Investigation of the efficacy of systemic N-Acetyl Cysteine therapy preventing nasal mucositis following radiotherapy

BACKGROUND

Radiotherapy (RT) is one of the main methods used in the treatment of head and neck cancers but may cause mucosal side effects in the tumor area and surrounding structures. These include nasal mucosal disorders and chronic rhinosinusitis due to disruption of the mucociliary system. This situation seriously affects the quality of life of the patients and there is no accepted effective method for its treatment yet. In our study, we aimed to examine the side effects of RT on the nasal mucosa and mucociliary system and to investigate histopathologically and immunohistochemically the effectiveness of N-acetyl cysteine (NAC) in preventing these side effects of RT.

METHODOLOGY

The study was carried out with 30 female Sprague Dawley rats devided in three groups. No intervention was made in the control group. On the second day of the experiment, 30 Gy radiotherapy was applied to the head area in the RT group. NAC was administered intraperitoneally at a dose of 1 g/kg/day for 14 days from the first day of the study to the RT+ NAC group. On the second day, 30 Gy of radiotherapy was applied to the head area 1 hour after the NAC application. On the 14th day, 1 hour after NAC was applied to the RT+NAC group, all animals were sacrificed. The nasal mucosa samples were stained with hematoxylin-eosin, and the intensity and extent of staining sentan in the nasopharyngeal tissue samples were evaluated by immunohistochemical staining using anti-SNTN antibody.

RESULTS

The loss of cilia in the nasal tissue was lower in the RT+NAC group than in the RT group. The intensity and extent of staining in the nasopharyngeal tissue of Sentan was higher in the RT+NAC group than in the RT group. Mucosal neutrophil and mononuclear inflammatory cell infiltration in the nasal tissue, vascular dilatation, hyperemia and hemorrhage, erosion and shedding of the mucosal epithelium, mucosal ulceration were found to be similar in the RT+NAC group and the control group. It was milder in the RT+NAC group than in the RT group, but not statistically significant.

CONCLUSIONS

Radiotherapy caused pathological changes in the nasal mucosa, caused loss of cilia and a decrease in the level of Sentan, the cilia apical protein. The results of our study showed that NAC treatment can reduce the side effects of RT on the nasal mucosa. It also showed that NAC was effective in preventing the loss of cilia, which is the building block of the mucociliary system, and improving the expression of Sentan.

Protective effect of nebivolol on gentamicin-induced nephrotoxicity in rats

OBJECTIVE

Nephrotoxicity is a major complication of gentamicin (GEN), which is widely used in the treatment of severe Gram-negative infections. As we know, treatment with nebivolol has been shown to decrease renal fibrosis and glomerular injury as well as improve endothelial dysfunction. Therefore, we evaluated the potential protective effect of nebivolol (NBV) against GEN-induced nephrotoxicity in rats.

MATERIAL AND METHOD

Twenty-four rats were randomly divided into four groups: control group (Group 1); rats intraperitoneally injected with GEN (100 mg/kg/day; Group 2); rats treated with GEN plus distilled water (Group 3); and rats treated with GEN plus NBV (10 mg/kg/day; Group 4). After 15 days, the rats were sacrificed, their kidneys taken, and blood analysis performed. Tubular necrosis and interstitial fibrosis scores were determined histopathologically in a part of kidneys; nitric oxide (NO), malondialdehyde (MDA), and reduced glutathione (GSH) levels were determined in other part of kidneys.

RESULTS

The GSH levels in renal tissue of only GEN-treated rats were significantly lower than those in control group, and administration of NBV to GEN-treated rats significantly increased the level of GSH. The group that was given GEN and NBV had significantly lower MDA and NO levels in kidney cortex tissue than that given GEN alone. Despite the presence of mild tubular degeneration, the rats treated with GEN+NBV showed a less severe tubular necrosis, and their glomeruli maintained a better morphology compared to GEN group.

CONCLUSION

NBV exerts antioxidant, anti-inflammatory and antifibrotic effects on GEN-induced kidney damage by reducing oxidative stress in rat model (Tab. 3, Fig. 2, Ref. 68).

Effect of benign testicular mass on fertility: an epidermoid cyst case

The article discusses the problem of epidermoid cysts - extremely rare but the most common benign intratesticular tumors. The majority of non-palpable testicular lesions, discovered by ultrasonography in a population of infertile men, are benign tumors. The case of a young man who had incidentally diagnosed, during his infertility evaluation, a right testicular mass which was pathologically reported as epidermoid cyst after partial orchiectomy is presented. It was suggested that benign testicular cysts may effect the normal parenchyma of testis even if the normal histopathology. Thus, the excision of these benign lesions especially in infertile population is recommended.

Virtual bronchoscopy using FDG-PET/CT images for the evaluation of lung cancer

PURPOSE

We aimed to put forward the contribution of virtual bronchoscopy in the determination and diagnosis of tracheobronchial system pathologies. We compared the data obtained from PET/CT and virtual bronchoscopy (VB) with the fiberoptic bronchoscopy (FOB) data of the cases with a diagnosis or pre-diagnosis of lung tumor.

MATERIALS AND METHODS

A total of 261 (male=238, female=23) lung cancer cases with a mean age of 53±7.3 years (range =35-77 years), who had undergone FOB and had bronchoalveolar lavage and/or biopsy results, were included in this multicenter, prospective study conducted between 2006 and 2008. FOB data confirmed with cytohistopathology were considered as the gold standard. Five cases that had peripheral lesions, with negative cytopathological results were excluded from the study. Positron emission tomography images were fused with 16/slice multi-detector computed tomography system images (Discovery ST PET/16 slice CT fusion system HPOWER 60; General Electric Medical Systems, Milwaukee, WI, USA). Thereafter, all of the cases were evaluated with virtual bronchoscopy, using a special multidisplay workstation with multiplanar reformatting (MPR) and minimum intensity projection (MINIP) to see the fused images simultaneously. The data obtained with both virtual bronchoscopy (PET/CT VB) and FOB in different centers were recorded, and the evaluation and comparison of these data were done by an independent researcher. The sensitivity, specificity, and positive and negative predictive values of making an accurate diagnosis and defining concomitant pathologies by both methods, were calculated.

RESULTS

The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values of VB and PET/CT-VB in determining the segment involved by malignancy were as follows, 91%, 83%, 94%, 77%, and 89%, and 95%, 97%, 99%, 87%, and 96%, respectively.

CONCLUSIONS

The sensitivity of PET/CT-VB in determining the involved tracheobronchial segment(s) in malignancy and concomitant pathologies in cases with lung tumor was remarkably higher than that with CT-VB. Therefore, PET/CT-VB is recommended to be included in routine lung cancer examinations since it provides similar outcomes to that of FOB+cytohistopathological examination.

Idiopathic abdominal cocoon: report of a case

The abdominal cocoon is a rare disease in which there is total or partial encapsulation of the small bowel by a fibrous membrane. A correct diagnosis is not often made pre-operatively. Awareness of this rare cause of surgical emergency may prevent delay in treatment and avoid unnecessary procedures for the patient, such as bowel resection. We report a patient diagnosed with abdominal cocoon who was subsequently treated.

Efficacy of imiquimod in solitary plaques of mycosis fungoides

Mycosis fungoides is the most common type of cutaneous T-cell lymphoma. The extent and type of skin involvement (T classification) and presence of lymph node or visceral involvement are important predictors in selecting the type of treatment. Skin directed treatment represents the most appropriate therapy for early stage disease. Current topical treatment including potent topical steroids and nitrogen mustard are associated with adverse effects such as cutaneous atrophy and contact dermatitis. In the present study, we tested the efficacy of imiquimod in mycosis fungoides plaques.

Castleman's disease masquerading as sigmoid colon tumor and Hodgkin lymphoma

Castleman's disease is a benign lymphoid neoplasm first reported as hyperplasia of mediastinal lymph nodes. Some authors referred to the lesions as isolated tumors, described as a variant of Hodgkin's disease with a possibility of a malignant potential and others proposed that the lymphoid masses were of a hamartomatous nature. Three histologic variants and two clinical types of the disease have been described. The disease may occur in almost any area in which lymph nodes are normally found. The most common locations are thorax (63%), abdomen (11%) and axilla (4%). We report two separate histologic types of Castleman's disease which were rare in the literature, mimicking sigmoid colon tumor and Hodgkin lymphoma. The diagnostic and therapeutic aspects of this rare entity is discussed.