Mediastinoscopy is the gold standard for diagnosis in the absence of parenchymal lesions in mediastinal tuberculosis lymphadenitis. During mediastinoscopy biopsy, tuberculous bacillus seeding into the mediastinum is a rare complication. This study aimed to test the safety of mediastinoscopy in terms of Mycobacterium tuberculosis seeding in the mediastinum by microbiologically evaluating mediastinal lavage samples taken before and after biopsy. Classical cervical mediastinoscopy was performed all of patients and who were reported as granulomatous inflammatory events results of histopathological examinations and who underwent mediastinal lavage before and after biopsy, were included in the study. All the lavage fluids were tested for AFB and subjected to Mycobacterium tuberculosis PCR DNA testing and standard tuberculosis culture. The patients were divided into two groups, Group 1: Necrotizing granulomatous inflammation, Group 2: non-necrotizing granulomatous inflammation. The microbiological tests of the patients in Group 1 were negative before biopsy. However, in two patients of Group 1, the results of cultures of lavage fluids that taken from after biopsy were positive for tuberculosis. In all patients in Group 2, all microbiological tests of the lavage fluids were negative (Power of the decision: 99.8%, with 5% error). All of patients in group 1, Antituberculosis treatment was initiated and continued for 6 months. There weren’t seen any serius complications due to treatment and recurrence during the follow-up period. Mediastinoscopy can be used safely, with low morbidity and mortality rates and a high success rate for the diagnosis of mediastinal tuberculosis.
Abstract Fascin and EMMPRIN (CD 147) have a demonstrated relationship with the invasion and progression of many tumors. The aim of this study was to analyze fascin and EMMPRIN expression in non-small cell lung carcinoma and their relationship with clinicopathologic features. Fascin and EMMPRIN expression levels were investigated via the immunohistochemistry of paraffin-embedded tissues of 64 patients with non-small cell lung carcinoma, including 46 squamous cell carcinoma and 18 adenocarcinoma patients. The patients were scored on the basis of staining extent and intensity, and were then assigned a combined score. Fascin expression was present in 44 of 46 (95.6%) patients with SCC and 16 of 18 (88.8%) patients with adenocarcinoma. There was a significant correlation between fascin expression and tumor stage in the SCC and adenocarcinoma groups. EMMPRIN expression was observed in all patients with SCC (46 of 46, 100%) and 16 of 18 (88.8%) patients with adenocarcinoma. There was significant correlation between EMMPRIN expression and both tumor stage and diameter in the SCC group, but not in the adenocarcinoma group. This study revealed that high levels of fascin and EMMPRIN expression may indicate the importance of their roles in the progression of non-small cell lung carcinoma and they could be used as prognostic marker for these tumors.
Background: Pneumomediastinum is defined as the presence of air in the mediastinal region.It is associated with events or diseases leading to a sudden increase in alveolar pressure.The air in the mediastinum may originate in the pharynx, the tracheobronchial tree or the esophagus.This study aimed to assess the clinical and radiological characteristics of patients who were diagnosed with spontaneous pneumomediastinum and received treatment at our clinic. Materials and Methods: A total of 23 patients who had spontaneous pneumomediastinum and were treated at our clinic between 2007 and 2019 were retrospectively assessed for their age, etiological factors, clinical and radiological characteristics; treatment and outcomes.Chest radiography and computed tomography of the thorax were used for diagnosis in all patients.Results: Of the patients, 15 were males and eight females and their mean age was 33.91 (15-82) years.The most common symptom on admission was shortness of breath (n = 12) and chest pain (n = 11).The etiological factors were excessive vomiting in six patients and excessive cough in five.Radiologically, the most common findings besides pneumomediastinum were subcutaneous emphysema (n = 6) and pneumothorax (n = 4).Of the patients, seven required esophagoscopy, four required bronchoscopy and no pathology was observed.All patients were fully recovered when they were discharged. Conclusions:The underlying etiological factor is crucial in pneumomediastinum.Conservative treatment methods are often sufficient in spontaneous pneumomediastinum patients with no pathology in endoscopic evaluation.
Exercise induced bone response although established, little is known about the molecular components that mediate bone response to mechanical loading (ML). In our recent QTL study, we identified one such possible molecular component responding to ML: cartilage oligomeric matrix protein (COMP). To address the COMP role in mediating ML effects on bone formation, COMP expression was evaluated as a function of duration and age in response to ML in female B6 mice. A 9N load was applied using a four-point bending device at 2Hz frequency for 36 cycles, once per day for 2-, 4- and 12-days on the right tibia. The left tibia was used as an internal control. Loading caused an increase in COMP expression by 1.3-, 2- and 4-fold respectively after 2-, 4- and 12-days of loading. This increase was also seen in 16 and 36-week old mice. Based on these findings, we next used COMP knockout (KO) mice to evaluate the cause and effect relationship. Quantitative analysis revealed 2 weeks of ML induced changes in vBMD and bone size in the KO mice (5.9 % and 21 % vs. unloaded bones) was not significantly different from control mice (7 % and 24 % vs. unloaded bones). Our results imply that COMP is not a key upstream mediator of the anabolic effects of ML on the skeleton.
