Quantification of PSA mRNA levels in peripheral blood of patients with localized prostate adenocarcinoma before,during, and after radical prostatectomy by quantitative real-time PCR (qRT-PCR)

Objective  To evaluate the clinical value of detected prostate-specific antigen (PSA) mRNA expression levels in circulating cells in patients with prostate cancer by quantitative real-time polymerase chain reaction (qRT-PCR) and to determine the effect of surgical manipulation on hematogenous dissemination. Methods  Blood samples before, during, and after (24 h) surgery were obtained from 34 patients with prostate cancer who underwent radical prostatectomy for detecting PSA mRNA expression levels. PSA mRNA expression levels, PSA levels, and Gleason scores were then compared. Results  PSA mRNA expression levels were detected in 14 of 34 (41%) patients, and biochemical recurrence of blood PSA was observed in 6 of 34 (17%) patients. Differences of PSA mRNA expression levels in pre-, per-, and postoperative periods were statistically significant (P < 0.001) and differences of PSA mRNA expression levels in pre- and peroperative samples (P < 0.008), pre- and postoperative samples (P < 0.031), and per- and postoperative samples (P < 0.001) were also statistically meaningful. There was significant relationship between the detectable PSA mRNA expression levels in preoperative samples and biochemical recurrence of blood PSA levels. We demonstrated that surgical manipulation had no effect on biochemical recurrence of blood PSA. We also showed that there was significant correlation between high Gleason score and the detectable PSA mRNA expression levels (P < 0.027). Conclusions  Our results suggest that highly detectable PSA mRNA expression levels in preoperative samples seem to be a significant predictable factor for prostate cancer recurrence.     

Comparison of different dose regimens of enoxaparin in deep vein thrombosis therapy in pregnancy

INTRODUCTION: Pregnant women have a higher risk of developing deep vein thrombosis (DVT) and consequent thrombogenic events, including pulmonary embolisms. Low-molecular-weight heparin (LMWH) products have been shown to successfully treat DVT with few significant side effects. The purpose of this study was to compare the effects of two dose regimens of enoxaparin (a LMWH) in the management of DVT in pregnancy. METHODS: A total of 35 pregnant patients with DVT were enrolled in this study. As first-line anticoagulation therapy, patients were administered an intravenous unfractionated heparin infusion for 5 days, followed by a subcutaneous injection of enoxaparin 1 mg/kg twice a day until discharge. The enoxaparin therapy continued at home with 1 mg/kg twice a day for 18 patients (group I) and 1.5 mg/kg once a day for the other 17 patients (group II). Enoxaparin was discontinued 12-24 hours before delivery and restarted within 8-12 hours after delivery. Warfarin was given as adjuvant therapy along with enoxaparin in the post-partum period. Enoxaparin was discontinued when an international normalised ratio of 2 or above was reached. Differences between the two groups in terms of therapy response, complications and efficacy were recorded. RESULTS: Thrombophilic disease was observed in three patients in each group. The iliac vein had the highest incidence of DVT in both groups. During therapy, two patients in group I were diagnosed with a mild haemorrhage; one patient (in group II) had abortion. There were no significant differences between groups in terms of recanalisation (measured by venous ultrasonography examination), post-thrombotic symptoms or safety parameters. CONCLUSION: Enoxaparin can be used safely in DVT therapy during pregnancy. Our results indicate that therapy consisting of a single daily dose of 1.5 mg/kg enoxaparin is as effective as twice-daily administration.     

Blood supply of the inferior turbinate and its clinical applications

One of the most effective treatments of inferior turbinate (IT) hypertrophy is surgical reduction. Bleeding from the IT branch of the posterior lateral nasal artery (ITB) may interfere with the outcome of IT surgery. The aim of this study is to define the anatomic localization of the ITB and its variations and to investigate its clinical importance. Anatomic relations of the ITB were determined by microdissecting 20 adult, sagittally cross‐sectioned head specimens. Branching characteristics of the ITB and its anatomical relations were evaluated. The most consistent two markers to define the ITB on the lateral nasal wall were the posterior attachment of the IT (PAIT) and the posterior attachment of the middle turbinate (PAMT). Mean horizontal distances of the ITB from the PAIT and the PAMT were 7.2 mm ± 2.8 mm (2.5–11.8 mm) and 8.2 mm ± 2.8 mm (4–14.6 mm), respectively. ITB was the only major artery that supplied the IT in 85% of the specimens, and, in 15%, there was more than one artery. ITB was located lateral to the IT in 95% and medial to the IT in 5%. The ITB coursed on the lateral nasal wall, vertically between the middle and ITs and always anterior to the PAIT. All the variations of blood supply to the IT were within a one square centimeter area, ～1‐cm anterior to the PAIT. Successful cauterization of this particular area may be an alternative cauterization site in IT surgery. Clin. Anat. 23:770–776, 2010. © 2010 Wiley‐Liss, Inc.     

Nasopharyngeal tuberculosis

Nasopharyngeal tuberculosis is a rare disorder. It usually occurs via hematogenous and lymphatic spread from coexistent pulmonary or systemic tuberculosis, and by airway during respiration or bacillary expectoration. MATERIAL: we present a case of nasopharyngeal tuberculosis in a 50-year-old female patient presenting with a cervical mass and unilateral otitis media with effusion. The diagnosis was made by PCR and by isolation of Mycobacterium Tuberculosis on Loveinstein-Jensen cultures. CONCLUSION: Nasopharyngeal tuberculosis may present with cervical mass, unilateral otitis media with effusion, and may mimic nasopharyngeal carcinoma. Furthermore, nasopharyngeal carcinoma may harbor foci of granulomatous reaction, and this feature may confuse the pathologist. However PCR carries the advantage to detect the DNA of Mycobacterium tuberculosis before its growth on culture. Even though it is rare, this entity must be considered in the differential diagnosis of the nasopharyngeal masses.     

Management of keratocystic odontogenic tumour with marsupialisation, enucleation and Carnoy's solution application: a case report

The keratocystic odontogenic tumour (KCOT) is a relatively common oral and maxillofacial lesion that derives from remnants of the dental lamina. It is aggressive, grows rapidly and invades the surrounding tissues. Various treatment modalities and differing recurrence rates have been reported for KCOT. In order to treat a 24-year-old male patient with KCOT the first stage was marsupialisation. This was followed six months later by enucleation with the application of Carnoy's solution. The defect was filled completely with newly formed bone tissue after two years. This case shows that a large KCOT can be treated with a combination of conservative and aggressive methods.     

An Asymptomatic Needle in the Left Ventricular Anterolateral Wall: A Prison Inmate's Strange Radio Antenna

A foreign body such as a needle in the heart can be life-threatening. While this may occur accidentally, needles may be inserted into the body by psychiatric patients or in cases involving domestic violence. A needle can migrate through the thorax toward the heart. In drug users, needles may also reach the right ventricle via the peripheral veins. Cardiac injury can occur via the esophagus after swallowing a needle. The clinical outcome may vary from an asymptomatic situation to tamponade or shock, depending on how severely the cardiac structures are affected. In injuries involving the thorax, pneumothorax may cause sudden shortness of breath. Here, we report the case of a 34-year-old male prison inmate who accidentally lodged a pin in his left ventricle while asleep. As he has refused surgery, it was decided to follow the patient carefully.