Emphysematous pyelonephritis and renal amoebiasis in a patient with diabetes mellitus

Emphysematous pyelonephritis is an uncommon and life-threatening infection of the kidney that is characterized by gas formation within or around the kidney and is associated with diabetes mellitus and urinary tract infection. Amoebiasis is a protozoal infection caused by Entamoeba histolytica. In its invasive forms, the disease is characterized by visceral abscess formations. We present a case of concomitant emphysematous pyelonephritis and renal amoebiasis in a 42-year-old female with uncontrolled diabetes mellitus. The patient did not respond well to initial supportive treatment and antibiotherapy. Therefore, nephrectomy was performed. She did extremely well after the operation and was discharged with antidiabetics and antibiotics.     

Dyskeratosis congenita: Unusual onset with isolated neutropenia at an early age

A 3.5 year old male patient with dyskeratosis congenita (DC) presented at the age of 13 months with isolated neutropenia preceding characteristic skin findings. The average absolute neutrophil count of 500/mm³ persisted without the presence of anemia or thrombocytopenia during the follow up. Neutropenia responded to granulocyte-colony stimulating factor (G-CSF) at a dose of 10 μg/kg per day. Immunologic findings were normal as was the chromosomal stability and sister chromatid exchange.     

Intravascular Ultrasound Imaging: Use in Peripheral Laser-Assisted Angioplasty

The proliferation of sophisticated endovascular interventions is mandating more definitive and comprehensive documentation of atherosclerotic lesions and the results of the interventional devices used in their removal. A technique with a potential to fulfill these goals, intravascular ultrasound imaging (IVUS), was evaluated against pressure gradients, arteriography, and femoral-radial indices in 11 patients with stenotic iliac lesions. The two-dimensional, real-time scans were useful in measuring pre-and posttreatment cross-sectional diameters and luminal areas for procedural assessment. Furthermore, the ultrasound scans clearly identified arterial wall calcifications, iliac veins, soft plague formations, dissections, synthetic graft anastomoses, and intravascular stents, often with definition superior to arteriography. The IVUS technique was useful in selecting interventional therapies, in particular, the need for stent implantation to control intimal flaps. Further, IVUS demonstrated its ability as a substitute for contrast arteriography in a twelfth patient with an iliac stent in whom a protocol-dictated follow-up arteriogram was contraindicated.     

Clinical and Dermoscopic Characteristics of Melanocytic Nevi in Turkish Children and Their Relationship with Environmental and Constitutional Factors

BACKGROUND/AIM: The number of melanocytic nevi strongly influences risk of melanoma. Researchers have therefore been prompted to study the epidemiology of nevi, particularly in children. Our aim was to determine the clinical and dermoscopic characteristics of melanocytic nevi in Turkish children and their relationship with environmental factors. METHODS: A total of 180 children were randomly included in the study. A survey was applied including age, sex, sunblock use, sunburn history, mother's dressing style, mother's education, and income. Dermoscopic patterns of nevi were noted. RESULTS: A total of 1,173 melanocytic nevi were examined. The mean number of nevi was 6.53+/-7.18. The number of melanocytic nevi significantly increased with age (Pearson r=0.616, p=.001). The most common localization was head and neck. A total of 81.1% of children had never used sunblock, and 57.2% of mothers dressed in the Islamic style. The mean number of melanocytic nevi in children whose mothers dressed in the Islamic style was lower than whose mothers dressed in non-Islamic style (p=.015). Sunblock use increased with mother's education (p=.001) and with income (p=.001). Children with more melanocytic nevi used more sunblock (p=.002), and sunblock use increased with age (p=.026). The most common dermoscopic feature was a globular pattern. CONCLUSION: This study lays the foundation for future studies showing the relationship between nevus phenotype, dermoscopic pattern, and social factors.     

Investigating the in vitro effect of taurine on the infant lymphocytes by sister chromatid exchange

BACKGROUND: Taurine (2-aminoethane sulphonic acid) is normally present in most mammalian tissues and the most abundant free amino acid in lymphocytes. It participates in various important physiological activities including modulation of the functioning of the central nervous system, cell proliferation, viability and prevention of oxidant-induced injury in many tissues. Its levels in human milk are very high which may be the most important difference from cow's milk. In contrast, an inverse association between breast-feeding and carcinogenesis in childhood or later in life has been suggested by several studies. METHODS: The study group consisted of eight healthy infants. Peripheral blood was collected and lymphocytes were cultured with either Taurine or Mitomycin C (MMC). Sister chromatid exchange in lymphocytes of the infants were calculated. RESULTS: Statistical differences were found between untreated and MMC-treated lymphocytes, untreated and MMC plus taurine-treated lymphocytes, and between MMC and MMC plus taurine-treated lymphocytes (P = 0.012). CONCLUSION: The results indicated that taurine plays a protective role in MMC-induced sister chromatid exchange in human lymphocytes. The authors suggest that the high levels of taurine found in human milk may induce protecting effects from breast-feeding against DNA damage and malignancy.     

Prevalence of lower urinary tract symptoms in a community-based survey of men in Turkey

AIM: The aim of the present study was to determine the frequency of lower urinary tract symptoms (LUTS), assess the impact of LUTS on quality of life (QOL) and compare the results with recent reports from other population-based studies. METHODS: A total of 266 men participated in the study. The men were stratified into 10-year age groups between 40 and 79 years. All participants were asked to complete a questionnaire that included a Turkish translation of the International Prostate Symptom Score (IPSS) with QOL questions, and void into a uroflowmeter to obtain voided urine volume, peak and mean flow rate. RESULTS: While 14.8% of men had no symptoms (IPSS = 0), 24.9% had moderate to severe symptoms (IPSS> 7). Severity of symptoms increased with age (P = 0.0018). There was a strong relationship between bother score and IPSS (rs = 0.79, P = 0.0001). Fifty-five percent of moderately symptomatic and 78% of severely symptomatic men reported poor QOL (QOL score >/= 3). The results of the survey provide a general picture of the symptomatology and urinary flow profiles of elderly men living in Turkey. CONCLUSION: The prevalence of LUTS in the Turkish community is fairly high, it increases with age and has an impact on QOL that is not negligible.     

Serum mannose‐binding lectin (MBL) levels are decreased in gout patients

Objective: Mannose binding lectin (MBL) is a circulating plasma protein that plays a pivotal role in innate immunity. We aimed to investigate serum levels of MBL in patients with gout disease. Material and methods: Mannose binding lectin levels were measured in sera of 38 patients with gout (study group; SG), 18 patients with other rheumatological diseases (patient controls; PC), and 24 healthy controls (HC) with ELISA. Results: Patients with gout had significantly lower serum MBL levels compared to HC and PC (SG: 1948 ± 1361ng/mL vs. HC: 2793 ± 2567 ng/mL and PC: 2355 ± 1218, p = 0.01). No significant difference was observed in serum MBL levels for PC (p = 0.1). Low MBL levels (500 ng/mL) were present in a higher proportion of gout patients compared to HC (21%, 8/38 vs. 12%, 3/24, p = 0.03). Interestingly, the gout patients with low MBL levels (500 ng/mL) used alcohol every day. Conclusions: Mannose binding lectin deficiency may contribute to the pathogenesis of gout patients.     

Radiation-induced benign glandular cells in posthysterectomy smears: a cytomorphologic and clinical analysis

In this retrospective study, we aimed to investigate the frequency and cytomorphologic characteristics of benign glandular cells (BGCs) in hysterectomized individuals. We also discussed the possible effect of radiation therapy on these cells. We reviewed our cytopathology archive material through a 5.5-year period and found 1460 posthysterectomy vaginal smears. Of these, 508 smears were from patients who had undergone hysterectomy for a gynecological malignancy. Review of this vaginal cytology material revealed 17 posthysterectomy patients whose smears contained BGCs. We obtained detailed clinical information in 16 of these. In addition to routine Papanicolaou staining, mucicarmine stain was also used to demonstrate cytoplasmic mucin in some cases. All the patients had a history of gynecological malignancy and had radiation therapy. Glandular cells appeared singly or in rows and honeycomb groups and did not show cytologic atypia. We concluded that radiation might give rise to a metaplastic process in which basal cells of squamous epithelium of the vagina transform into glandular cells. Most probably this process is independent of radiation dosage and period and is irreversible. We also propose that the possibility of encountering glandular cells in posthysterectomy smears is higher than expected, if the mucin stains have been used for the microscopic examination.     

Immunohistochemical expression of SPARC is correlated with recurrence,survival and malignant potential in meningiomas

Meningioma is a common neoplasm that constitutes almost 30% of all primary central nervous system tumors and is associated with inconsistent clinical outcomes. The extracellular matrix proteins play a crucial role in meningioma cell biology and are important in tumor cell invasion and in progression to malignancy. SPARC (secreted protein, acidic and rich in cysteine) (osteonectin) is a matricellular glycoprotein that regulates cell function by interacting with different extracellular matrix proteins. The aim of this study was to evaluate the expression of SPARC with proliferation index, p53 reactivity in WHO grade 1 (benign), grade 2 (atypical) and grade 3 (anaplastic) meningiomas and correlate with clinical features of the patients, including location of the tumor, recurrence of the tumor and survival of patients. We studied 111 meningiomas, 69 being benign, 34 being atypical and eight being anaplastic meningiomas of various histological types. Using immunohistochemical analysis, we evaluated the expression of SPARC, Ki‐67 (MIB‐1) and p53 in meningiomas. Immunohistochemical scores of SPARC were determined as the sum of frequency (0–3) and intensity (0–3) of immunolabeling of the tumor cells. A high immunohistochemical score (4–6) for SPARC was more frequent in atypical and in anaplastic meningiomas than in benign meningiomas (p < 0.01). MIB‐1 proliferation index showed significant association between tumor grades in meningiomas (p < 0.01). At the end of a follow‐up period of 47.53 ± 25.04 months, 30 tumors recurred. A high SPARC expression was significantly associated with tumor recurrence (p = 0.02). The immunoreactivity of p53 protein and MIB‐1 score were significantly higher in recurrent meningiomas than in non‐recurrent meningiomas. The cumulative survival of patients with high SPARC expression was significantly lower than patients with low SPARC expression. The high SPARC expression scores were predominantly identified in meningothelial, fibrous and chordoid meningiomas; low SPARC expression scores were mostly spotted in secretory and psammomatous meningiomas. Evaluating SPARC expression might help assessing recurrence risk and survival estimation in meningiomas.