Possible role of sildenafil in inhibiting rat vas deferens contractions by influencing the purinergic system

AIM: To evaluate the effect of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-selective type 5 phosphodiesterase, on isolated rat vas deferens and its connections with the purinergic system. METHODS: Epididymal and prostatic portions of isolated vas deferens were placed in organ baths containing Krebs' solution. Contractions were induced by noradrenaline (NA), adenosine triphosphate (ATP), alpha,beta-methylene ATP and electrical field stimulation (EFS). The effect of sildenafil on the contractions was compared with suramin and Evans blue (EB). RESULTS: NA, ATP, alpha,beta-methylene ATP and EFS caused contractions in both portions of vas deferens. NA-induced contractions were unaffected by sildenafil and suramin but potentiated by EB. ATP-induced contractions were non-competitively inhibited in both portions by sildenafil and suramin but potentiated by EB. alpha,beta-methylene ATP-induced contractions were unaffected by sildenafil but were inhibited in both portions by suramin and EB. EFS-induced contractions were inhibited by sildenafil and suramin while potentiated by EB. CONCLUSION: Sildenafil inhibited the contractions in both portions of vas deferens, as did suramin. We have suggested that purinergic system has a role in this antagonism and it seems to be mediated by an ATP-dependent mechanism instead of a receptor interaction.     

Ascites and epithelial ovarian cancers: a reappraisal with respect to different aspects

Ascites is a common finding in patients with epithelial ovarian cancer (EOC). Clinico-pathologic correlations with respect to the presence of ascites, positive cytology and prognostic role of ascites, and the impact of ascitic volumes were not previously studied extensively. A total of 372 patients with EOC were retrospectively evaluated with respect to presence and amount of ascites, cytologic findings, and survival. Two groups were compared by using Chi-square, Student's t and Mann-Whitney U, binary logistic regression, Kaplan Meier and Cox-regression analysis tests, where appropriate. Omental metastasis (P < 0.001; OR: 3.21, 95% CI = 1.945-5.297) and mean number of metastatic lymph nodes (P= 0.008; OR: 1.063, 95% CI = 1.016-1.112) were significantly related with presence of ascites. Evaluation of ascitic volume at different thresholds revealed lymphatic-omental metastasis, and also the disease stage to be significantly different among patient groups at lower threshold values and the positive cytology and high-grade diseases at higher threshold values. In conclusion, presence of ascites correlates with both the intraperitoneal and also the retroperitoneal tumor spread. Amount of ascites has different correlations with the clinico-pathologic factors depending on the thresholds chosen. At lower volumes, lymphatic and omental metastasis seems to correlate with the development of ascites. Once ascites develops, tumor grade seems to be important for larger ascites volumes. Neither the presence of ascites or its volume nor the cytologic positivity was an independent predictor of survival.     

Wound approximation with tissue glue in circumcision

BACKGROUND: To assess the feasibility of using tissue glue in the approximation of circumcision wounds in children. PATIENTS AND METHODS: A prospective randomized trial was carried out on 30 boys (age, 1-10 years) admitted to the Kahramanamaras Sutcuimam University Medical Faculty, Turkey. The results of wound approximation in circumcision with cyanoacrylate tissue glue and suturing with interrupted 5/0 plain catgut were compared. The operations were carried out by the same surgeon using an identical technique. The wounds were assessed 1 day, 3 days, 1 week and 1 month postoperatively. RESULTS: There was no difference between the two groups in the rates of wound inflammation, infection, bleeding and dehiscence, although cosmetic appearance was better in the tissue glue group. The operation time was also shorter in this group. CONCLUSION: Using tissue glue for wound approximation in circumcision is a feasible alternative.     

Multi-institutional analysis of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy: TROD 01-005 study

The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma (CEC) patients who underwent definitive chemoradiotherapy (CRT). The clinical data of 175 biopsy-confirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed. The prognostic factors predicting overall survival (OS), progression-free survival (PFS), and local recurrence-free survival (LRFS) were assessed in uni- and multivariable analyses. The median age of the entire cohort was 56 years (range: 26–87 years). All patients received definitive radiotherapy with a median total dose of 60 Gy, and 52% of the patients received cisplatin-based concurrent chemotherapy. The 2-year OS, PFS, and LRFS rates were 58.8%, 46.9%, and 52.4%, respectively, with a median follow-up duration of 41.6 months. Patients’ performance status, clinical nodal stage, tumor size, and treatment response were significant prognostic factors for OS, PFS, and LRFS in univariate analysis. Non-complete treatment response was an independent predictor for poor OS (HR = 4.41, 95% CI, 2.78–7.00, p < 0.001) and PFS (HR = 4.28, 95% CI, 2.79–6.58, p < 0.001), whereas poor performance score was a predictor for worse LRFS (HR = 1.83, 95% CI, 1.12–2.98, p = 0.02) in multivariable analysis. Fifty-two patients (29.7%) experienced grade II or higher toxicity. In this multicenter study, we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC. Higher radiation doses were found to have no effect on treatment outcomes, but a better response to treatment and a better patient performance status did.     

Proton magnetic resonance spectroscopy findings of a sacrococcygeal schwannoma

Abstract.   Hascalik S, Celik O, Erdem G, Ara C, Kirimlioglu H. Proton magnetic resonance spectroscopy findings of a sacrococcygeal schwannoma. Int J Gynecol Cancer 2006; 16(Suppl. 1): 344–348.
Schwannoma is tumor of peripheral nerves, originating from Schwann cells. It is a rare nerve sheath tumor, which frequently occurs in the intracranial acoustic nerve and spinal nerves. We report on a 28-year-old woman who suffered from a large pelvic mass that was diagnosed to be sacrococcygeal schwannoma. The features of proton magnetic resonance spectroscopy (MRS) study are discussed. The magnetic resonance imaging instrument was a 1.5T, Gyroscan Intera with a body coil as a radiofrequency transmitter and a signal receiver. T2-weighted images were obtained under the following conditions—turbo spin echo (TSE) T2: turbo spin echo repeat time (TR) = 4500 msec, echo time (TE) = 96 msec. Single voxel MRS was performed by the point-resolved spectroscopy technique with a long TE (136 msec). MRS measurement was performed on two different parts of the tumor. As well as strongly elevated choline and lipid signals, the tumor spectrum showed increased N -acetylaspartate resonances. MRS can be used effectively in the preoperative diagnosis of retroperitoneal and pelvic masses, which demonstrate unusual clinical features.