Elevated serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis and its association with disease activity and quality of life

This study was carried out to determine the serum levels of high mobility group box protein 1 (HMGB1) in patients with ankylosing spondylitis (AS) and to evaluate its correlation with disease activity and quality of life. According to our knowledge, it is the first trial evaluating HMGB1 levels in AS. Serum samples of 30 patients (18 males and 12 females) with AS and 29 healthy controls (HC) (15 females and 14 males) were collected. HMGB1 levels were measured by enzyme-linked immunosorbent assay, activity of disease was assessed according to the Bath AS Disease Activity Index (BASDAI), and functional status of patients was evaluated with Bath AS Functional Index (BASFI). Modified Schober, chest expansion values and AS Quality of Life Questionnaire (ASQoL) scores were noted. The serum levels of HMGB1 were obtained significantly increased in AS patients compared to HC (p < 0.05). There was no significant correlation between HMGB1 levels and ESR (p > 0.05), and CRP (p > 0.05) values. BASDAI, BASFI and ASQoL scores were also not correlated with serum levels of HMGB1 (p > 0.05). Our results suggest that HMGB1 might play an important role in the pathogenesis of AS; however, it seems not to be a good candidate for reflecting disease activity, functional abilities and the quality of life in patients with AS; on the other hand, the increased levels of HMGB1 in patients may open a new dimension for targeting this cytokine as a new therapy option in AS.     

Cyclic sciatica caused by infiltrative endometriosis: MRI findings

Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch.     

Mapping of internal mammary vessels by multidetector computed tomography for parasternal transthoracic intervention guidance

OBJECTIVE: To measure the distances between the internal mammary arteries (IMAs) and the sternum for determining a route for parasternal transthoracic interventions. METHODS: Coronal reconstructed multidetector computed tomography images of 202 patients were evaluated to measure the distances between the IMAs and sternum at 3 levels (manubrium, midsternal corpus, and distal sternal corpus). The arrangements (2 veins-single artery or single vein-single artery) were documented. RESULTS: The most frequently encountered arrangement (42.1%) was a single vein and single artery on both sides. Mean distances on the right and left sides were 10.2 and 10.1 cm at the manubrium, 14.5 and 14.3 cm at the midsternal corpus, and 17.9 and 17.5 cm at distal sternal corpus, respectively. CONCLUSION: To be aware of the courses of the IMAs at different sternal levels is important during attempts at transthoracic intervention via a parasternal approach.     

Medullary thyroid carcinoma,follicular variant

We report here a 48-yr-old woman presenting with a solitary thyroid nodule in the left lobe of the thyroid. The aspiration cytology of the nodule was reported as follicular neoplasia and she underwent surgery. Frozen section was suspicious for medullary thyroid carcinoma and a total thyroidectomy was performed. The pathology report revealed medullary thyroid carcinoma, follicular variant. Immunohistochemical analysis was negative for thyroglobulin and positive for calcitonin. A few patients with this variant have been reported in the literature, mainly diagnosed by immunohistochemical features of the tumor. In light of the limited information we have obtained from the literature, it is reasonable to emphasize that these cases should be distinguished from the mixed medullary-follicular thyroid carcinomas and medullary carcinomas with entrapped follicles. Immunohistochemical examination with calcitonin and thyroglobulin is also essential.     

Clinical importance of vascular endothelial growth factor (VEGF) for papillary thyroid carcinomas

Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis and may be produced by some cancer cells. Several recent reports have documented that increased expression of VEGF is associated with risk of recurrence or decreased recurrence-free survival in papillary thyroid cancers (PTC). The aims of this study were to determine whether immunohistochemical expression of VEGF is related to local and distant recurrence of PTC and to evaluate the relationship between hypervascularization and VEGF expression in papillary thyroid carcinomas. VEGF expression was examined immunohistochemically in 48 papillary carcinomas. Ten normal thyroids were used as controls. Patients were followed for 61.7 (range 24-143) months. Twelve of the patients had local and distant recurrences. VEGF immunostaining, blinded for clinicopathological data, was evaluated semiquantitatively by two pathologists. The difference between the recurrent (n:12) and nonrecurrent (n:36) carcinomas was statistically significant (p:0.001). VEGF expression was also stronger in papillary thyroid carcinomas than in normal thyroid tissues. The mean microvascular densities were significantly higher than in normal thyroid tissues. These data indicate that VEGF staining is strongly associated with increased frequency of local and distant recurrence in PTC and that the immunohistochemical profile of the expression may be used as a marker for predicting which tumors have metastatic potential.     

Primary breast lymphoma cytologic diagnosis

Primary non-Hodgkin lymphoma of the breast is a rare pathology, and bilateral involvement is exceptional. We report a case of bilateral primary non-Hodgkin lymphoma of the breast in a 40-year-old woman. Predominantly atypical lymphocytes and rare plasma cells were found in the microscopic evaluation of the fine-needle aspiration biopsy of the right and left breasts. Microscopic findings of the incisional biopsy of the left breast were in accordance with non-Hodgkin diffuse large B-cell lymphoma. The patient received systemic chemotherapy and is alive with no evidence of recurrence for 2 years.     

Pseudomass of the sternal manubrium in osteogenesis imperfecta

Skeletal abnormalities such as hypertrophic callus formation and "popcorn" calcifications are rare radiological findings of osteogenesis imperfecta, causing tumor-like appearances on imaging. We report on a 7-year-old girl with osteogenesis imperfecta presenting with hepatomegaly and palpable lymphadenopathy in the left inguinal region on physical examination. Computed tomography examination revealed a high-density mass-like lesion of the manubrium sterni. Ultrasonography and a lateral roentgenogram of the chest verified that this was a pseudomass caused by a bowed sternal manubrium.     

A transmission electron microscope investigation of the effect of lead acetate on the hepatopancreatic ceca of Gammarus pulex

The freshwater Amphipod Gammarus pulex is a sensitive indicator organism for environmental contamination. In this study, effects of heavy metal lead acetate were investigated by using electron microscopy techniques. Control group was not expose to lead acetate but experimental group was for 96 h. The ultrastructural changes of hepatopancreatic ceca cells were studied in these two groups by electron microscopy techniques analysing cellular structure, structure of organelles and vacuolization. The number of cells based on the toxic effects of lead acetate was increased compared with the control group. The number and length of cell microvilli was decreased. Additionally degenerated mitocondria, dilation of golgi vesicules and cytoplasmic vacuolization were observed. The results of present study suggest that the exposure to the lead acetate may cause some ultrastructural changes on hepatopancreatic ceca of digestive system in Gammarus pulex. The significance of this change in terms of environmental toxicology needs to be further studied.