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Many authors agree that the Interval-Valued Intuitionistic Fuzzy Set (IVIFS) theory generates as realistic as possible evaluation of real-life problems. One of the real-life problems where IVIFSs are often preferred is the Multi-Criteria Decision-Making (MCDM) problem. For this problem, the ranking of values obtained by fuzzing the opinions corresponding to alternatives is an important step, as a failure in ranking may lead to the selection of the wrong alternative. Therefore, the method used for ranking must have high performance. In this article, a new score function SKE and a new accuracy function HKE are developed to overcome the disadvantages of existing ranking functions for IVIFSs. Then, two illustrative examples of MCDM problems are presented to show the application of the proposed functions and to evaluate their effectiveness. Results show that the functions proposed have high performance and they are the eligibility for the MCDM problem.

We investigated changes in thymic tissue of male rats exposed to a 900 megahertz (MHz) electromagnetic field (EMF) on postnatal days 22–59. Three groups of six 21-day-old male Sprague-Dawley rats were allocated as: control (CG), sham (SG) and EMF (EMFG) groups. No procedure was performed on the CG rats. SG rats were placed in a Plexiglas cage for 1 h every day between postnatal days 22 and 59 without exposure to EMF. EMFG rats were placed in the same cage for the same periods as the SG rats and were exposed to 900 MHz EMF. Rats were sacrificed on postnatal day 60. Sections of thymus were stained for histological assessment. Oxidant/antioxidant parameters were investigated biochemically. Malondialdehyde (MDA) levels in EMFG increased compared to the other groups. Extravascular erythrocytes were observed in the medullary/corticomedullary regions in EMFG sections. We found that 900 MHz EMF applied for 1 h/day on postnatal days 22–59 can increase tissue MDA and histopathological changes in male rat thymic tissue. [ABSTRACT FROM AUTHOR]

We investigated the effects of a 900 Megahertz (MHz) electromagnetic field (EMF), applied during the prenatal period, on the spleen and thymus of 21-day-old male rat pups. Pregnant Sprague-Dawley rats were divided into control and EMF groups. We applied 900 MHz EMF for 1 h/day to the EMF group of pregnant rats. Newborn male rat pups were removed from their mothers and sacrificed on postnatal day 21. Spleen and thymus tissues were excised and examined. Compared to the control group, thymus tissue malondialdehyde levels were significantly higher in the group exposed to EMF, while glutathione levels were significantly decreased. Increased malondialdehyde and glutathione levels were observed in splenic tissue of rats exposed to EMF, while a significant decrease occurred in superoxide dismutase values compared to controls. Transmission electron microscopy showed pathological changes in cell morphology in the thymic and splenic tissues of newborn rats exposed to EMF. Exposure to 900 MHz EMF during the prenatal period can cause pathological and biochemical changes that may compromise the development of the male rat thymus and spleen. [ABSTRACT FROM AUTHOR]

Langerhans' cell histiocytosis is a rare disease characterized histologically by the proliferation of Langerhans' cells. Oral involvement is frequent and the disease simulates severe localized periodontitis. In this report, we present a case of disseminated Langerhans' cell histiocytosis in a 30-month-old boy who had a mass covering the entire maxillopalatine region and suffered severe periodontal destruction in the posterior maxilla and mandible. We discuss the radiological, histopathological and immunohistochemical findings. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the effect of Dermalix® (Dx) on wound healing and anastomotic leakage in a rat model of end-to-end colon anastomosis., Methods: The study was carried out on 40 rats, as divided into three groups, including a negative control group (n=10, laparotomy only) control group (n=15, colon anastomosis), and the experimental group (n=15, colon anastomosis plus Dx applied to anastomo-sis site). The rats were sacrificed on the 3rd post-operative day, and resected colon segments were evaluated for bursting pressure (mmHg) using an infusion pump set-up and for pathological parameters of wound healing including neutrophil infiltration, epithelial regeneration, granulation tissue formation, local inflammatory response, neovascularization, and foreign body reaction., Results: Anastomotic leakage rate was significantly lower (1 rat vs. 6 rats, P=0.040). Moreover, mean bursting pressure was signifi-cantly (2.95 times) higher (mean 121 vs. 41 mmHg, respectively, P<0.05) in the Dx experimental group than in the control group. Dx was considered to significantly accelerate wound healing by increasing neovascularization (P<0.001). Control and experimental groups were similar in terms of other pathological parameters., Conclusion: Based on significantly lower rate of anastomotic leakage and its positive effects especially on the bursting pressure and neovascularization, Dx seems to be considered as a promising technology in preventing anastomotic leakage.

Aim: The aim of this research is to determine the effect of stoma self-efficacy of people with stoma on their sexual function and satisfaction., Method: This descriptive research was carried out between November 2022 and May 2023. One hundred and forty people with stoma were included in the research. A descriptive information form, a visual analogue scale (VAS) for satisfaction with sexual life, the Stoma Self-Efficacy Scale (Stoma SE) and the Arizona Sexual Experience Scale (ASEX) were used for the research., Results: According to the findings of the research, it was established that 90% of the participants had sexual dysfunction according to the ASEX. The average VAS satisfaction with sexual life score was 2.77 ± 3.19, the average Stoma SE Total score was 76.26 ± 19.63 and the average ASEX score was 21.62 ± 7.88. The VAS-satisfaction with sexual life score of the participants had a positive relationship with the social self-efficacy score and a negative relationship with the ASEX score. There was a negative relationship between the social self-efficacy score and the ASEX score of the participants. It has been determined that the social self-efficacy scores of the participants affect their ASEX and VAS-satisfaction with sexual life scores., Conclusion: Development of care self-efficacy is as critical as the development of social self-efficacy for people with stoma. Development of social self-efficacy by people with stoma can contribute to their sexual function and satisfaction with sexual life., (© 2023 Association of Coloproctology of Great Britain and Ireland.)

Introduction: Hemorrhage is a challenging complication of pelvic surgery. This study aimed to analyze the causes, management, and factors associated with morbidity in patients experiencing major pelvic hemorrhage during complex abdominopelvic surgery., Methods: Patients who had major intraoperative pelvic hemorrhage during complex abdominopelvic surgery at 11 tertiary referral centers between 1997 and 2017 were included. Patient characteristics, management strategies to control bleeding, short- and long-term postoperative outcomes were evaluated retrospectively., Results: There were 120 patients with a mean age of 56.6 ± 2.4 years and a mean BMI of 28.3 ± 1 kg/m2. While 104 (95%) of the patients were operated for malignancy, 16 (5%) of the patients had surgery for a benign disease. The most common bleeding site was the presacral venous plexus 90 (75%). Major pelvic hemorrhage was managed simultaneously in 114 (95%) patients. Electrocauterization 27 (23%), pelvic packing 26 (22%), suturing 7 (6%), thumbtacks application 7 (6%), muscle welding 4 (4%), use of energy devices 2 (2%), and topical hemostatic agents 2 (2%) were the management tools. Combined techniques were used in 43 (36%) patients. Short-term morbidity and mortality rates were 48 (40%) and 2 (2%), respectively. High preoperative CRP levels (p = 0.04), history of preoperative radiotherapy (p = 0.04), longer bleeding time (p = 0.006), and increased blood transfusion (p = 0.005) were the factors associated with postoperative morbidity., Conclusion: Postoperative morbidity related to major pelvic hemorrhage can be reduced by optimizing the risk factors. Prehabilitation prior to surgery to moderate inflammatory status and prompt action with proper technique to control major pelvic hemorrhage can prevent excessive blood loss in complex abdominopelvic surgery., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Objectives: Skin cancers are the most common type of cancer with a significantly increasing incidence. The purpose of the study was to uncover the one-year frequency of melanoma and non-melanoma skin cancers (NMSC) and to determine the risk factors in the development of skin cancer., Methods: The study included 7396 people from all age groups admitted to the dermatology clinic between October 2020 and 2021. The sociodemographic characteristics, sun protection habits, chronic diseases, and drug and vitamin use were evaluated. Lesions with clinical suspicion of skin cancer were excised., Results: The frequency of skin cancer was found to be 2.7%, basal cell cancer (BCC) 1.2%, squamous cell cancer (SCC) 1.1%, malignant melanoma (MM) was 0.4%. Daily black tea consumption was found to be a risk factor for three type of skin cancer, BCC (p = 0.021), SCC (p = 0.006), and MM (p = 0.002), respectively. Obesity was observed as a risk factor for BCC (p = 0.005) and MM (p = 0.008). We found that having a history of alcohol use were an independent risk factor for all skin cancer types and BMI <30 for SCC. Vitamin D and supplemental drugs intake were observed as protective factors for BCC (p = 0.035, p = 0.007, respectively). Daily coffee consumption was determined as a protective factor for SCC (p < 0.001) and MM (p = 0.049)., Conclusion: This study estimates the frequency of NMSC and melanoma. Also provides evidence to determine the risk factors and probably protective factors for the development of skin cancers., (© 2022 Wiley Periodicals LLC.)

Background: The novel coronavirus disease 2019 (COVID-19) has resulted in major changes in health-care systems and emer-gency surgical interventions. Here, we examined patients with acute appendicitis who presented to emergency departments and com-pared diagnosis, treatment, and post-treatment processes before and during the pandemic period and investigated how the pandemic affected management of acute appendicitis., Methods: A national, multicenter, and cohort study model was designed that included patients older than 18 years of age diag-nosed with acute appendicitis clinically and/or radiologically, with patients compared before (pre-pandemic period: January 1-April 30, 2019) and after (pandemic period: January 1-April 30, 2020) the pandemic. Our investigation included comparisons of pre-operative imaging methods, presence of plastron appendicitis/abscess, conservative/surgical approach, type of anesthesia given, laparoscopic/open surgical approach, bowel resection rates, drain insertion rates, and presence of post-operative complications RESULTS: For the two study groups, 8972 patients from 69 centers were examined, with 4582 patients operated in the pre-pan-demic period and 4234 patients operated in the pandemic period. During the pandemic period, 63.6% of patients underwent open surgery, whereas 34.4% had laparoscopic surgery. Although 60 patients (1.3%) requested non-operative follow-up in the pre-pandemic period, 94 patients (2.2%) requested this in the pandemic period. When conditions of patients were evaluated regardless of their own wishes, 114 patients (2.4%) before and 163 patients (3.8%) during the pandemic received non-operative follow-up., Conclusion: Our study did not show the direct correlation between the application of COVID-19-related restrictions and the severity of acute appendicitis. Although non-operative management rates have been increased during the COVID-19 period, the incidences of both complicated and the uncomplicated appendicitis were similar during the COVID-19 crisis period. Given this infor-mation non-operative management can be employed for patients diagnosed with appendicitis.

The aim of the present study was to investigate the effectiveness of melatonin and genistein in preventing radiation therapy (RT)-induced liver injury in mice. A total of 70 Swiss Albino male mice were divided into 7 equal groups (n=10/group) as follows: Melatonin (M group, G3), genistein (G group, G4), polyethylene glycol-400 (P group, G5), RT only (RT group, G2) and sham irradiation (C group, G1). RT plus genistein (RT+G group, G7) and RT plus melatonin (RT+M group, G6) were the co-treatment groups. Firstly, hepatic tissue damage was induced in mice via exposure to a single dose of 6-Gy irradiation. RT was performed with a cobalt-60 teletherapy machine (80 cm fixed source-to-surface distance, 2.5-cm depth). Melatonin was processed (100 mg/kg, intraperitoneal) 30 min before and genistein was administered (200 mg/kg, SC) one day prior to the single dose of irradiation. Six months following irradiation, all mice were sacrificed. The degree of liver injury was measured using histological liver sections. Liver injury was significantly worse in the RT group than in the control group (C; RT vs. C; P<0.05); however, liver injury decreased following co-treatment with melatonin or genistein vs. RT alone (RT+M and RT+G vs. RT; P<0.05). No difference was observed between the RT+M and RT+G groups (P>0.05). The present study revealed that melatonin and genistein administration prior to irradiation protects mice against liver injury, which may have therapeutic implications for RT-induced injuries.

The effects on human health of the electromagnetic field (EMF) emitted by mobile phones, used by approximately 7 billion people worldwide, have become an important subject for scientific research. Studies have suggested that the EMF emitted by mobile phones can cause oxidative stress in different tissues and age groups. Young people in adolescence, a time period when risky behaviors and dependences increase, use mobile phones more than adults. The EMF emitted by mobile phones, which are generally carried in the pocket or in bags when not in use, will very probably affect the sciatic nerve. No previous study has investigated the effect of mobile phone use in adolescence on peripheral nerve. This study was planned accordingly. Twenty-four male Sprague Dawley rats aged 21 days were divided equally into control (CGr), Sham (SGr) and EMF (EMFGr) groups. No procedure was performed on CGr rats. EMFGr were exposed to the effect of a 900-megahertz (MHz) EMF for 1 h at the same time every day between postnatal days 21-59 (the entire adolescent period) inside a cage in the EMF apparatus. SGr rats were placed inside the cage for 1 h every day without being exposed to EMF. All rats were sacrificed at the end of the study period, and 1 cm sections of sciatic nerve were extracted. Malondialdehyde (MDA), glutathione, catalase (CAT) superoxide dismutase (SOD) values were investigated biochemically in half of the right sciatic nerve tissues. The other halves of the nerve tissues were subjected to routine histopathological tissue procedures, sectioned and stained with hematoxylin and eosin (H&E) and Masson's trichrome. Histopathological evaluation of slides stained with Masson's trichrome and H&E revealed a normal appearance in Schwann cells and axons in all groups. However, there was marked thickening in the epineurium of sciatic nerves from EMFGr rats. MDA, SOD and CAT levels were higher in EMFGr than in CGr and SGr at biochemical analyses. Apoptotıc index (AI) analysis revealed a significant increase in the number of TUNEL (+) cells when EMFGr was compared with CGr and SGr. In conclusion, our study results suggest that continuous exposure to a 900-MHz EMF for 1 h throughout adolescence can cause oxidative injury and thickening in the epineurium in the sciatic nerve in male rats., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Introduction: Granulomatous lung disease (GLD) is caused by a wide range of conditions and it is challenge for pulmonologist. A detailed history of exposures is fundamental in GDL and has been found pivotal to reach a precise diagnosis., Materials and Methods: Between September 2014 and December 2016, the distribution of patients diagnosed with granulomatous lymphadenitis in the mediastinal/hilar lymph nodes by endobronchial ultrasound (EBUS) or mediastinoscopy was analyzed. To be listed as 'confident', a diagnosis of sarcoidosis required compatible histological, radiological and clinical findings in conjunction with negative cultures. Infectious entities listed as 'confident' had either microorganisms in tissue section, positive culture, positive serology or positive antigen detection in a consistent clinical pathological setting., Result: Granulomatous lymphadenitis was detected in 110 patients. The included 110 cases consisted of 70.9% women and median age of 53 (range 44-61) years. The final diagnosis of the patients was accepted to be sarcoidosis in 79 (71.8%), sarcoid like granulomas in 7 (6.4%), tuberculosis in 4 (3.6%), silicosis in 4 (3.6%), drug-associated granuloma in 2 (1.8%), hypersensitivity pneumonitis in 1 (0.9%), Chron disease in 1 (0.9%), unspecified in 12 (10.9%). Three patients were classified as tuberculosis based on culture., Conclusions: In this study, we found that the most common cause of granulomatous lymphadenitis was sarcoidosis. Contrary to expectations, the number of patients diagnosed with tuberculosis was very low.

Background/aim: Multiple zones of injuries are formed after burns, consisting of a zone of coagulative necrosis, a zone of hyperemia, and a zone of stasis, in which progressive microcirculatory thrombosis leads to degeneration and deepening of the wound. We used an experimental rat comb burn model to test the hypothesis that use of low molecular weight heparin (LMWH) may save the zone of stasis. Materials and methods: Adult female rats were randomly divided two groups: the LMWH group (n = 8) rats received subcutaneous LMWH injections, while the saline group (n = 8) rats were injected with the same volume of saline solution by the same route. The zone of stasis was evaluated macroscopically and histologically, and functional capillary density was evaluated. Results: Histological assessments revealed higher macrophage numbers and PML density, fibroblast proliferation, and angiogenesis in the LMWH group than in the saline group. Functional capillary density measurement in the stasis zones revealed no significant difference between the two groups in the first 4 days, although a significant difference in favor of the LMW group was observed in the last 3 days. Conclusion: The results of this experimental study show that LMWH is effective in saving the zone of stasis.

Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease characterised by alveolar accumulation of surfactant composed of proteins and lipids. Three main categories of PAP have been defined depending on the aetiology: primer/idiopathic, neonatal/congenital, secondary and exogenous/environmental exposure. Radiologically diffuse ground glass opacities, interlobular and intralobular septal thickening is seen. Although open lung biopsy is accepted as the gold standard in diagnosis, it can be diagnosed by showing bronchoalveolar lavage (BAL) fluid with a milky appearance and periodic acid-schiff (PAS) positive globules in biopsy with clinical and radiological findings. Theraphy for PAP are supportive care (oxygen), total lung lavage, inhale/subcutaneous granulocyte macrophage colony stimulating factor (GM-CSF), rituximab, plasmapheresis, lung transplantation. We report a case of PAP presented with cough and shortness of breath, diagnosed with BAL and transbronchial lung biopsy, treated by total lung lavage by reviewing literature.

Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories., Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire., Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells /Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers., Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

We present an extremely rare case of a pleomorphic rhabdomyosarcoma of the true vocal fold. The histopathological diagnosis was confirmed by immunohistochemistry. The patient was treated with radical surgery including total laryngectomy and radical neck dissection followed by postoperative radiotherapy. The clinicopathologic features of this rare malignancy are discussed together with a review of the literature. This case report and literature review highlights the more favorable prognosis of pleomorphic rhabdomyosarcoma in the larynx than in other locations.

Pancreatic pseudocysts (PPs) are defined as fluid collections more than 4 weeks old that are surrounded by a nonepithelial wall of fibrous or granulation tissue. Many risk factors have been associated with pseudocyst development but predictive factors remain to be explored. The aim of this study was to investigate the clinical, and biochemical parameters that may predict the development of a PPs after an attack of acute pancreatitis (AP). The medical charts of 102 patients diagnosed with AP were enrolled into the study. Demographic, clinical and laboratory details were recorded at admission and at the 48(th) hour. There were several risk factors on admission and at the 48(th) hour that was predictive of PP formation when evaluated by univariate analysis such as: Alanine aminotransferase level at 48 hrs, calcium level at admission, base excess at 48 hrs, calcium level at 48 hrs, and albumin level at 48 hrs. In multivariate analysis, low calcium level at admission was the only variable that was shown to predict formation of PPs. Lower serum calcium level may be a predictive factor for the development of PPs after AP attack. We advise that patients with calcium levels below 8 mg/dl, after AP should be followed more closely., (© Acta Gastro-Enterologica Belgica.)

The aim of the study was to analyze the accuracy of (i) HLA-DQ typing and anti-tissue transglutaminase antibodies immunoglobulin A (tTG-IgA) serology and (ii) a "simple scoring system" (SSS) for the diagnosis of celiac disease (CD). The study included 91 patients with positive tTG-IgA, who had been tested for HLA-DQ. Patients were divided into 3 groups: typical CD, atypical CD, and non-CD. The sensitivity, specificity, positive (PPV) and negative predictive value (NPV), positive (PLR) and negative likelihood ratio (NLR) and accuracy of the test combining genotyping and tTG-IgA positivity and the simple scoring system for the diagnosis of CD were evaluated. The combination of genotyping and strong tTG-IgA positivity had a sensitivity of 93.5%, specificity of 61.5%, PPV of 93.5%, NPV of 61.5%, PLR of 2.4, NLR of 0.1 and accuracy of 89% for "CD." SSS had a higher specificity (84.6%), higher PPV (97.3%), higher NPV (68.7%), higher PLR and higher accuracy (92.3%). The combination of genotyping and strong tTG-IgA positivity missed two patients with typical CD (4%) and three patients with atypical CD (10.7%). Two cases with malabsorptive symptoms (33.3%) and three patients without malabsorptive symptoms (42.8%) would have been misdiagnosed as CD if these tests were used. Intestinal biopsy is still mandatory for diagnosis of CD in Turkish children.

Colorectal carcinoma (CRC) is the third most common cancer, and approximately 35%-55% of patients with CRC will develop hepatic metastases during the course of their disease. Surgical resection represents the only chance of long-term survival. The goal of surgery should be to resect all metastases with negative histological margins while preserving sufficient functional hepatic parenchyma. Although resection remains the only chance of long-term survival, management strategies should be tailored for each case. For patients with extensive metastatic disease who would otherwise be unresectable, the combination of advances in medical therapy, such as systemic chemotherapy (CTX), and the improvement in surgical techniques for metastatic disease, have enhanced prognosis with prolongation of the median survival rate and cure. The use of portal vein embolization and preoperative CTX may also increase the number of patients suitable for surgical treatment. Despite current treatment options, many patients still experience a recurrence after hepatic resection. More active systemic CTX agents are being used increasingly as adjuvant therapy either before or after surgery. Local tumor ablative therapies, such as microwave coagulation therapy and radiofrequency ablation therapy, should be considered as an adjunct to hepatic resection, in which resection cannot deal with all of the tumor lesions. Formulation of an individualized plan, which combines surgery with systemic CTX, is a necessary task of the multidisciplinary team. The aim of this paper is to discuss different approaches for patients that are treated due to CRC liver metastasis.

Aim: Although the pathogenesis of cyclosporine (CsA) nephropathy is not completely understood, it is attributed to oxidative damage and apoptosis. Grape seed proanthocyanidin extract (GSPE) is a molecule with anti-oxidant and anti-apoptotic properties. Our aim was to demonstrate the effects of GSPE in preventing CsA nephropathy., Methods: Twenty-four Sprague-Dawley rats were divided into four groups. The control, GSPE, CsA and CsA+GSPE groups were given 1 mL olive oil, 100 mg/kg GSPE, 25 mg/kg CsA and 100 mg/kg GSPE+25 mg/kg CsA, respectively. On day 21, blood samples were taken for blood urea nitrogen (BUN), creatinine and CsA levels, and renal tissue was used for total oxidant system (TOS), total anti-oxidant system (TAS), oxidative stress index (OSI) and malondialdehyde (MDA) measurements. In addition to renal histopathology, apoptosis staining was performed on renal tissue., Results: The BUN, creatinine, TOS, OSI, MDA, histopathological score, and apoptotic index exhibited increases in the CsA group. In the CsA+GSPE group, however, BUN, creatinine, OSI, MDA, renal histopathological score and apoptotic index (AI) decreased and TAS levels increased. In addition, there was no difference between the CsA and CsA+GSPE groups with regard to CsA levels., Conclusion: We demonstrated that GSPE prevents CsA nephropathy and that this effect is achieved by anti-apoptotic and anti-oxidant activity. We also achieved a significant recovery in kidney functions without affecting CsA plasma levels., (© 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.)