Objectives We aimed to investigate the effect of sugammadex on the motor, sensory and deep sensory block in the sciatic nerve created by bupivacaine in rats. Materials and Methods 18 Sprague-Dawley adult male rats treated with unilateral sciatic nerve block by bupivacaine (0.2 ml) were randomly divided into three groups. Control group (Group C, n = 6, 1.5 mL saline) perineural sugammadex group (Group PNS, n = 6, 16 mg/kg) and intraperitoneal sugammadex group (Group IPS, n = 6, 16 mg/kg) Motor, sensory, and deep sensory functions were evaluated every 10 minutes by a blind researcher. 6 tissue samples each belonging to the sciatic nerve, 1.5 cm in length and 0.2 cm in diameter, were taken from paraffin blocks. Sections of 3-4 micrometers were stained with Hematoxylin + Eosin, Masson Trichrome dyes and examined under a light microscope. Results There was no statistically significant difference between 3 groups in terms of the time to return to normal motor, sensory and deep sensory function. There was also no significant difference in edema, extracellular matrix, and myelin. Inflammatory cells were seen in all groups, mainly epineurium, epineurium, and perineurium. Conclusion There are findings of no histological effects or effects on local block of sugammadex in rats undergoing sciatic nerve block.

Background: The purpose of this study was to report the outcomes of an extremely rare and misdiagnosed embryonal neuroepithelial intraocular tumor. Material and methods: The medical records of 28 nucleated eyes with unilateral vision loss in childhood and young adults were reviewed retrospectively. Demographic information, clinical history, visual acuity, indication for surgery, and histopathological findings were all noted. Cases of visual loss related to ocular trauma or endophthalmitis were not included in this study. B-scan ultrasonography was performed on patients due to media opacity. Results: A total of 7 eyes of 28 patients, age between 1–18 years, who were underwent enucleation surgery for intraocular malignancy were included in the study. The mean follow-up period was 29.4 ± 10.2 months (range, 15–60 months ). The mean age of the patients was 5.85 ± 7.33 years. There were four females and three males with equal eye distribution. The patients had no light perception. Five of 7 patients were operated on for retinoblastoma in the early period of life with easily recognized clinical signs. The other two patients wanted surgery just because they were uncomfortable with the appearance of their eyes. One of them was a 15-year-old girl with a history of blind eye and glaucoma. She had been treated for congenital glaucoma since the age of 5. At the time of the research she was complaining about the painful, blind eye as an aesthetic defect. Histopathological diagnosis was reported as medulloepithelioma. As a long-term complication, submandibular lymph node metastasis was detected during the follow-up period. Otolaryngologists performed the radical neck dissection. The patient received radiotherapy and chemotherapy. She is now in her 30s. No other complication was observed during the follow-up period. The other patient was an 18-years-old boy, who had lost his vision for an unknown cause in childhood, and wanted to have surgery for aesthetic purposes due to opaque cornea. Ultrasonography detected a mass in the ciliary body. The enucleation surgery was performed, and histopathological diagnosis was reported as medulloepithelioma. The patient received radiotherapy, and no metastasis developed during the follow-up period. Conclusion: Ophthalmologists need to be more familiar with early diagnoses and screening of the eye, especially detecting tumor cases “medulloepithelioma” which is often misdiagnosed and treated as glaucoma.

Aim: Detailed evaluation of patients in preoperative stage is an important factor that reduces morbidity and mortality as well as the operation itself. In our study, we aimed to examine clinically, pathologically and endocrinologically, the patients who were decided to undergo transsphenoidal surgery, in light of the literature.Materials and Methods: In this retrospective observational study, preoperative and pathological data of consecutive pituitary adenoma patients who applied to our department from January 2019 to June 2020 and underwent transsphenoidal surgery with microscopic methods, were examined.Results: The study included a total of 31 patients. Distribution of patients in relation to pathological diagnoses was as follows: Functional pituitary adenoma (n: 15), non-functional adenoma (n: 11), apoplexy (n: 2), carcinoma metastasis (n: 2) and craniopharyngioma (n: 1). No statistically significant difference was found between functional and non-functional adenomas, in terms of tumor size, cavernous sinus invasion, Ki-67 index and p53 staining pattern (p> 0.05) whereas presence of suprasellar extension and visual field defect were significantly more in non-functional adenomas (p = 0.015, p = 0.045, respectively).Conclusion: Highly invasive character was detected in both functional and non-functional pituitary Ki-67 indexes were low in the study population, increased p53 expression was noticeable. We can state that the Ki-67 index may not be directly proportional to the invasive behavior of the disease.

Glioblastoma (GB) is the most common malignant central nervous system tumor in adults, accounting for 47.7% of all primary malignant brain tumors.[1] The main treatment is surgical resection and gross total resection improves overall survival. Temozolomide (TMZ) and adjuvant chemotherapy along with postoperative radiotherapy have also become standardized for patients with GB.[2] The prognosis is very poor and most patients die within 1 year of diagnosis. GBs usually show local growth and infiltration. Despite the aggressive characteristics of these tumors, extracranial metastases are extremely rare.[3] Incidence is reported to be approximately 0.4-2.0%.[4] In this study, a case of GB with extensive extracranial metastasis is presented in the light of current literature.

Among all benign cardiac tumors, lipomas are rarely encountered and generally asymptomatic. Our patient, who applied to hospital with chest pain, was diagnosed with ST elevated inferior myocardial infarction. The patient was operated following pericardial tamponade. Intrapericardial extracavitary lipoma was discovered incidentally.

BACKGROUND:Upregulation of caveolin-1 (Cav-1) expression is correlated with histopathological grade and poor prognosis in several human cancers. However, in gastric cancer, its clinical utility as a useful prognostic molecular marker remains unclear.METHODS:The prognostic importance of Cav-1 expression was retrospectively analyzed by immunohistochemistry in 148 patients with gastric cancer who had undergone radical gastrectomy.RESULTS:Cav-1 expression was positive in 23 (15.5%) patients and negative in 125 (84.5%) patients. Tumor location, tumor grade, lymph node involvement, pT stage, pTNM stage, and the presence of recurrence were found to be significantly associated with Cav-1 expression. The median disease-free survival (DFS) of patients with negative Cav-1 expression was significantly better than that of patients with positive Cav-1 expression (not reached vs. 10.2 months, p < 0.001). Moreover, patients with positive Cav-1 expression had a worse median overall survival (OS) compared to patients with negative Cav-1 expression (14.2 vs. 40.3 months, p = 0.004). In the multivariate analysis, Cav-1 expression (positive vs. negative) was an independent prognostic factor for DFS (p < 0.001, hazard ratio (HR) 2.58) and OS (p = 0.031, HR 1.87), as was lymph node metastasis.CONCLUSION:Our results suggest that positive Cav-1 expression is associated with progression and poor prognosis in gastric cancer patients after radical gastrectomy. Targeting Cav-1 would be a potential option for future gastric cancer treatment.

ÖZETMeme kanserinin kranial metastazları; kemik, dura veya beyin

Although Ras-association domain family of gene 2 (RASSF2) has been shown to undergo promoter methylation at high frequency in some cancer types and in brain metastases, its clinical utility as a useful prognostic molecular marker remains unclear in gastric cancer.

Objective: The role of the galectin-3 and CD44v6 expression in the differentiation of the thyroid follicular carcinoma and follicular adenoma were investigated in many preoperative cytologic samples and significant results were achieved. In this study, we investigated galectin-3 and CD44v6 as potential supportive markers of histopathologic diagnosis in the differentiation of follicular carcinoma and adenoma of thyroid in conventional tissue sections. Material and Method: A total of 60 thyroidectomy specimens from Kartal Dr. Lutfi Kirdar Training and Research Hospital and Istanbul University Cerrahpasa Medical Faculty Pathology Department were investigated retrospectively. Twenty cases of the 60 thyroidectomy specimens were diagnosed as follicular carcinoma and 40 cases were diagnosed as follicular adenoma. Sections taken adjacent to the capsule of the nodule were stained immunohistochemically by HRP-AEC method for galectin-3 and CD44v6 antibody. Then sections were investigated under light microscope and labeled as no staining (-), focal weak staining (+), moderately intense staining (++), intense staining (+++). Results: Galectin-3 expression was significant in the differentiation of the follicular carcinoma and adenoma (p0.05). Conclusion: Galectin-3 was determined as a potential marker in the diagnosis of follicular carcinoma but CD44v6 expression was not a diagnostic value in the differentiation of follicular carcinoma and adenoma.

ÖZETGangliogliom, genellikle çocuklarda gözlenmekte olup, sinir sisteminin nadir tümörüdür.Hem nöronal hem de glial hücrelerden oluşan mikst tipte kitledir.Erişkin yaşta oldukça nadirdir.Sıklıkla supratentorial olarak yerleşim gösteren bu tümör, çok daha az sıklıkta serebellar

AIMS:Patients with suspected tuberculosis without pulmonary lesions and with intrathoracic lymphadenopathy often pose a diagnostic challenge. The aim of this study was to describe the diagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with isoleted intrathoracic lymphadenopathy due to tuberculosis (TB). MATERIALS AND METHODS:Cases with tuberculous lymphadenitis (TBLA) as the final diagnosis were analysed among patients in whom EBUS-TBNA had been performed. All patients underwent routine clinical assessment and a CT scan prior to EBUS-TBNA. Demographic data, pathological findings, and microbiological results were recorded. All patients received 6-month antituberculous treatment, followed-up regularly and recovered both on clinical and radiological basis. RESULTS:Forty-four patients were included. EBUS-TBNA diagnosed TB intrathoracic lympadenopathy in 42 (95.4%) patients. In 2 patients, EBUS-TBNA was not able to confirm a diagnosis and additional procedures were required. Cytopathological findings alone revealed TB in 32 (72.7%) patients. One of the patients (2.2%) was smear positive while microbiological investigations provided a positive culture of TB in 22 (50%) patients. TB culture was positive in 10 of 12 patients in whom cytopathologic evaluation was not able to diagnose. Addition of mycobacterium culture to cytopathologic investigation s improved the diagnostic yield from 72.7% to 95.4%. CONCLUSION:EBUS-TBNA is a safe and effective first line investigation for evaluating isolated intrathoracic tuberculous lympadenopathy. Addition of mycobacterium culture to cytopathologic investigation improves the sensitivity of EBUS-TBNA.

60 Background: Tumor invasion and metastasis are complex processes, involving regulation at the molecular level of adhesive molecules, proteolitic enzymes, and cell growth and angiogenesis factors. A Disintegrin and Metalloproteinase (ADAM)17 has been indicated to be indispensable regulator of celular event from proliferation to migration.Although prognostic importance of ADAM17 expression has been investigated in several tumors, its clinical utility as a useful prognostic molecular marker remains unclearin gastric cancer.In the present study, we evaluated the expression of ADAM17 and its prognostic significance in gastric cancer patients after surgery. Methods: Prognostic significance of ADAM17 expression was analyzed by immunohistochemically in 158 patients with gastric cancer and the relationship between its expression and clinicopathological factors was also evaluated. Results: High expression of ADAM17 was detected in 81 patients(51%),while low expression was found in 77 cases (49%). There was significant correlation between gender, histology, lymph node metastasis, vascular invasion, the presence of recurrence and high ADAM17 expression. Recurrence in patients with high ADAM17 expression was significantly higher than that for patients with low ADAM17 expression(p=0.032). The median disease-free survival (DFS) time for patients with high ADAM17 expressed tumors were worse than those of patients with low ADAM17 expressed tumor (16.6 vs. 44.2 months, p=0.004).In addition, patients with low ADAM17 expression had a higher median overall survival (OS)interval than those of high ADAM17 expressed patients (49.6 vs. 26.9 months, p=0.019). Multivariate analysis indicated that the rate of ADAM17 expression was an independent prognostic factor for DFS, in addition to known important clinicopathological prognostic indicator for DFS. But its' prognostic importance could not be proved by multivariate analysis for OS. Conclusions: The potential value of ADAM17 expression as a useful molecular marker in gastric cancer progression should be evaluated comprehensively,it may predict recurrence and poor prognosis in patients with gastric cancer after curative resection.

BACKGROUND:Approximately 75 % of patients with testicular seminoma present with stage I disease, and the probability of long-term survival approaches 100 %. However, the standard adjuvant treatment for stage I seminoma patients remains controversial, and there is no uniform consensus in the literature. The present study was performed to evaluate treatment preference and outcomes for men with stage I testicular seminoma.MATERIALS AND METHODS:From 1997 to 2013, 282 patients with histologically confirmed stage IA and IB testicular seminoma who underwent orchiectomy were included. The outcomes of three management options and survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated by univariate and multivariate analysis; in addition, the factors predicting relapse were also evaluated by logistic regression analysis.RESULTS:Of the 282 patients with stage I seminoma, 130 (46.1) received adjuvant radiotherapy (RT), 80 (28.4 %) were treated with adjuvant carboplatin, while the remaining 72 patients (25.5 %) underwent surveillance. At the time of analysis, the median follow-up period of 38.5 months; relapses were observed in 16 patients (22.3 %) on surveillance, in one patient (1.2 %) treated with adjuvant carboplatin and in ten patients (%7.7) who received adjuvant RT. The 5-year disease-free survival (DFS) rate for patients who underwent surveillance was worse than those of patients treated with adjuvant carboplatin and RT (64.2 vs. 97.7 vs. 91.9 %, respectively; p < 0.001). However, the 5-year overall survival (OS) rate for patients on surveillance was similar compared with the adjuvant treatment groups (100 vs. 92.3 vs. 97.4 %, respectively; p = 0.44). Univariate analysis showed that only the treatment approach (surveillance vs. adjuvant carboplatin vs. adjuvant RT) for DFS (p < 0.001), invasion of the rete testis (p = 0.041) and the presence of relapse (p < 0.001) for OS were important prognostic indicators. Multivariate analysis indicated that the treatment strategy for DFS (p < 0.001, HR 0.34) was an independent prognostic factor. Furthermore, a logistic regression analysis showed that adjuvant treatment was found to be an independent factor for predicting relapse (p = 0.004, odds ratio: 0.39).CONCLUSIONS:Our results indicate that adjuvant treatment with carboplatin or RT is associated with improved DFS compared with surveillance for men with stage I testicular seminoma after orchiectomy. Moreover, the treatment strategy is an important prognostic indicator for DFS and a predictive factor for relapse. Although adjuvant treatment, especially carboplatin, seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still feasible and the preferred management option after radical orchiectomy in men with stage I seminoma. More reliable predictive factors are needed to make treatment decisions.