerve conduit in a rat model and to compare the functional and histologic results of this modality to those obtained after nerve grafting and traditional end-to-side nerve coaptation. In group A, a peroneal nerve defect measuring 1 cm was created in the left hind limb, and a nerve graft 1 cm long was used to bridge the defect. In group B, only the distal stump of the peroneal nerve was coapted to the intact tibial nerve. In group C, both ends of the peroneal nerve defect were coapted to the intact tibial nerve in an end-to-side fashion 1.5 cm apart from each other, and in group D, the peroneal nerve defect was left unrepaired. Group E was consisted of nonoperated peroneal nerves that were used to obtain normative data. Although significantly higher myelinated axon densities were observed in groups B and C compared with group A and group E, total number of the myelinated axons was significantly higher only in group C. Peroneal functional index assessments demonstrated that nerve recovery in the peroneal nerve was similar in groups A and C, and both were better than those observed in groups B and D. Collectively, these results suggest that end-to-side coaptation of both ends of a severed nerve to an intact nerve, in case of a nerve defect in this length, may serve as an alternative for nerve grafting.
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Microcirugia/métodos , Regeneración Nerviosa/fisiología , Transferencia de Nervios/métodos , Nervio Peroneo/cirugía , Análisis de Varianza , Animales , Recuento de Células , Masculino , Fibras Nerviosas , Conducción Nerviosa/fisiología , Nervio Peroneo/citología , Ratas , Ratas Sprague-DawleyAsunto(s)
Hiperparatiroidismo Secundario/complicaciones , Metacarpo , Osteítis Fibrosa Quística/etiología , Deficiencia de Vitamina D/complicaciones , Adulto , Femenino , Humanos , Metacarpo/diagnóstico por imagen , Metacarpo/patología , Osteítis Fibrosa Quística/diagnóstico por imagen , Osteítis Fibrosa Quística/patología , Radiografía , Luz SolarRESUMEN
The aim of this study was to analyze 37 patients with malignant primary gastrointestinal stromal tumors and to compare the findings and their therapeutic implications with those previously reported. The medical records of 37 patients who were diagnosed and operated on between January 1996 and December 2002 were retrospectively reviewed. The patients' age, tumor size, type of surgery, histologic type, mitotic counts, presence of necrosis, Ki-67 proliferative index, National Institutes of Health 2001 consensus classification, immunohistochemical staining, and recurrence were examined to analyze factors affecting survival. Overall actuarial survival for all patients was 46%. When analyzed by type of resection, the complete resection group (R0 resection) had a mean overall survival of 48.2 +/- 6.18 months compared with the patients with incomplete resection (R1-R2) who survived a mean of 10.8 +/- 3.2 months (P=0.00). Univariate analysis showed development of recurrence (P=0.00), tumor size of 8 cm or greater (P=0.05), Ki-67 proliferative index greater than 0.82 (P=0.0448), desmin staining (P=0.0076), age younger than 49 years (P=0.0009), and incomplete resection (P=0.00) to be significantly correlated with a poor survival. In multivariate analysis, desmin staining (P=0.031), tumor size (P=0.033), age (P=0.01), recurrence (P=0.038), and R0 resection (P=0.02) were significant independent prognostic factors. We recommend that more careful preoperative and more frequent postoperative follow-up examinations be performed for patients with large tumors, age of younger than 49 years, and Ki-67 proliferative index greater than 0.82.
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Transformación Celular Neoplásica/patología , Neoplasias Gastrointestinales/mortalidad , Neoplasias Gastrointestinales/patología , Tumores del Estroma Gastrointestinal/mortalidad , Tumores del Estroma Gastrointestinal/patología , Adolescente , Adulto , Factores de Edad , Anciano , Análisis de Varianza , Biopsia con Aguja , Estudios de Cohortes , Femenino , Neoplasias Gastrointestinales/cirugía , Tumores del Estroma Gastrointestinal/cirugía , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Lesiones Precancerosas/patología , Probabilidad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores Sexuales , Estadísticas no Paramétricas , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
METHODS: We investigated cyclin D1 expression in proliferative endometrium, endometrial hyperplasia and endometrioid adenocarcinoma, and examined the correlation of cyclin D1 expression with Ki67 as a cell proliferation associated marker. Immunohistochemical expression of cyclin D1 and Ki67 were studied in 30 cases with endometrial carcinoma, 14 cases with atypical hyperplasia, 15 cases with simple hyperplasia and 30 cases with proliferative endometrium. RESULTS: One out of 30 patients (3.3%) with proliferative endometrium, 1 out of 14 patients (7.1%) with atypical hyperplasia, and 8 out of 30 patients (26.6%) with endometrial carcinoma were found to have immunoreactivity to cyclin D1. All cases of simple hyperplasia had negative staining for cyclin D1. A positive immunoreaction for Ki67 was obtained in all cases. Statistically significant difference was found in cyclin D1 immunoreactivity between both proliferative endometrium and adenocarcinoma, and simple hyperplasia and adenocarcinoma (p<0.05). In patients with adenocarcinoma, cyclin D1 immunoreactive cases had higher mean Ki67 values compared with the non-immunoreactive ones (p<0.05). Ki67 and cyclin D1 immunoreactivity had no impact on overall survival. Univariate analysis revealed a significant relationship between survival and grade and stage (p<0.01). Cyclin D1 expression was not correlated with age, depth of myometrial invasion, lymphovascular space involvement, grade, lymph node metastasis and stage. CONCLUSION: Cyclin D1 expression in endometrial carcinoma is higher than proliferative endometrium and simple hyperplasia. These findings support that cyclin D1 may play a role in endometrial carcinogenesis.
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Carcinoma Endometrioide/metabolismo , Ciclina D1/biosíntesis , Hiperplasia Endometrial/metabolismo , Neoplasias Endometriales/metabolismo , Endometrio/metabolismo , Biomarcadores , Proliferación Celular , Femenino , Humanos , Antígeno Ki-67/análisis , Persona de Mediana EdadRESUMEN
After the chondrogenic potential of free grafts of perichondrium was shown in several experimental studies, perichondrium has been used to reconstruct cartilage tissue in various clinical situations. This study investigates the effects of human amniotic fluid on neochondrogenesis from free perichondrial grafts in a rabbit model. Since this fluid contains high concentrations of hyaluronic acid, hyaluronic acid-stimulating activator, growth factors, and extracellular matrix precursors during the second trimester, it may have a stimulating effect on neochondrogenesis. Perichondrial grafts, measuring 20 x 20 mm2 were obtained from the ears of 144 New Zealand young rabbits and were sutured over the paravertebral muscles. The rabbits were randomly divided into three groups with 48 rabbits per group. In group 1, 0.3 ml human amniotic fluid, and in group 2, 0.3 ml saline were injected underneath the perichondrial grafts. Group 3 formed the control group in which no treatment was given. Histologically, neochondrogenesis was evaluated in terms of cellular form and graft thickness at 2, 4, 6, and 8 weeks after surgery. In group 1, the mature cartilage was generated quickly and the cartilage plate in this group was significantly thick and extensive when compared with groups 2 and 3 at 8 weeks ( p<0.05 ANOVA). In conclusion, our study shows that human amniotic fluid enhances neochondrogenesis from free perichondrial grafts. The rich content of hyaluronic acid and growth factors possibly participate in this result.
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Líquido Amniótico/fisiología , Cartílago/fisiología , Regeneración/fisiología , Análisis de Varianza , Animales , Cartílago/anatomía & histología , Cartílago/trasplante , Humanos , ConejosRESUMEN
The purpose of this study was to investigate the effects of combined application of human amniotic membrane wrapping and hyaluronic acid injection on peripheral nerve scarring in an adult rat model. After circumferential epineurectomies of right sciatic nerves were performed in each of 72 rats, nerves were randomly divided into three groups: (1) nothing was done additional to epineurectomy; (2) the epineurectomized segment was wrapped with human amniotic membrane; and (3) the epineurectomized segment was wrapped with human amniotic membrane and hyaluronic acid was injected inside. The extent of adhesions and perineurial scar thickness was macroscopically and histologically evaluated at 4 and 12 weeks. The least adhesion and perineurial scar tissue were observed in nerves treated with human amniotic membrane wrapping and hyaluronic acid injection. This combination appears to be safe and effective in preventing perineurial scar formation after peripheral nerve surgery in rats.
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Adyuvantes Inmunológicos/administración & dosificación , Apósitos Biológicos , Ácido Hialurónico/administración & dosificación , Neuropatía Ciática/terapia , Animales , Cicatriz/prevención & control , Terapia Combinada , Inyecciones Intralesiones , Masculino , Modelos Animales , Traumatismos de los Nervios Periféricos , Ratas , Ratas Sprague-Dawley , Nervio Ciático/lesiones , Adherencias Tisulares/prevención & controlRESUMEN
A 76-year-old woman underwent surgery for pelvic mass, during which a 13 x 8-cm right ovarian tumor was discovered. On histopathological examination, she was diagnosed with an endodermal sinus tumor with right tubal metastasis. The patient was treated with four cycles of Bleomycin, Etoposide and Cisplatin. She died of disseminated disease four years later.
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Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Tumor del Seno Endodérmico/patología , Neoplasias de las Trompas Uterinas/secundario , Neoplasias Ováricas/secundario , Factores de Edad , Anciano , Bleomicina/administración & dosificación , Cisplatino/administración & dosificación , Tumor del Seno Endodérmico/terapia , Etopósido/administración & dosificación , Neoplasias de las Trompas Uterinas/terapia , Resultado Fatal , Femenino , Procedimientos Quirúrgicos Ginecológicos/métodos , Humanos , Neoplasias Ováricas/terapiaRESUMEN
A case of primary chondrosarcoma of the testis is reported. A 40-year-old man presented a painless swelling of the right testis that he has been observing for 3 years. Gross examination of the resected specimen showed an encapsulated, gray to tan colored, roughly rounded tumor. Histologically, the tumor revealed a well-differentiated chondrosarcoma.