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Amac: Pediatrik yas donemi nevogevez icin dinamik bir yapiya sahip olup nevus gelisimi icin onemli ip uclarini bunyesinde barindirmaktadir. Bu calismada pediatrik yas grubunda kazanilmis melanositik nevuslerin dermoskopik patern ve pigment ag yapilari incelenerek banal ve atipik yapili nevuslarin taninmasina katki saglanmasi amaclanmistir. Hastalar ve Yontem: Calismaya nevogenez icin yatkinligi bulunmayan 150 pediatrik gonullu dahil edilmistir. Cocuklar 7 yas ve alti ve 8 yas ve ustu olarak iki gruba ayrilmistir. Muayene edilen nevuslerden govde ve ekstremite yerlesimli nevuslerin sayi, boyut, patern ve pigment yapilari incelenmistir. Bulgular: Nevus sayi ortalamasi buyuk yas grubunda (9,72) kucuk yas grubundan (3,44) daha fazla oldugu izlendi. Her iki grupta da predominant patern yapisinin globuler patern oldugu, 8 yas ve ustu grubunda retikuler paterne sahip nevuslarin 7 yas ve alti grubundan daha fazla oldugu izlendi (p=0,03). Her iki grupta da globuler paterne sahip nevuslarin govdede, retikuler paterne sahip nevuslarin ekstremite de daha yogun oldugu izlendi (p=0,001). Nevuslerin Pigment ag yapilari incelendiginde en sik izlenen pigment ag yapisi uniform olmakla birlikte 8 yas ve ustu grupta santral pigmentasyon degisikligi bulunan nevuslarin daha fazla izlendigi goruldu (p=0,001). Sonuc: Pediatrik yas grubunda kazanilmis melanositik nevusler siklikla globuler patern ve uniform pigment ag yapisina sahip olsa da artan yas ile birlikte retikuler paterne ve santral pigmentasyon degisikligine sahip nevus sayisi artmaktadir.

The aim of this study was to investigate the effect of subacromial decompression on the results of full thickness rotator cuff repair applied arthroscopically. Examination was also made of the effect of acromion type on the subacromial decompression procedure in patients applied with arthroscopic rotator cuff repair.The study included a total of 150 patients, comprising 102 (68%) females and 48 (32%) males with a full thickness rotator cuff tear repaired arthroscopically. The patients were separated into three groups of 50. Group A comprised those with acromioplasty and bursectomy applied additional to the repair. In Group B, only bursectomy was performed additional to the repair and in Group C, only rotator cuff repair was applied. Evaluation was made of the post-operative long-term pain and functional results.The mean age of the cases was 65.63±9.22 years (range, 46-86 years). The affected side was right side in 95 (63.3%) cases and left side in 55 (36.7%). No statistically significant difference was determined between the groups according to the post-operative Constant Murley and ASES scores (p0.05). In the paired comparisons, the post-operative VAS scores of Group C were higher than those of Groups A and B (p=0.018, p=0.029, p0.05). No statistically significant difference was determined between Group A and Group B in respect of the post-operative VAS scores (p0.05).In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coracoacromial ligament loosening nor bursectomy were determined to have any positive effect on the results. Whatever the acromion type, there is no need for an additional subacromial decompression procedure after rotator cuff repair, in respect of pain and functional outcomes. Only acromial spurs should be gently removed paying attention to the coraco-acromial ligament.

AIM demonstrate the changes in Grade II and III glial tumors after a new classification. MATERIAL AND METHODS The previous diagnoses and postoperative treatment of the 83 patients were recorded. We used real-time PCR (mutation assay) for the analysis of IDH1 and IDH2, while we used FISH test to determine 1p/19q codeletion. The integrated diagnosis was compared with classical histopathological diagnoses. RESULTS We studied 13 oligodendendrogliomas, 41 astrocytomas and 29 oligoastrocytomas patients with classical histopathological diagnosis group. IDH mutation was detected in 51 of the patients after genetic analysis, whereas 1p/19q codeletion was detected in 20 patients. We found that grade II IDH-mut astrocytoma patients had significantly better survival outcomes compared to grade III IDH-mut astrocytoma patients. CONCLUSION Grade II and III gliomas are separated into more homogeneous diagnostic groups for survival after molecular marker analyses. Compared to histopathological diagnosis, the WHO 2016 glioma classification with molecular markers provides new perspectives in patient prognosis and treatment. However, due to the costs of using molecular markers, the extent to which it can be used remains questionable.

Objective Knowledge concerning treatment and care of hand lesions is often based on small case series, case reports and a few large general case series. The aim of this study is to present our experience with hand tumors' and tumor-like lesions' incidence, age range and localizations. Material and method Between 2006-2016, 402 patients operated and histopathologically diagnosed with bone and soft tissue tumorous conditions of the hand were evaluated retrospectively. Results Three hundred sixty one out of 402 cases (89.8%) were soft tissue tumors and 41 cases (10.2%) were osseous tumors of the hand. A total of 10 malignant tumors (2.5%) were encountered in the hand. The average age of the patients was 41.9 years (ranged from 1 to 83 years). Among 361 soft tissue tumors, only 6 cases (1.6%) were malignant and they were squamous cell tumors (n=5) and synovial sarcoma (n=1). The most common soft tissue pathology was ganglion cyst (n=125). The most common bone tumor was enchondroma, diagnosed in 26 patients (6.4% of all patients). Primary malignant bone tumors were extremely rare in the hand; one osteosarcoma and one chondrosarcoma were reported. Metastatic tumors to the hand were seen in two patients; and they were lung carcinoma and chondrosarcoma metastasis. Conclusion Up-date knowledge and a thorough understanding of the nature and demographic characteristics of the tumorous conditions of the hand are crucial for accurate diagnosis and appropriate treatment.

56th Congress of the European-Societies-of-Toxicology (EUROTOX) - Toxicology of the Next Generation -- SEP 27-OCT 01, 2021 -- ELECTR NETWORK, [No Abstract Available], European Soc Toxicol, Ege University [18ECZ-008]; NIH NIGHMS [P20GM109005]; UAMS FY19 Chancellor Award; TUBITAK 2214/A scholarship, This study was supported by Ege University Research Fund grant 18ECZ-008, NIH NIGHMS P20GM109005 and UAMS FY19 Chancellor Award. A.T.A. was supported with TUBITAK 2214/A scholarship.

Aim: Fractures are a major source of disability in all age groups; however, little is known about their epidemiology despite being quite a few studies on this subject. The aim of this study was to identify the frequency, gender, and seasonal distributions of fractures in an emergency department.Materials and Methods: Patients who had been admitted to an emergency department because of extremity and spine problems were included in this study. Physical examinations, radiographs, ultrasonography, computed tomography, and magnetic resonance images were recorded. All demographic data such as age and gender, and other data, including season and history, were collected retrospectively. Diagnoses and treatment types (conservative or surgery) were evaluated.Results: Between January 2012 and January 2014, 190.986 patients (95.619 males and 95.367 females) with various complaints were admitted to an emergency ward. After assessment of 32.300 patients who had pain in an extremity or the spine, 4.036 of them were diagnosed with fractures, with a total of 4.301 fractures being diagnosed. The average age of the patients who presented symptoms in an extremity or the spine was 36.2 years, and the gender ratio (men/ women) was 60:40. The most common fractures were at the radius (15.6%), and the least common fractures were at the sesamoid bones (0.04%).Conclusion: This study showed that 17% of the patients admitted to the emergency ward had extremity or spinal complaints and 2.2% of the patients had fractures. These epidemiological data may be relevant for physicians working in emergency departments when evaluating trauma patients.

Purpose: Deep palmar tumors of the hand are very rare, and reported cases are usually benign. The most important issue is frequent anatomical variations with challenging surgical exposure and excision of these lesions. Some case reports or a small series of patients have been reported in the literature. The aim of this study was to present our experience with the deep palmar tumors of the hand. Patients and Methods: In the study, retrospective analyses of 43 patients treated with deep palmar tumors of the hand between January 1998 and June 2015 were evaluated. Tumors and tumor-like pathologies of the deep palmar space of the hand were retrospectively evaluated according to age, gender, localization, preoperative symptoms, size, site, treatment methods, histopathology, and early and late complications. Statistics and data analyses were also performed. Results: All 43 pathologies were benign, and histopathologic diagnoses were 10 lipomas, 8 ganglions, 5 giant cell tumor of the tendon sheath, 4 schwannomas, 3 hemangiomas, 3 palmar fibromatosis, 2 epidermal cysts, 2 neurofibroma, 1 angiolymphoid hyperplasia with eosinophilia, 1 granuloma, 1 calcifying aponeurotic fibroma, 1 digital fibroma, 1 foreign body granuloma, and 1 lipofibromatous hamartoma. The most common complication was temporary numbness and paresthesias of the digits. Marginal excision was performed in 40 patients, excision with nerve grafting in 2 patients (with neurofibroma) and carpal tunnel release in one patient with lipofibromatous hamartoma. Conclusion: In the deep palmar space of the hand, pathologies are closely associated with tendons, muscles, and neurovascular structures. Preoperative magnetic resonance imaging is helpful for the preoperative diagnosis, evaluating tumor extension, and successful surgical planning. Level of Evidence: IV Therapautic

Ameloblastic fibroma (AF) is rare benign odontogenic tumour which usually occurs in the first two decades of life. It can occur either the mandible or maxilla but it is most frequently found in the posterior region of the mandible. Treatment of AF in usual is a conservative approach, such as enucleation and curettage but the aggressive lesions require a radical approach. A more radical approach should be considered in older patients who have likely high recurrence tendency. This report describes a case of AF in a 38-year-old female patient identified during a routine radiographic exam. Tomographic examination through three-dimensional reconstruction indicated vestibular fenestration of the cortical bone, with involvement of lingual cortical bone as the lession extended to the posterior region. We removed the tumor under local anesthesia. In this case patient has continued to be followed frequently and has been disease-free for 3 years.

In this study, a novel molecule, a nucleotide permanent marker for nuclear staining from Papaver rhoeas (common poppy), and a sustainable stain formulation is disclosed. The molecule appears to penetrate tissue layers aggressively, and specifically attaches deoxyribonucleic acid nucleotides, staining the nucleus and revealing microscopic details. Various hematoxylin nuclear stain formulations have been presented for diagnostics, in the relative absence of viable alternatives. Millions of surgical microscopic diagnostic tests (2.5–3 million slides every day) are processed with hematoxylin, throughout the world. Apparently, hematoxylin is the most commonly used nuclear stain for histopathology diagnostics in the world, although the present cost – financial and ecological – of hematoxylin protocols is substantial and not well appreciated, even by pathologists and histologists. The origin of the hematoxylin is the Logwood tree (Haematoxylum campechianum), a species indigenous to the tropical rainforests of Ce...

Objective The purpose of this study was to compare neurological development of children with cyanotic or hemodynamically impaired congenital heart disease (CHD) and healthy controls by using “Bayley Scales of Infant and Toddler Development Screening Test, Third Edition” (Bayley-III). Patients Children with CHD (n = 37) and healthy controls (n = 24) aged between 1 and 41 months who were admitted to the Department of Pediatric Cardiology at our university hospital were included. The participants were assessed using Bayley-III test. All patients had cyanotic or hemodynamically impaired CHD. Weight, height, body mass index (BMI), mid-arm circumference (MAC), triceps skinfold thickness (TSF), and head circumference (HC) were measured and standard deviation scores (SDSs) were determined. Results SDS values of weight, height, BMI, MAC, and TSF of the patients as well as HC values were significantly lower than the control group (P .05). Conclusion This study demonstrated that children with cyanotic or hemodynamically impaired CHD have delayed neurodevelopmental outcomes compared with healthy children as assessed using Bayley-III.

Objective : The aim of the present study is to investigate the effect of Nissen fundoplication to the pacemaker cells of an intestinal system and the serotonin receptors on an ICC membrane. Methods : Sixteen adult male rats were taken into study. Rats were divided in to the following two groups. Nissen fundoplication was performed to study group (Group 1) and no surgical procedures were applied to control group (group 2). The rats who were subjected to surgery and the rats without surgery were sacrificed on to postoperative 14 days. Specimens for the pathologic analysis were obtained from upper esophagus (group A) and esophagogastric junction (EGJ) (group B). Distribution of ICC and 5HT-3A were evaluated separately. Results : There was a significant difference ( p = 0.01, p = 0.02, respectively) regarding number of cells stained with CD117 between the group 1B-2B and group 2A-2B. Also there was a significant difference between ( p = 0.01, p = 0.01 respectively) number of cells stained with 5HT-3A in groups 1A-1B and 2A-2B. However, no correlation was detected between group 1B-2B for 5HT-3A. Conclusion : A reduction in the number of ICC was observed in esophagogastric junctions of the fundoplication group but 5HT-3A distribution did not show a significant difference. A decrease in the number of ICC may be effective at postfundoplication dysphagia.

Purpose: We aimed to evaluate the pediatric patients diagnosed with symptomatic seizure who presented with convulsion or developed convulsion after admission due to another reason with regard to etiology and type of seizure, electroencephalography and cranial imaging findings, duration of antiepileptic therapy, seizure recurrence, and sequalea. Materials and methods: Our study sample consisted of 65 children aged between 1 month and 16 years who presented to the Emergency Unit of Sami Ulus Pediatric Health and Diseases Teaching and Research Hospital directly with convulsion or developed convulsion after admission due to another reason and subsequently diagnosed with symptomatic seizure between June 1, 2006 and December 31, 2007. Results: A total of 65 patients complying with the definition of acute symptomatic seizure were included in the study. The youngest patient was 2-month-old, whereas the oldest was 180-month-old, with the seizures generally occurring between 1-12 months. Central nervous system infections were observed to be the most common reason of acute symptomatic seizure. Organic causes with central nervous system are observed to induce seizure recurrence and sequelae more commonly as compared with the metabolic causes (p=0.015). Conclusion: Since seizure recurrence is a very low possibility when no organic lesion or focal neurologic sign is found in patients that have been put on antiepileptic therapy during the acute period due to acute symptomatic seizure, discontinuation of the antiepileptic therapy should be planned and the patient should be scheduled for discharge. Pam Med J 2014;7(1):19-25

Renal sarcomas are rare tumors. They constitute only 1-2% of malignant renal tumors in adulthood. Leiomyosarcoma is the most common histological type of renal sarcoma (50-60%). Renal leiomyosarcomas are aggressive tumors arising from the renal capsule, renal vein, pelvic musculature or the renal parenchyma. Diagnosis is usually post operative and requires a thorough sampling of the tumor to rule out an epithelial component. We report 4 new cases of primary renal leiomyosarcomas. Typical morphologic pattern shows alternating fascicles of spindle cells with blunt-ended, non-tapering nuclei and eosinophilic cytoplasm. Nuclear pleomprphisim atypia, mitotic figures and necrosis are seen in different ratios. Immunohistochemically the tumor cells of leiomyosarcoma are positive for SMA, desmin, calponin and h-caldesmon and negative for CK, S-100, HMB-45 and CD117. These tumors are classified using the French Federation of Cancer Centers System. To make a diagnosis of a primary renal sarcoma the following criteria should be met: 1) The patient must not have a sarcoma elsewhere to rule out metastasis. 2) Gross must be compatible with origin in the kidney rather than involvement due to retroperitoneal sarcoma. 3) Sarcomatoid renal cell carcinoma must be excluded. They usually have poor prognosis. But small size (

The aim of this study was to determine the changes in body mass index (BMI) of patients after renal transplantation regarding causes like steroid use, lower necessity for dietary restrictions, and changes in eating habits. Ninety-seven patients were enrolled in this retrospective study; they had undergone cadaver or living donor renal transplantation between 2011 and 2013. Demographic features of patients, height, weight, and BMI were evaluated before and 6 and 12 months after surgery. The patients were grouped as malnutritioned, normal, overweight, and obese. Statistical analyses were performed using the SPSS 11.0 statistics program. Mean age of patients was 39.1 ± 10.7 years. Twenty-six (26.8%) were female and 71 (73.1%) were male. Mean BMI before surgery was 22.52 ± 3.97 kg/m(2). Six months post-transplantation the mean BMI was 24.40 ± 4.1 kg/m(2) and after 12 months it was 25.56 ± 4.14 kg/m(2) (P.05). Also, 68% of patients showed improvement 12 months after surgery; they were in the preoperative malnutrition group. There is a significant increase in the BMI of patients in the first year who undergo renal transplantation, and the reason is multifactorial. BMI is relevant to diabetes, hypertension, and allograft nephropathy. BMI should be carefully considered in the follow-up of patients who have undergone renal transplantation, and early nutritional changes with dietary and exercise programs should be performed in overweight cases.

Purpose: To evaluate patients who had acute symptomatic seizures during an infection of the central nervous system. Materials and methods: In this study, we included patients with a central nervous system infection diagnosed after an admission to the emergency department because of convulsions and also the patients who developed convulsions during their hospital stay for a central nervous system infection. In these patients, we collected data about age, gender, seizure type, EEG findings, brain imaging findings and the duration of anti-epileptic drug use and examined the incidence of epilepsy. Results: A total of 24 patients who had acute symptomatic seizures during an infection of the central nervous system were included. The most frequently seizure type was generalized tonic clonic seizures. Six of these patients (25%) developed epilepsy. Conclusion: In patients with acute symptomatic seizures during central nervous system infections, anti-epileptic drug treatment must be stopped if there is no recurrence of seizures when the underlying disease recovers. Pam Med J 2013;6(1):22-25

Context Prolotherapy is a popular injection-based complementary treatment, which has shown promising results in the treatment of sprained and degenerated ligaments, and damaged dense connective tissues structures. More research was conducted in this area and many authors declared successful results for different indications. Evidence Acquisition The purpose of this study was to present a literature review regarding the current concepts of prolotherapy injections and improvements in the orthopedic clinical care practice. The Medline and PubMed databases were searched for the articles related to prolotherapy injections in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation. Results Numerous studies have been conducted on prolotherapy injections for different indications for orthopedics clinical care practice. Prolotherapy injections have successfully used for major orthopedic procedures in terms of rotator cuff lesions, knee ligamentous lesions, osteoarthritis-cartilage defects, and ligament-tendon injuries. Most of the studies showed that prolotherapy provided faster and better healing of tissues. Conclusions There is a great interest to prolotherapy in orthopedic clinics, especially to manage musculoskeletal lesions. More research conducted in this area and many authors declared successful results in their studies. In spite of this increasing trend for prolotherapy injections, there were only one or two clinical studies investigated prolotherapy injections for different indications and most of them have limited participants, short-term follow-up or poor quality studies. There is still need for further high-quality studies investigated optimal strategy of the injections of prolotherapy.

Background: Patch angioplasty is one of the several surgical options for patients with left main coronary ostial stenosis. It restores native antegrade blood flow in the left main coronary artery (LMCA) and does not leave the patient with graft-dependent retrograde perfusion. Various direct techniques have been described for left coronary ostioplasty. Herein, we described the use of autologous aortic tissue in the surgical treatment of left main coronary ostioplasty, and reported the short- and long-term outcomes of the patients. Methods: Between January 2003 and December 2010, 11 patients (nine males and two females) underwent surgical patch angioplasty for LMCA ostial stenosis using autologous aortic tissue as the patch material. Results: All patients survived the operation, and there were no significant postoperative complications. The follow-up period was 44.09 ± 30.26 months (range, 1–94 months), and no deaths or restenoses were observed during follow-up. Conclusions: The use of autologous aortic tissue as an onlay patch for reconstruction of left main coronary ostial stenosis is safe and free of major complications. This tissue is a reasonable material for treating selected types of LCMA patients. (J Card Surg 2011;26:586-590)

Introduction: Mean platelet volume (MPV) was shown to be significantly increased in patients with acute ischaemic stroke, especially in non-lacunar strokes. Moreover, some studies concluded that increased MPV is related to poor functional outcome after ischaemic stroke, although this association is still controversial. However, the determinants of MPV in patients with acute ischaemic stroke have never been investigated. Subjects and methods: We recorded the main demographic, clinical and laboratory data of consecutive patients with acute (admitted within 24 h after stroke onset)

In recent studies, it has been observed that androgen receptors are densely located in pelvic floor muscles. We aimed to investigate the effect of testosterone on urodynamic findings and histopathomorphology of pelvic floor muscles in rats with experimentally induced stress urinary incontinence.Twenty-eight adult female rats were randomized into four groups. Group I: rats in which SUI was induced and single-dose testosterone was administered 30 days later, group II: rats in which SUI was induced and single-dose testosterone was administered within the same session, group III: rats in which SUI was induced and saline was injected intramuscularly 30 days later, and group IV: the sham group. In order to demonstrate objectively the curative and preventive role of testosterone in experimental model of SUI, urodynamic examination and histopathomorphological evaluation of levator ani muscle were performed.Myofiber areas in groups I and II were detected to be significantly larger than those of the control group (P0.001). Another parameter was leak point pressure value by urodynamy. Regarding this parameter, LPP values in groups 1, 2 and 4 were observed to be significantly higher than those of group 3 (P0.001). The results of the comparison among groups 1, 2 and 4 revealed no significance (P0.05), which indicates that testosterone provides continence in a similar way to the group in which sciatic nerve section was not performed.In the present study, it has been demonstrated that testosterone has both preventive and curative effects on rat models of experimental SUI.

Intravital or multiphoton microscopy and laser-speckle imaging have become popular because they allow live monitoring of several processes during cerebral ischemia. Available rodent models have limitations for these experiments; e.g., filament occlusion of the proximal middle cerebral artery (MCA) is difficult to perform under a microscope, whereas distal occlusion methods may damage the MCA and the peri-arterial cortex. We found that placement of a 10% FeCl3-soaked filter paper strip (0.3 × 1 mm2) on the duramater over the trunk of the distal MCA through a cranial window for 3 minutes induced intraarterial thrombus without damaging the peri-arterial cortex in the mouse. This caused a rapid regional cerebral blood flow decrease within 10 minutes and total occlusion of the MCA segment under the filter paper in 17 ± 2 minutes, which resulted in a typical cortical infarct of 27 ±4 mm3 at 24 hours and moderate sensorimotor deficits. There was no significant hemispheric swelling or hemorrhage or mortality at 24 hours. Reperfusion was obtained in half of the mice with tissue plasminogen activator, which allowed live monitoring of clot lysis along with restoration of tissue perfusion and MCA flow. In conclusion, this relatively simple and noninvasive stroke model is easy to perform under a microscope, making it suitable for live imaging and thrombolysis studies.

Background: Behcet's disease is predominantly an inflammatory disease with oral and genital ulcus, uveitis and erythema nodosum. It is a chronic disease with unprecetended remission and activation periods. Behcet's disease may also affect extremities in the form of arthritis, myositis, enthesis, tenosynovitis and dactylitis. The most affected joints are knee, wrist -hand, ankle and elbow. A history of sytemic inflammatory disease in a patient with a hand disease or a one who is a candidate for hand surgery may affect the surgical procedure and post-operative rehabilitation. Thus recognition of this condition is essential for the hand surgeon, physiotherapist, and the patient. Objective: To evaluate the impact of Behcet's disease on grip and key pinch strength. Subjects: Fifty (31 male, 19 female) patients with Behcet's disease and 50 (32 male, 18 female) controls. Results: Hand grip and key pinch strength of Behcet's patients did not differ from that of normal subjects. Conclusions: Behcet's disease does not seem to affect grip and pinch strength.

Objective The objective of this study is to investigate the presence of viral DNAs of HSV-1, HSV-2, HHV-6, HHV-8, and CMV in hippocampus of the patients with mesial temporal lobe epilepsy (MTLE) syndrome. Methods Pathological specimens were obtained from 33 patients with MTLE undergone temporal lobectomy with amygdalo-hippocampectomy due to intractable seizures. Autopsy materials from the hippocampus of 7 patients without neurological disease were used as controls. The data was also correlated with the clinical history of patients including febrile convulsions, age, and history of CNS infections. Real-time polymerase chain reaction method was performed for detection of DNAs of these viruses. Results HHV-6, HSV-1 and HHV-8 were detected in the hippocampus of 3, 2 and 1 patients with MTLE respectively. None of the hippocampus of patients with MTLE was positive for DNA of HSV-2 and/or CMV. Three patients with positive HHV-6 DNAs had febrile convulsions and family history for epilepsy. None of our control specimens showed PCR positivity to any of the 5 tested viruses. Conclusions Our study is the first to report the presence of HHV-8 viral genome in the brain tissue of patient with MTLE. Viral DNAs were detected in a total of 18% of the patients in this study; we can conclude that activity of the latent virus in patients with hippocampal sclerosis should be more extensively studied to establish its role in active infection.

During dissection of the retropubic region of a 55-year-old female cadaver, we encountered an angiolipoma located inside the obturator canal which was connected to the wall of the urinary bladder by a fibrous cord. The angiolipoma was supplied by a branch originating from the umbilical artery. Microscopically the benign soft tissue tumor was characterized by lobules of mature adipocytes and densely distributed networks of small and larger blood vessels, thus resembling typical histological features of an angiolipoma. Both the uncommon location of the angiolipoma and the abnormal branch of the umbilical artery entering the obturator canal should be taken into account during surgical procedures in this region, such as for orthopedic pelvic procedures, hernia repair or bladder/urethra-related interventions (e.g. transobturator tape, tension-free vaginal tape, colposuspension).

SummarySutured visceral anastomoses are time-consuming and complex when performed endoscopically. Theoretically, laser-welded visceral anastomoses are possible and are potentially easier and quicker to perform endoscopically than the sutured anastomoses. In this living canine study, we compared the operating time and intraluminal bursting pressure of laser-welded vs sutured anastomoses of (1) common bile duct (CBD), (2) small intestine, (3) colon and (4) ureter. Each organ was joined to itself using both anastomotic techniques. Welded anastomoses were much quicker in each organ system. Watertight anastomoses were achieved in each organ tested with both anastomotic techniques. Intraluminal hydrostatic bursting pressures occurred at lower pressures (approximately 70% of sutured anastomosis bursting pressure) in all organs. Though not qualified, tensile disruption pressure appeared to be significantly lower in the welded anastomoses as compared to the sutured anastomoses. Laser-welded visceral anastomoses ar...

The case of a 66-year-old man with extraskeletal osteosarcoma (ESOS) arising in the pretibial subcutaneous tissue is presented. On radiographs, there were no calcifications or ossifications within the soft-tissue mass. Magnetic resonance imaging (MRI) showed the tumor to be in the subcutaneous tissue anteriorly to the patellar tendon without attachment to the bone. Histologic examination revealed a cystic hemorrhagic cavity containing necrotic and viable tumor and a large solid component. A diagnosis of chondroblastic type extraskeletal osteosarcoma was made.

NeuN immunoreactivity is used as a specific marker for neurons. The number of NeuN-positive cells decreases under pathological conditions. This finding is usually considered as an evidence of neuronal loss. However, decrease in NeuN labeling may also be caused by depletion of the protein or loss of its antigenicity. Hence, we have investigated the morphological features of neurons that lost NeuN immunoreactivity and the NeuN protein levels in mouse brain after cerebral ischemia. The number of NeuN-labeled cells was decreased 6 h after a mild ischemic insult (30 min middle cerebral artery occlusion) in penumbral and core regions. Hematoxylin and eosin (H&E) staining of adjacent sections showed that neurons in the penumbra were not disintegrated but displayed early ischemic changes. The nuclear NeuN staining was dramatically reduced or lost in some neurons. However, Hoechst 33258 staining of the same sections revealed that these nuclei were preserved with an intact membrane. Labeling of neurons that had lost NeuN-positivity with antibodies against caspase-3-p20, which is constitutively not present but emerges in neurons after ischemia, disclosed that these neurons still preserved their integrity. Moreover, Western blots showed that NeuN protein levels were not decreased, suggesting that reduced NeuN antigenicity accounted for loss of immunoreactivity in this mild brain injury model. Supporting this idea, NeuN labeling was partially restored after antigenic retrieval. In conclusion, since NeuN immunoreactivity readily decreases after metabolic perturbations, reduced NeuN labeling should not be taken as an indicator of neuronal loss and, quantitative analysis based on NeuN-positivity should be used cautiously after central nervous system (CNS) injury.

In this study we investigated the structural lesions of patients with periodic lateralized epileptiform discharges (PLEDs) to determine the possible relationship of lesions to PLEDs' localization on EEG and to metabolic abnormality. Clinical findings and electroencephalography (EEG), computerized tomography (CT) and magnetic resonance imaging (MRI) of the 71 adult patients with PLEDs were evaluated. Stroke, herpes encephalitis and intracranial tumor or abscess were the most common etiological factors. Cortical gray matter and adjacent subcortical white matter lesions were detected in 64.7%, cortical gray matter lesions in 11.3% and subcortical white matter lesions in 4.2% of the patients. Although it is thought that PLEDs occur mostly with acute lesions, chronic lesions causing PLEDs were found in 35.2% of the patients. Bilateral lesions were detected in 19.7% and 33.8% of the patients had metabolic abnormality. PLEDs localized the region of the lesion in 63.4% of the patients. PLEDs are usually self-limited features, but chronic PLEDs were detected in 5 patients in this study. Acute structural lesions involving cortical gray matter with adjacent subcortical white matter were found in most of the patients with PLEDs, but the lesion localization and age, acute or chronic, varied.

The present study was undertaken to investigate the involvement of oxidative damage in lead-induced toxicity in humans and to enlighten whether oxidative stress indicators are correlated with the known indices of lead toxicity. For these purposes, selected oxidative stress parameters along with some clinical indices of lead poisoning were determined in blood of battery plant workers and control subjects. Workers had significantly increased erythrocyte malondialdehyde (MDA) levels, catalase and glucose-6-phosphate dehydrogenase (G6PD) activities, and decreased blood glutathione:glutathione disulfide ratio compared to the controls. Increased blood lead concentrations and zinc protoporphyrin (ZPP) levels, and decreased delta-aminolevulinic acid dehydratase (ALAD) activity were used as clinical indices of lead toxicity. Statistically significant correlation between oxidative stress parameters and clinical indices implies that disrupted prooxidant/antioxidant balance might contribute to lead-induced toxicity in erythrocytes. A significant correlation was found between ALAD activity and blood lead levels in human subjects. Similarly significant correlation between ALAD activity and erythrocyte MDA concentrations was shown. Present data indicates that ALAD can serve as a valuable biomarker of oxidative stress in lead-exposed hematological system as well as being a biochemical indicator of lead exposure.

The aim of this study was to investigate the expression pattern and cellular source of matrix metalloproteinases (MMP) in vasculitic neuropathy. Matrix metalloproteinases are endopeptidases degrading components of extracellular matrix proteins, and they have been implicated in the pathogenesis of inflammatory demyelination. They are induced by cytokines, secreted by inflammatory cells, and enhance T cell migration. Vasculitic neuropathy occurs as a component of systemic vasculitis or as an isolated angiitis of the peripheral nervous system, and T cell-mediated inflammation is detected in its pathogenesis. Nerve biopsy sections of eight patients with nonsystemic vasculitic neuropathy (NSVN) and four with systemic vasculitic neuropathy were examined for the presence of CD4+, CD8+, and CD68+ cells and immunohistochemically for MMP-2 and MMP-9 expression. Nerve biopsies of eight patients with noninflammatory neuropathy were used as a control group. Semiquantitative polymerase chain reaction analysis was performed to detect MMP-2 and MMP-9 mRNA. The predominant cells were CD8+ and CD68+ T cells. Expression of MMP-9, but not MMP-2, was increased in perivascular inflammatory infiltrate in nerve tissues of vasculitic neuropathy patients. This MMP-9 expression correlated positively with immunostaining of CD8+ T cells. No difference was detected between immunostaining patterns of nonsystemic and systemic vasculitic neuropathies with the antibodies used, except in MMP-9 immunostaining, which was found to be enhanced in NSVN group. Polymerase chain reaction analysis revealed elevated mRNA levels of MMP-9 and MMP-2 compared with controls, but this did not reach statistical significance. Our results imply a pathogenic role for MMP-9 secreted from CD8+ cells in vasculitic neuropathy.

Generalised periodic epileptiform discharges (GPEDs) are very rare patterns and are classified as periodic short-interval diffuse discharges (PSIDDs), periodic long-interval diffuse discharges (PLIDDs) and suppression-burst patterns according to the interval between the discharges. In this study we analysed the demographics, history of the seizures during the current illness, mental status, diagnosis, metabolic abnormalities, neuroimaging studies and prognosis of 37 adult patients who had GPEDs in their EEGs. Ages ranged from 17 to 82 years (mean 45 years). There were 19 mates and 18 females. The most common aetiology of GPEDs was metabolic and/or infectious disease which was established in 22 patients (59.5%). Other aetiologies included subacute sclerosing panencephalitis (SSPE) in I I patients (29.7%) and Creutzfeld-Jakob disease (CJD) in 4 patients (10.8%). We showed that structural lesions were found in most of the patients with GPEDs, but concurrent metabolic abnormalities and/or infectious diseases were also detected. Consciousness was impaired and clinical conditions were poor in various degrees in all of the patients when GPEDs were seen. Relatively little is known regarding the mechanism of GPEDs. When GPEDs are seen in EEG, the patient should carefully be checked for metabolic abnormalities and/or infectious diseases and intracranial lesions. GPEDs may be helpful in the determination of prognosis, showing the poor prognosis especially in cases when suppression-burst pattern is seen. (D 2003 BEA Trading Ltd. Published by Elsevier Science Ltd. All rights reserved.

Somatostatin analogues are potent growth hormone and glucagon inhibitors and are commonly used in the treatment of several endocrine and non-endocrine disorders. We report severe and longstanding hypoglycemia triggered by long-acting octreotide (Sandostatin LAR) in a 62-year-old women with malignant mesenchymal tumor. Hypoglycemia developed after 6 hours of octreotide injection and she was admitted to the emergency unit with sweating, tremor, palpitation and confusion. On admission, her plasma glucose level was: 17 mg/dl (normal: 65-110), cortisol: 31 microg/dl (normal: 5-25), insulin: 4.32 microIU/ml (normal: 6-27), C-peptide: 2.64 ng/ml (normal: 0.9-4.0), growth hormone: 0.06 ng/ml (normal: 0.06-5.0), insulin-like growth factor-I: 8.5 ng/ml (normal: 101-303), insulin-like growth factor binding protein-3: 1715 ng/ml (normal: 2020-3990). Intravenous dextrose infusion was given for a month to sustain normoglycemia since hypoglycemia recurred following cessation of infusion. Therefore, prednisolone, 35 mg/day was added and the parenteral dextrose infusion rate was decreased gradually and finally stopped. Normoglycemia could be maintained with prednisolone 20 mg/day. In patients prone to tumor hypoglycemia, long-acting octreotide may trigger severe and prolonged hypoglycemia due to suppression of counter-regulatory hormones; clinical trial with short-acting octreotide may be warranted to predict and prevent this life-threating complication.

article i nfo Article history: Objective: The aim of the present study was to assess the role of CX3CL1 in patients with active and inactive Behcet's Disease (BD), Neuro-Behcet's Disease (NBD) and control subjects. Methods: Fifty-six patients admitted to the BD and NBD Outpatient Clinics, and 30 healthy controls were enrolled in the study. Serum CX3CL1 levels were measured by an enzyme linked immunosorbent assay (ELISA). Results: No significant difference was found between the serum CX3CL1 levels of control subjects, and patients with active and inactive BD or NBD, regardless of treatment. Conclusion: To our knowledge, this is the first study analyzing CX3CL1 levels in patients with BD and NBD. Our results demonstrated that serum CX3CL1 levels were not changed in active and inactive BD and NBD. However, further large-scale studies are needed to confirm our results.

Thenar hypoplasia can be an isolated defect, as in Cavanagh's syndrome, can be present with cardiac (Holt-Oram syndrome) or eye (Okihiro's syndrome) disorders, or can be associated with hand anomaly, as in Haas's malformation. Vascular abnormality may be associated with thenar hypoplasia, which has been demonstrated in Okihiro's syndrome. Cavanagh's syndrome is a rare anomaly of the upper extremities that presents with unilateral or bilateral hypoplasia of the thenar eminence. Typical clinical, radiographic, and electrophysiologic findings emphasize the diagnosis. Differentiation from carpal tunnel syndrome is important to prevent unnecessary intervention. Electrophysiologic and radiographic findings are necessary tools for the physician to establish a correct diagnosis and make an appropriate referral. Because of its rarity, we present the case of an 8-year-old girl with this syndrome. (J Child Neurol 2002;17:51-54).

Atopic dermatitis (AD) is a chronic and relapsing skin disease with severe eczematous lesions. Long-term topical corticosteroid treatment can induce skin atrophy, hypopigmentation and transepidermal water loss (TEWL) increase. A new treatment approach was needed to reduce the risk by dermal targeting. For this purpose, Betamethasone valerate (BMV)/Diflucortolone valerate (DFV)-loaded liposomes (220-350 nm) were prepared and incorporated into chitosan gel to obtain adequate viscosity (similar to 13 000 cps). Drugs were localized in stratum corneum + epidermis of rat skin in ex-vivo permeation studies. The toxicity was assessed on human fibroblast cells. In point of in-vivo studies, pharmacodynamic responses, treatment efficacy and skin irritation were evaluated and compared with previously prepared nanoparticles. Liposome/nanoparticle in gel formulations produced higher paw edema inhibition in rats with respect to the commercial cream. Similar skin blanching effect with commercial creams was obtained via liposome in gels although they contain 10 times less drug. Dermatological scoring results, prognostic histological parameters and suppression of mast cell numbers showed higher treatment efficiency of liposome/nanoparticle in gel formulations in AD-induced rats. TEWL and erythema measurements confirmed these results. Overview of obtained results showed that liposomes might be an effective and safe carrier for corticosteroids in skin disease treatment.

Introduction Renal transplantation is the optimum treatment to improve the quality and length of life in end-stage renal disease. The aim of this study is to evaluate patients who underwent renal transplantation in our transplantation center and to present our clinical experience. Methods Living donor and cadaveric renal transplants performed in the Transplantation Center of Sanko University Medical School between 2011 and 2014 were evaluated retrospectively. In our study, important parameters, such as delayed graft function, early and late phase infections and urologic complications after the operation, results of renal transplants with marginal donors with high creatinine levels, and increase in posttransplant body mass index were evaluated regarding to the living donor and cadaveric renal transplants performed in our transplantation center. Results We included 136 patients were (92 males [68%] and 44 females [32%]), with an average age of 38.9 ± 9.8 years (range, 17–67). There were 63 living donor renal transplantations (43%) and 73 cadaveric renal transplantations (57%). The youngest cadaveric donor was 3 years old, and the oldest was 86. Fifteen of the cadaveric donors had blood creatinine levels around 1.5 g/dL. The highest level of creatinine from cadaveric donors was 5.1 g/dL. Conclusions Living donor renal transplantations have higher success rate than cadaveric renal transplantations. Ureteroneocystostomy and native ureteropyelostomy seem to be safe and efficient treatment methods for ureteral complications. High creatinine levels in marginal donors do not affect graft function in early stages.

subacute sclerosing panencephalitis (sspe), chronic progressive inflammatory disorder of the central nervous system, is associated with the presence of persistent and aberrant measles virus infection. The diagnosis is based on characteristic clinical features, periodic electroencephalographic complexes, and elevated measles antibody titer in cerebrospinal fluid. Ocular changes occur approximately in 50 % of cases, but rarely presenting as a first symptom [1]. Visual system abnormalities in SSPE include retinal vasculitis, maculopathy, chorioretinitis, optic neuritis, papillitis, papilledema, optic atrophy, nystagmus, cranial nerve palsies and transient hemianopia, and acute vision loss because of cortical involvement. The most common ocular manifestations are because of macular retinitis and macular pigment disturbances [2–4]. In the beginning, during brain conventional magnetic resonance imaging (MRI) findings are normal, though magnetic resonance spectroscopy (MRS) of SSPE patient may show some abnormalities [1, 5]. Our patient’s neurologic and fundoscopic examination and laboratory findings were normal except loss of visual acuity and abnormal brain MRI and MRS findings. Herein, we report a case of cortical blindness diagnosed as SSPE with the help of neuroimaging without the classical clinical presentation of central nervous system involvement initially.

Hemangiomas in the spinal epidural area are very rare lesions, and most of these lesions are of the cavernous type. Only seven cases of capillary hemangiomas have been reported in the English literature, and all of these cases occurred in adulthood. Here, we report on a 17-month-old girl who presented with an inability to walk. MRI revealed an epidural mass, which was diagnosed as an epidural capillary hemangioma in the thoracic region. To our best knowledge, this case is the first epidural capillary hemangioma case to occur in childhood that has been reported.

Oxidative stress is proposed as a molecular mechanism in lead toxicity, which suggests that antioxidants might play a role in the treatment of lead poisoning. The present study was designed to investigate whether taurine has a beneficial effect both on Chinese hamster ovary (CHO) cells and on Fisher 344 (F344) rats following lead exposure. Therefore, oxidative stress parameters (glutathione, malondialdehyde levels, catalase, and glucose-6-phosphate dehydrogenase [G6PD] activities) of lead-exposed CHO cells and F344 rats were determined following taurine treatment. Taurine was found to be effective in (1) increasing glutathione levels that had been diminished by lead; (2) reducing malondialdehyde levels, an end-product of lipid peroxidation; (3) decreasing catalase and erythrocyte G6PD activity, which had been increased by lead exposure; and (4) improving cell survival of CHO cells. However, taurine had no effect on blood and tissue lead levels when 1.1 g/kg/day taurine was administered to F344 rats for 7 days, following 5 weeks of lead exposure (2,000 ppm lead acetate). As a result, taurine seems to be capable of fortifying cells against lead-induced oxidative attack without decreasing lead levels. Therefore, administration of taurine, accompanied by a chelating agent, might increase its effectiveness in the treatment of lead poisoning.

Cholestasis is one of the major complications of parenteral nutrition. The purpose of this experimental study was to detect the effects of acetylsalicylic acid (ASA), vitamin E (Vit E), and interferon-alpha (IFN-alpha) on prevention of parenteral nutrition-associated cholestasis.Ten experimental groups, each consisting of 10 4-week-old Wistar albino rats, were formed: control 10- and 20-day groups (C10 and C20), parenteral nutrition-only 10- and 20-day groups (T10 and T20), ASA-supplemented parenteral nutrition 10- and 20-day groups (TA10 and TA20), Vit E-supplemented parenteral nutrition 10- and 20-day groups (TE10 and TE20), and IFN-alpha-supplemented 10- and 20-day groups (TF10 and TF20). Acetylsalicylic acid, Vit E, and IFN-alpha were administered in the parenteral nutrition solution through an intraperitoneal route. At the end of the study, serum total bile acids, serum aspartate and alanine aminotransferases, and alkaline phosphatase were measured biochemically. In addition, the histopathologic findings of cholestasis were evaluated by using a morphologic portal inflammation index.Although the difference in the serum levels of transferases and alkaline phosphatase was not significant among all groups (p0.05), it was significant in total bile acid levels (p0.05). There was also a significant correlation between the histopathologic changes of the liver and serum total bile acid concentrations (p0.05). Portal inflammation in varying degrees was seen in all experimental groups, but not in the control groups. Serum total bile acid concentrations in parenteral nutrition groups receiving ASA were significantly lower than those in the parenteral nutrition-only group (p0.01). Although Vit E-supplemented parenteral nutrition was effective in preventing the development of cholestasis in the 10-day group (p0.05), it was not effective in the 20-day group when compared with incidence of cholestasis in the parenteral nutrition-only group (p0.05). Conversely, IFN-alpha-supplemented parenteral nutrition had no effect on cholestasis in the 10-day group (p0.05) but lowered cholestasis in the 20-day group when compared with incidence the parenteral nutrition-only group (p0.05).Our results indicate that acetylsalicylic acid may be beneficial in preventing, and (alpha-interferon in treating, parenteral nutrition-associated cholestasis.

Lead (Pb) is known to negatively affect glutathione (GSH) metabolism in the lens. The present study examined the effects of Captopril, Taurine, and α-Lipoic acid on the Pb-induced GSH depletion and lipid peroxide increase in the lenticular system. Captopril administration returned the GSH, cysteine (CYS), and malondialdehyde (MDA) levels to near normal. Following Taurine administration the GSH, CYS and MDA levels were intermediate between the control group and the Pb group levels. α-Lipoic acid administration, however, only increased the CYS levels. No significant changes in oxidized glutathione (GSSG) levels were observed in any treatment group.

Aim: Effective anti-Helicobacter pylori therapies with few side-effects are needed. We studied the effectiveness of a low-dose combination of metronidazole, amoxycillin and omeprazole for treatment of ulcer patients in Seoul, Korea. Methods: Patients with gastric or duodenal ulcer received metronidazole (125 mg b.d.), amoxycillin (500 mg b.d.) and omeprazole (20 mg at bedtime) for 2 weeks. Endoscopic examinations were performed before treatment and at least 6 weeks after completion of antimicrobial therapy. H. pylori status was confirmed by histological examination of two gastric biopsies using the Genta stain. Results: Seventy-nine patients (64 men, 15 women, mean age 46 years) with peptic ulcer were enrolled. H. pylori infection was cured in 56 (71%, 95% CI: 60–81%). The cure rate in non-smokers was significantly higher than in smokers (88% vs. 65%, P=0.035). Twelve pre-treatment isolates were available and metronidazole resistance was noted in all; H. pylori infection was cured in 10. Thirty-six patients cured of H. pylori have been followed for 1 year (mean of 361 days) and 2 cases became reinfected (5.5%, 95% CI: 1–18%). Conclusions: The low-dose combination of metronidazole, amoxycillin and omeprazole was effective even in the face of metronidazole resistance. Recurrence of H. pylori infection is infrequent even in countries with a high prevalence of H. pylori infection.

delta-Aminolevulinic Acid (delta-ALA) is a heme precursor accumulated in lead poisoning and acute intermittent porphyria. Although no single mechanism for lead toxicity has yet been defined, recent studies suggest at least some of the lead-induced damage may originate from delta-ALA-induced oxidative stress. The present study was designed to test the hypothesis that delta-ALA accumulation in Chinese hamster ovary (CHO) cells contributes to the cumulative oxidative challenge of lead poisoning as indicated by the oxidative stress parameters glutathione (GSH), glutathione disulfide (GSSG), malondialdehyde equivalents (MDA), and catalase (CAT). It will also examine the possibility that this oxidative challenge can be reversed by treatment with an antioxidant such as N-acetylcysteine (NAC). First in vitro administration of delta-ALA to CHO cells was found to have a concentration-dependent inhibitory effect on colony formation and cell survival. NAC administration was shown to alleviate this inhibition in CHO survival. The oxidative status of CHO cell cultures exposed to increasing concentrations of delta-ALA was then examined. Decreases in GSH levels (P0.05) were observed in the delta-ALA-treated cultures as compared to the controls, while GSSG and MDA levels were significantly increased in delta-ALA-treated cells (P0.05). CAT activity was not significantly affected. NAC administration concurrent with delta-ALA exposure resulted in GSH and GSSG levels similar to the control levels, while no significant improvement in MDA was observed. These results indicate a state of oxidative stress and suggest that the delta-ALA- induced inhibitory effect on CHO colony formation may be due to its pro-oxidant effect. To assess whether this oxidative challenge would induce antioxidant increases during extended exposure to delta-ALA, CHO cells were exposed to 5 mM delta-ALA for increasing time periods. The GSH and GSSG levels were measured and a rebound effect was observed after 12 h of delta-ALA exposure.

A 16-year-old boy with a 4-month history of pain and a palpable mass in the right wrist was presented to our clinic. Preoperative diagnosis was a ganglion cyst according to symptoms and physical examination. The lesion was removed by marginal resection and histopathologic examination revealed a juxta-articular myxoma. No recurrence was detected at 1-year follow-up evaluation. We report a case of juxta-articular myxoma of the wrist joint.

Whether drains should be routinely used after laparoscopic cholecystectomy is still debated. We aimed to retrospectively evaluate the benefits of drain use after laparoscopic cholecystectomy for non-acute and non-inflamed gallbladders.Two hundred and fifty patients (mean age, 47±13.8 years; 200 females and 50 males) who underwent laparoscopic cholecystectomy for cholestasis were included in the study. The medical files of the patients were examined retrospectively to obtain data on patient demographics, cholecystitis attacks, complications during the operation, whether a drain was placed in the biliary tract during the operation, etc. The volume of the fluid collection detected in the subhepatic area by ultrasonography on the first postoperative day was recorded.Drains were placed in 51 patients (20.4%). The mean duration of drain placement was 3.1±1.9 (range 1-16) days. Fluid collection was detected in the gallbladder area in 67 patients (26.8%). The mean volume of collected fluid was 8.8±5.2 mL. There were no significant effects of age, gender, and previous cholecystitis attacks on the presence or volume of the fluid collection (P0.05 for all). With regard to the relationship between fluid collection and drains, 52 of 199 (26.1%) patients without drains had postoperative fluid collection, compared to 15 of 51 (29.4%) patients with drains (P0.05).In conclusion, there is no relationship between the presence of a drain after laparoscopic cholecystectomy and the presence of postoperative fluid collection. Thus, in patients without complications, it is not necessary to place a drain to prevent fluid collection.Laparoskopik kolesistektomi sonrası rutin olarak dren kullanımı hala üzerinde tartışılan bir konudur. Bu çalışmada akut olmayan noninflamatuar safra kesesi için uygulanan laparoskopik kolesistektomi sonrası dren kullanımının avantajlarını retrospektif olarak değerlendirmeyi amaçladık.Çalışmaya kolestaz nedeniyle laparoskopik kolesistektomi uygulanan 250 hasta (ortalama yaş, 47±13.8 yıl; 200 kadın ve 50 erkek) dahil edildi. Hasta dosyaları retrospektif olarak değerlendirilerek demografi, kolesistit atak, cerrahi komplikasyonlar, cerrahi sırasında biliar trakt üzerine dren yerleştirilme durumu v.b. üzerine veri toplandı. Postoperatif ilk gün ultrasonografide subhepatik alanda biriken sıvı hacmi kaydedildi.Hastaların 51’ine (%20.4) dren yerleştirildi. Ortalama dren kalış süresi 3.1±1.9 gün (aralık, 1–16 gün) idi. Altmış yedi (%26.8) hastada safra kesesi bölgesinde sıvı birikimi görüldü. Ortalama sıvı hacmi 8.8±5.2 mL idi. Sıvı birikimi varlığı ve hacmi üzerinde yaşın, cinsiyetin ve önceki kolesistit ataklarının etkisi yoktu (tümü için P0.05). Sıvı birikimi ve dren arasındaki ilişki değerlendirildiğinde, dren takılmayan 199 hastanın 52’sinde (%26.1) ve dren olan 51 hastanın 15’inde (%29.4) sıvı birikimi olduğu görüldü (P0.05).Laparoskopik kolesistektomide dren varlığı ile postoperatif sıvı birikimi arasında ilişki yoktur. Bu nedenle komplikasyonsuz hastalarda sıvı birikimini önlemek için dren kullanımına gerek yoktur.

Traumatic brain injury (TBI) is one of the most common causes of death among trauma patients. Earlier prediction of possible poor neurological outcomes, even upon admission to the emergency department, may help to guide treatment. The aim of this prospective study was to assess the predictive value of plasma copeptin levels for early morbidity and mortality in patients with isolated TBI. This prospective study comprised 53 patients who were admitted to the emergency department with isolated TBI. Forty-two of these patients (group I) survived at least 1 month after the TBI; the other 11 (group II) did not. Plasma levels of copeptin were measured in these TBI patients at admission and 6 h after trauma, and were compared with those of healthy volunteers (group III). At admission, the copeptin levels of the TBI patients (groups I and II combined) were not statistically significantly different from those of the control group (III). The copeptin levels 6 h after trauma were also not statistically significantly different from those at admission. Δ-Copeptin levels (the difference between the copeptin level at the 6th hour after trauma and that at admission) were higher in the patients who died within a month of the TBI. Further, Δ-copeptin levels were higher in patients who showed no improvement in the modified Rankin score when compared with patients with an improved modified Rankin score. The best cutoff point for Δ-copeptin was 0.51 ng/ml for predicting mortality and 0.23 ng/ml for predicting improvement in the modified Rankin score. Plasma Δ-copeptin levels may help physicians predict the prognoses of patients suffering from traumatic brain injury.