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The aim of this study is to present the advantages of LAGB (Laparoscopic adjustable gastric banding), its effects on weight loss and influence on comorbidities such as diabetes and hypertension.90 middle-aged obese patients with body mass index [BMI] of 35-50 kg/m2 underwent LAGB between October 2007 and April 2010.There were 33 men and 57 women underwent LAGB. The ages of the cases ranged from 22 to 39 years [mean 29.5 years]. The percentage of decrease on BMI at the 3, 6, 12, 24 month marks were 9.85%, 14.8%, 25.8% and 32.9%, respectively. No early operative complications were recorded. Pouch dilation occured in 6 patients and band erosion-migration was observed in 3 patient.LAGB is a safe and effective approach in short-term management of morbid obesity. Weight loss, complications and resolution of comorbidities are comparable with the other obesity procedures.

Background/Aims: Variations in pro and anti-inflammatory cytokine levels occur commonly after ERCP procedure complications, such as in post-ERCP pancreatitis. Besides, the relationship between increased cytokine levels and multidrug resistance has been shown in cholangiocarcinoma patients. Our aim was to investigate the impact of cytokine level changes on treatment strategy after uncomplicated ERCP procedures in cholangiocarcinoma patients. Materials and Methods: Of 75 patients enrolled in this study, 25 were cholangiocarcinoma, and 50 were choledocholithiasis patients. Levels of serum IL-1β, IL-6, IL-8, IL-10, and TNF-α were evaluated 2 hours before and 12 hours after complication-free ERCP, and statistical analysis of the results was obtained; if p value

Objektif: Dogum sonu kanamanin önlenmesinde rektal yoldan verilen prostaglandin E1 analogu misoprostol ile parenteral oksitosininin etkinliklerinin karsilastirilmasi. Planlama: Prospektif randomize çalisma Ortam: Üniversite hastanesi Hastalar: Aktif travayda ve miadinda 240 gebe Girisim: Dogumdan hemen sonra Grup 1’de 80 hastaya rektal yoldan 200 μg misoprostol, Grup 2’de 80 hastaya 400 μg rektal misoprostol ve üçüncü grupta 80 hastaya 1000 ml %5 Dekstroz ringer laktat içinde 10 IÜ oksitosin intravenöz yoldan verildi. Degerlendirme parametreleri: Dogum sonu kan kaybi ve hematokrit degisimleri ve misoprostole bagli olasi yan etkiler. SONUÇ: Ortalama kan kaybi miktari açisindan gruplar arasinda istatistiksel olarak anlamli fark bulunmadi (F=1.50, p=0.22). Her üç grup dogumun 3. dönemi ortalama süreleri açisindan karsilastirildiginda istatistiksel olarak anlamli fark bulunmadi (F=1.13, p=0.32). Dogum öncesi (F=3.28, p=0.52) ve sonrasi (F=1.84, p=0.16) hematokrit degerleri açisindan gruplar arasinda istatistiksel olarak anlamli fark bulunmadi. Vücut isisi artisi, rektal yoldan 400 μg misoprostol verilen grupta diger iki gruba göre anlamli olarak yüksek bulundu. YORUM: Dogum sonu kanamayi önleme açisindan rektal misoprostol ile parenteral oksitosin tedavisi arasinda fark bulunmadi. Ancak misoprostol, özel depolanma kosullari gerektirmemesi, hipertansif hastalarda güvenle kullanilabilmesi, uzun yillar depolanabilmesi, yüksek sicakliklara dayanikli olmasi, özellikle rektal uygulandiginda bulanti, kusma gibi yan etkilerinin az görülmesi nedeniyle dogum sonu kanamanin önlenmesinde tercih edilebilir.

Background/aims: We first reported in this study that serum placenta growth factor and carcinoembryonic antigen in combination were useful markers for selecting early-stage colorectal cancer patients. The aim of the present study was to determine whether serum placenta growth factor could provide carcinoembryonic antigen-independent prognostic information on patients undergoing curative surgery. Methods: Serum and tissue samples were collected from 158 patients with colorectal cancer and from 50 controls. Serum and tissue levels of placenta growth factor were measured by enzyme-linked immunosorbent assay. The serum placenta growth factor levels in colorectal cancer patients were compared with those in healthy controls, and we retrospectively assessed the association between serum placenta growth factor levels and clinicopathological findings and survival. Results: Expression of placenta growth factor was significantly higher in colorectal cancer tissues compared with non-tumor tissues. The mean serum placenta growth factor level in patients was significantly higher than that in controls and significantly higher in patients with large tumor, lymph-node involvement and distant metastasis. Conclusions: Elevated serum placenta growth factor levels are significantly associated with colorectal cancer development, lymph or distant invasive phenotypes and survival, especially in stage II or III patients.

Thymidine kinase (TK) plays an essential role in the processing of thymidine within the cell and therefore it is an important marker of proliferation, particularly in tumor cells. The aim of our study was to determine the diagnostic and prognostic importance of TK measurement in gastric adenocarcinoma. The serum level of TK was measured in 72 patients with gastric adenocarcinoma. Serum levels of TK were significantly elevated in gastric adenocarcinoma in comparison with healthy individuals. Also, we have found that there are significant variations in TK serum concentrations when measured that correlate with important variations in clinico-pathological features and prognostic significance (Tab. 2, Ref. 16).

The total des-gamma-carboxyprothrombin (DCP) produced in pancreatic adenocarcinoma and the correlation between the tissue DCP and serum DCP levels has been examined. Fifty patients with resectable pancreatic head cancer were examined regarding both the tissue and serum levels of DCP. The mean tissue DCP in the cancer tissue, non-cancer tissue, the serum levels in patients, and the serum levels in controls was 190.500 mAU/ml mg protein, 32.000 mAU/ml mg protein, and 46.000 mAU, and 10.000 mAU, respectively. The elevation of tissue and serum levels of DCP in pancreatic adenocarcinoma patients is a very useful marker for pancreatic adnocarcinoma and should be used without any other tumor marker (Tab. 2, Ref. 15).

The major biomarker for rectal cancer is the pathologic development of the tumor. In our study, we identified Dikkopf-1 (DKK1) as a novel biomarker and a therapeutic target for rectal cancer. To emphasize the biological and clinicopathologic significance, we performed tumor tissue and serum analysis of 150 rectal cancer samples with enzyme-linked immunosorbent assay. Serum DKK-1 levels are found significantly higher in controls, in poor differentiation, and depth of invasion (in pT3 and pT4), present lymph node metastasis, and TNM stage (in pT3 and pT4) according to good differentiation, depth of invasion (in pT1 and pT2), absent lymph node metastasis, and TNM stage (in pT1 and pT2; P < 0.001 and P < 0.0001, respectively). Tissue DKK-1 levels are found in patients with rectal cancer than in control tissues ( P < 0.0001). Dikkopf-1 correlated significantly with depth of invasion ( P = 0.009), lymph node metastasis ( P = 0.028), venous involvement ( P = 0.019), and advanced pTNM stage ( P = 0.001). There was no correlation between DKK-1 and age or sex ( P > 0.05). This marker is also a potential candidate for development of rectal cancer cells and cancer progression.

Objective. Biological levels of localized colon tumors are needed for the diagnosis and prevention of colon cancer. Numerous biomarker studies are produced currently through research. We investigated some peptides with the aim of identifying biomarkers for colorectal cancer and lymphatic and hepatic metastasis. Materials and methods. A total of 100 patients with histologically proven colorectal cancer and 60 normal volunteers were included in this study. Preoperative serum was collected for analysis. Human neutrophil peptides levels (HNP) were assayed by solid phase RIA (Radio Immun Assay) based on monoclonal antibodies. Results. The HNP-1, -2 and -3-also known as alpha-defensin-1, -2 and -3-are present in elevated concentrations in the plasma from colorectal cancer patients. Conclusion. Preoperative high plasma HNP 1-3 levels are associated with colorectal cancer. The HNP 1-3 levels may procure information on patients with lymph node or hepatic metastasis.

To evaluate the levels of preoperative serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in gastric cancer.One hundred gastric cancer patients who underwent gastrectomy were enrolled in this study. The serum concentrations of MMP-1 and TIMP-1 in these patients and in fifty healthy controls were determined using an enzyme-linked immunosorbent assay.Higher serum MMP-1 and TIMP-1 levels were observed in patients than in controls (P0.001). Serum MMP-1 and TIMP-1 levels were positively associated with morphological appearance, tumor size, depth of wall invasion, lymph node metastasis, liver metastasis, perineural invasion, and pathological stage. They were not significantly associated with age, gender, tumor location, or histological type.Increased MMP-1 and TIMP-1 were associated with gastric cancer. Although these markers are not good markers for diagnosis, these markers show in advanced gastric cancer.

Background Reducing ischemic damage is one of the goals of surgery. The aim of this study was to apply human VEGF-A and FGF-2 DNA-mediated gene therapy in order to identify their effects in the healing of ischemic colon anastomoses and eliminating the negative effects of ischemia. Methods Forty male Wistar albino rats weighing 250–280 g were divided into five equal groups ( n = 8) as follows: group 1: control, ischemic left colonic anastomosis; group; 2: ischemic left colonic anastomosis with control plasmid delivery; group 3: ischemic left colonic anastomosis with VEGF plasmid delivery; group 4: ischemic left colonic anastomosis with FGF plasmid delivery; group 5: ischemic left colonic anastomosis with VEGF and FGF plasmid delivery. All rats were sacrificed on the 4th postoperative day. Anastomosis burst pressures were measured for mechanical examination of anastomosis. Tissue hydroxyprolin, VEGF and FGF levels were determined as biochemical parameters. Necrosis, epithelisation, inflammatory processes, fibroblastic activity, collagen deposition and neovascularisation at the anastomic site were studied. Results VEGF, FGF and combined therapy significantly accelerated many of the histological parameters of healing, including fibroblast activation, collagen deposition, and angiogenesis, and augmented the levels of hydroxyproline and bursting pressure. Conclusions This is the first study to use gene therapy with growth factors for the healing of ischemic colonic anastomosis. This therapy can be effectively used in increasing ischemic anastomosis wound healing.

The total des-gamma-carboxyprothrombin (DCP) produced in pancreatic adenocarcinoma and the correlation between the tissue DCP and serum DCP levels has been examined. Fifty patients with resectable pancreatic head cancer were examined regarding both the tissue and serum levels of DCP. The mean tissue DCP in the cancer tissue, non-cancer tissue, the serum levels in patients, and the serum levels in controls was 190.500 mAU/ml mg protein, 32.000 mAU/ml mg protein, and 46.000 mAU, and 10.000 mAU, respectively. The elevation of tissue and serum levels of DCP in pancreatic adenocarcinoma patients is a very useful marker for pancreatic adnocarcinoma and should be used without any other tumor marker (Tab. 2, Ref. 15). Full Text in free PDF www.bmj.sk.

BACKGROUND Gastric cancer is the second commonest cause of cancer-associated deaths in the world. Its molecular markers can be useful not only for the diagnostic pursuit but also for prognostic purposes. Endoglin was proposed as a marker of neovascularization in solid malignancies. A circulating form of endoglin is referred to as soluble endoglin (sol-end).The purpose of this study was to investigate the clinical importance of serum level of soluble form of sol-end in gastric cancer patients. MATERIALS AND METHODS Serum levels of sol-end were measured in 69 healthy controls and in 60 gastric adenocarcinoma patients with ELISA and serum levels of sol-end were compared with clinicopathological features and outcomes in gastric cancer patients. RESULTS Serum levels of sol-end in gastric adenocancer patients were significantly higher than in control patients (p

To analyze the serum levels and prognostic significance of vascular endothelial growth factor (VEGF) family (VEGF-A, -C and -D) and their receptors (VEGFR-1 and -2) in patients with hepatocellular carcinoma. The serum levels of VEGF family members were measured in 56 control subjects and 68 patients with hepatocellular carcinoma using an enzyme-linked immunosorbent assay (ELISA). These measurements were correlated with clinic pathological features. The serum levels of VEGF-A and its receptor, VEGFR-1, were significantly higher in patients with hepatocellular carcinoma than in controls (p0.001). There was no significant difference in serum levels of VEGF-C and VEGFR-2 between patients and controls. VEGF-A levels were associated with advanced tumor stage and presence of metastases. VEGFR-1 was associated with metastases, advanced overall stage, tumor differentiation. VEGFR-2 levels were associated with poor tumor differentiation. Serum VEGF levels are significantly in the same cohort of patients with variable clinic pathological features and prognostic values. The measurement of VEGF-A and its VEGFR-1 levels in sera may reflect the development of tumor, metastasis and angiogenesis (Tab. 2, Ref. 20).

The aim of this study was to analyze the serum levels and prognostic significance of vascular endothelial growth factor (VEGF)-A, -C, and -D, and their receptors, VEGFR-1 and -2 in inflammatory bowel disease (IBD). The serum levels of VEGF family members were measured in 80 control subjects and 200 patients with inflammatory bowel disease using an enzyme linked immunosorbent assay (ELISA). These measurements were evaluated with regard to the levels of inflammatory markers, such as C reactive protein (CRP) and serum amyloid A (SAA) and the clinical characteristics of patients, so that potential correlations could be recorded. A correlation between VEGF and their receptors serum levels is present in IBD patients. These new findings open the question on the potential role of VEGF and their receptors in IBD (Tab. 2, Ref. 9).

Background The incidence of hepatocellular cancer in complicated alcoholic and non-alcoholic fatty liver diseases is on the rise in western countries as well in our country. Vascular adhesion protein-1 (VAP-1) levels have been presented as new marker. In our study protocol, we assessed the value of this serum protein, as a newly postulant biomarker for hepatocellular cancer in patients with a history of alcoholic and non-alcoholic fatty liver diseases. Methods Pre-operative serum samples from 55 patients with hepatocellular cancer with a history of alcoholic and non-alcoholic fatty liver diseases and patients with cirrhosis were assessed by a quantitative sandwich ELISA using anti-VAP-1 mAbs. This technique is used to determine the levels of soluble VAP-1 (sVAP-1) in the serum. Results sVAP-1 levels were evaluated in patients with hepatocellular cancer and liver cirrhosis. There was a significant difference in mean VAP-1 levels between groups. Serum VAP-1 levels were found higher in patients with hepatocellular cancer. Conclusion These findings indicate that the serum level of sVAP-1 might be a beneficial marker of disease activity in chronic liver diseases.

Backgraund Acute-phase response proteins (APRP), cytokines and hormones have been claimed to be an independent prognostic factor of malignancies, however the basis for their association with prognosis remains unexplained. We suggest that in colon malignancies, as similar to pancreatic and lung cancers, changes in APRP are associated with angiogenesis. Methods C-reactive protein (CRP), albumin, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, midkine, VEGF-A, VEGF-C, leptin, adiponectin, and ghrelin serum levels are studied in 126 colon cancer patients and 36 healthy subjects. Results We found statistically significant difference and correlations between two groups. We found significantly higher serum CRP, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, VEGF-A, VEGF-C and leptin concentrations in patients relative to controls (p < 0.001). We found lower levels of the serum albumin, midkine, adiponectin and ghrelin in patients compared to control subjects (p < 0.001). Conclusions Cachexia in patients with colon cancers is associated with changes in APRP, cytokines and hormone concentrations. These biomarkers and cachexia together have a direct relationship with accelerated angiogenesis. This may lead to a connection between the outcomes in malignancies and the biomarkers.

The aim of this study was to analyze the serum levels and prognostic significance of vascular endothelial growth factor (VEGF)-A, -C, and -D, and their receptors, VEGFR-1 and -2 in inflammatory bowel disease (IBD).

WOS: 000356908200009 PubMed ID: 25542189 Objectives: Mesenchymal stem cells hold promise for renal disease treatment. Vascular endothelial growth factor may heal tubule-interstitial fibrosis in unilateral ureteral obstruction by inhibiting epithelial-mesenchymal transition. We investigated the protective effect of vascular endothelial growth factor in transfected mesenchymal stem cells in unilateral ureteral obstruction-induced renal injury in rats. Materials and Methods: Male Wistar Albino rats (32 rats; weight, 250-300 g) were divided into 4 equal groups: group 1, control; group 2, unilateral ureteral obstruction; group 3, unilateral ureteral obstruction and mesenchymal stem cells; and group 4, unilateral ureteral obstruction and vascular endothelial growth factor-transfected mesenchymal stem cells. Vascular endothelial growth factor-transfected mesenchymal stem cells were administered intravenously before onset of unilateral ureteral obstruction. On day 14, the rats were killed and kidneys were retrieved. Tubular necrosis, mono-nuclear cell infiltration, and interstitial fibrosis were evaluated in paraffin blocks. We evaluated green fluorescent protein-positive and vascular endothelial growth factor-positive cells; anti-inflammatory (Prostaglandin E2 Receptor) and interleukin 1 receptor antagonist), proinflammatory/anti-inflammatory (interleukin 6), and proinflammatory (MPO) cytokine expression levels; and levels of nitric oxide; transforming growth factor beta 1, E-cadherin, and hydroxyproline. Results: Green fluorescent protein-positive cells were negative in the renal parenchyma in groups 1 and 2 and positive in groups 3 and 4. Vascular endothelial growth factor levels were significantly higher in group 4. Transforming growth factor 131, nitric oxide, and E-cadherin levels were significantly higher in the unilateral ureteral obstruction than control group; however, in the study groups, these values were not significantly different from the unilateral ureteral obstruction group. In stem cell-transplanted tissue samples, EP3, interleukin 1 receptor antagonist, and interleukin 6 levels were elevated, but MPO expression levels were low. Although there were significant differences for tubular necrosis and fibrosis in group 2, there were significant reductions in tubular injury and fibrosis in groups 3 and 4. Conclusions: Systemic stem cells transplanted into the kidney protected against unilateral ureteral obstruction-induced renal epithelial-mesenchymal transition and renal fibrosis.

PubMedID: 26514466 Cancer is a major public health problem due to the jeavy disease burden, fatality and tendency for increased incidence. Of all cancer types, cervical cancer is reported to be the fourth most common cancer in women, and the seventh overall, with an estimated 528,000 new cases worldwide in 2012. It features a long preclinical phase with slowly progressing precancerous lesions such as CIN 2 and 3 and adenocarcinoma in situ. Therefore, screening programs such as with Pap smear tests may play an important role in cervical cancer prevention. The purpose of this study was to present results of a Pap smear screening survey for cervical cancer targeting women living in an urban area in the province of Mersin, located in the Mediterranean region of Turkey. This communitybased descriptive study included women living at Akdeniz county of Mersin province. A total of 1,032 screened women between 30 and 65 ages within the routine screening programme constituted the study population. The mean age of the participants was 43.8±8.6 (min. 30, max. 65) years. The percentage of the participants who had previously undergone smears was 40.6%. Epithelial cell changes were found in 26 (2.5%) participants, with ASC-US in 18 (1.7%), ASC-H in 2 (0.2%), LSIL in 5 (0.5%) and HSIL in 1 (0.1%). The most common clinical presentation together with epithelial changes was abnormal vaginal discharge. Taking into account the presence of women who had never undergone Pap test; it should be offered at primary level of health care in the form of a community-based service to achieve reduced morbidity and mortality rates.

WOS: 000352115800002 PubMed ID: 25916043 Background/Aims: The purpose of our study is researching into impact of glucagon like peptide 1 (GLP 1) analogue on liver regeneration after major hepatectomy. Methodology: 24 wistar albino rats were consecutively divided into 3 groups. Group 1: Control (sham) group day 14 (n=8), Group 2: Liver resection group day 14 (n=8); 70% Liver resection was performed, Group 3: Study group day 14 (n=8); Subsequent to performing 70% liver resection, GLP-1 analogue was administered 2 times a day (10 mu gr/70 kg x 2 times). After 14 day, rats were sacrificed. Oxidative stress and antioxidant enzymes and mitochondrial permeability transition, cytochrome-c, Bax, Bcl-2, caspase-3, caspase-8 and caspase-3 activity were examined. Results: 70% Liver resection induced oxidative stress of liver tissue was ameliorated by GLP 1 induction. Administration of GLP increased Bcl-2 expression. Decreased expression of cytochrome-c was accompanied by a decrease caspase-3, caspase-8, and Bax expression and caspase-3 activity. Conclusions: Glp 1 induction plays a regenerative role in the major hepatectomy. This effect is dependent on modulation of the antiapoptotic and antioxidative pathways by GLP 1 expression.

Hepatocyte growth factor (HGF) has been reported the cause of many biological events, including cell proliferation, invasiveness, morphogenesis, and angiogenesis. Elevated HGF content in tumor tissue was reported to predict a more aggressive biology in breast and gastric cancer patients.Eighty patients with invasive pancreatic cancer investigated. Venous blood samples were collected before the surgery. Sera were obtained by centrifugation and stored at -70 degrees C until assayed. The control group created from healthy individuals. Serum concentrations of soluble HGF were measured by the quantitative sandwich enzyme immunoassay technique.The mean value of serum soluble HGF in patients with invasive pancreatic cancer was 497.2 +/- 53.8 pg/ml and that of control group was 53.6 +/- 7.5 pg/ml and the difference was significant (p0.001).The serum levels of soluble HGF might reflect the severity of invasive pancreatic cancer and deserve further evaluation (Tab. 2, Ref. 19). Full Text (Free, PDF) www.bmj.sk.

Mesenchymal stem cells hold promise for renal disease treatment. Vascular endothelial growth factor may heal tubule-interstitial fibrosis in unilateral ureteral obstruction by inhibiting epithelial-mesenchymal transition. We investigated the protective effect of vascular endothelial growth factor in transfected mesenchymal stem cells in unilateral ureteral obstruction-induced renal injury in rats.Male Wistar Albino rats (32 rats; weight, 250-300 g) were divided into 4 equal groups: group 1, control; group 2, unilateral ureteral obstruction; group 3, unilateral ureteral obstruction and mesenchymal stem cells; and group 4, unilateral ureteral obstruction and vascular endothelial growth factor-transfected mesenchymal stem cells. Vascular endothelial growth factor-transfected mesenchymal stem cells were administered intravenously before onset of unilateral ureteral obstruction. On day 14, the rats were killed and kidneys were retrieved. Tubular necrosis, mononuclear cell infiltration, and interstitial fibrosis were evaluated in paraffin blocks. We evaluated green fluorescent protein-positive and vascular endothelial growth factor-positive cells; anti-inflammatory (Prostaglandin E2 receptor) and interleukin 1 receptor antagonist), proinflammatory/anti-inflammatory (interleukin 6), and proinflammatory (MPO) cytokine expression levels; and levels of nitric oxide; transforming growth factor β1, E-cadherin, and hydroxyproline.Green fluorescent protein-positive cells were negative in the renal parenchyma in groups 1 and 2 and positive in groups 3 and 4. Vascular endothelial growth factor levels were significantly higher in group 4. Transforming growth factor β1, nitric oxide, and E-cadherin levels were significantly higher in the unilateral ureteral obstruction than control group; however, in the study groups, these values were not significantly different from the unilateral ureteral obstruction group. In stem cell-transplanted tissue samples, EP3, interleukin 1 receptor antagonist, and interleukin 6 levels were elevated, but MPO expression levels were low. Although there were significant differences for tubular necrosis and fibrosis in group 2, there were significant reductions in tubular injury and fibrosis in groups 3 and 4.Systemic stem cells transplanted into the kidney protected against unilateral ureteral obstruction-induced renal epithelial-mesenchymal transition and renal fibrosis.

Aim: Cholangiocarcinoma is generally detected late in the course of disease, and current diagnostic techniques often fail to differentiate benign from malignant disease. Ongoing biomarker studies for early diagnosis of cholangiocarcinoma are still continues. By this study, we analyzed the roles of serum and biliary MMP-9 and TIMP-1 concentrations in the diagnosis of cholangiocarcinoma. Materials and methods: The 113 patients (55 males, 58 females) were included; 33 diagnosed with cholangiocarcinoma (malignant group) and 80 diagnosed with choledocholithiasis (benign group). MMP-9 and TIMP-1 concentrations were analyzed in serum and bile and compared in the malignant and benign groups. Results were evaluated statistically. Results: Biliary MMP-9 concentrations were significantly higher (576 ± 209 vs. 403 ± 140 ng/ml, p < 0.01) and biliary TIMP-1 concentrations were significantly lower (22.4 ± 4.9 vs. 29.4 ± 6.1 ng/ml, p < 0.01) in the malignant than in the benign group. In contrast, serum MMP-9 and TIMP-1 concentrations were similar in the two groups. Receiver operating curve analysis revealed that the areas under the curve of bile MMP-9 and TIMP-1 were significantly higher than 0.5 (p < 0.001). The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and accuracy were 0.94, 0.32, 0.36, 0.93, 1.40, 0.19 and 0.5 for biliary MMP-9, respectively, and 0.97, 0.36, 0.39, 0.97, 1.5, 0.08 and 0.54 for biliary TIMP-1, respectively. Conclusion: Serum and biliary MMP-9 and TIMP-1 tests do not appear to be useful in the diagnosis of cholangiocarcinoma.

Phyllodes Tumor is a rare fibroepithelial breast tumor with variable malignant potential. These tumors that currently accepted nomenclature are benign, borderline and malignant according to the World Health Organization. It tends to behave in a benign way but it may undergo a malignant transformation. The purpose of this study was to present our Case load of phyllodes tumor, and evaluate the management and follow-up the behavior of these tumors.36 patients with phyllodes tumor were treated in Bezmialem Vakif University and Okmeydani Training and Research Hospitals analyzed retrospectively. Demographics, presenting symptoms, history, local examination, preoperative clinical diagnosis, treatment, postoperative histopatology, follow-up period were evaluated retrospectively and studied.A total of 36 patients treated for phyllodes tumor were analyzed. Mean age of the patients was 38 (14-79) and all were females. The presentation of the patients was breast lump in all cases, either as a primary or recurrent lump presentation. The right and left breast were affected 58% and 42% respectively. 34 of these 36 cases are briefly mentioned in this paper but the two cases, one with sarcomatous malignant transformation and the other with fatal metastatic phyllodes tumor in an adolescent female are discussed in detail. The mean duration of the symptomatic mass was 9.8 ± 7.3 months (range 0.5 to 24).Phyllodes tumor is a type of tumor that may be benign or malignant. The type with malignant features may be fatal. The tumors diagnosed as benign may transform and become malignant because of unknown reasons and may be an aggressive tumor.

Ophthalmic involvement appears rarely in multiple myeloma (MM). Ophthalmic findings are mostly noted as complications caused by disease or treatment. MM-associated with 6th nerve paralysis is a rare entity. Bortezomib, one of the novel agents used to treat MM, has neurotoxic effect and may cause permanent nerve damage. Herein, we report a 50-year-old male patient with MM who developed the 6th nerve paralysis while receiving bortezomib and discuss its relevant causes.

Background: Emergency cases become a widespread problem in prisons across Turkey. The opening of a new prison hospital in January 2012 within the catchment of Silivri Penitentiary Institution gave a unique opportunity to treat the inmates quickly. Aims: The study was to conduct an extensive review for documentation of prisoners' healthcare problems leading to emergency admission following the first year after the opening of Penitentiary Institution Hospital and point to decrease redundant hospital transfers of this individual cohort. Materials and Methods: A cross-sectional study was carried out where 12,325 visits to the Silivri Penitentiary Institution Hospital for emergency visits from the period of 1 st January 2012 to the 31 st December 2012 were identified from electronic medical records. After obtaining consent from the local IRB, data including details of the type, cause and nature of the complaints of the illnesses were processed. Results: In the 12-month period, there were 12,325 visits to the emergency department, of which 4328 for surgical conditions (35.1%), 2684 for medical disorders (21.8%), 1867 for sports injuries (15.2%), 1327 for Ear Nose Throat (ENT) problems (10.8%), 827 for psychiatric disorders (6.70%), 396 for violence injury (3.2%), 169 for self harm (1.4%), and 727 for miscellaneous (5.8%). The most common cause of emergency visits was sports injuries, followed by non-specific abdominal pain and ENT problems. Eighteen prisoners re-attended 243 times, ranging from 8 visits to a maximum of 56 visits. Conclusion: Inmates in prison have a wide range of complaints, and sometimes these complaints do not suggest an illness. Prison population exhibited substantially higher prevalence rates of diseases than the civilian population. We conclude that this new healthcare system in prisons will prevent redundant hospital transfers and guarantee detainees have access to the same health care that is offered to non-detained population.

– OBJECTIVE: Phyllodes Tumor is a rare fibroepithelial breast tumor with variable malignant potential. These tumors that currently accepted nomenclature are benign, borderline and malignant according to the World Health Organization. It tends to behave in a benign way but it may undergo a malignant transformation. The purpose of this study was to present our Case load of phyllodes tumor, and evaluate the management and follow-up the behavior of these tumors. PATIENTS AND METHODS: 36 patients with phyllodes tumor were treated in Bezmialem Vakif University and Okmeydani Training and Research Hospitals analyzed retrospectively. Demographics, presenting symptoms, history, local examination, preoperative clinical diagnosis, treatment, postoperative histopatology, followup period were evaluated retrospectively and studied. RESULTS: A total of 36 patients treated for phyllodes tumor were analyzed. Mean age of the patients was 38 (14-79) and all were females. The presentation of the patients was breast lump in all cases, either as a primary or recurrent lump presentation. The right and left breast were affected 58% and 42% respectively. 34 of these 36 cases are briefly mentioned in this paper but the two cases, one with sarcomatous malignant transformation and the other with fatal metastatic phyllodes tumor in an adolescent female are discussed in detail. The mean duration of the symptomatic mass was 9.8 ± 7.3 months (range 0.5 to 24). CONCLUSIONS: Phyllodes tumor is a type of tumor that may be benign or malignant. The type with malignant features may be fatal. The tumors diagnosed as benign may transform and become malignant because of unknown reasons and may be an aggressive tumor.

Objective: We aimed to evaluate the effect of preinduction cervical length and Bishop score for induction-to-delivery interval in nulliparae and multiparae. Materials and Methods: A total of 97 pregnant women (55 nulliparae, 42 multiparae) between 35 and 44 weeks of gestation were included in the study. Misoprostol 50 g tablet was used as labour induction agent intravaginally. Cervical length measurement was obtained by transperineal ultrasonographic approach and Bishop score was determined with digital examination. While Mann-Whitney U test, Pearson correlation, spearman correlation and multiple linear regressions were used for continuous variables, chi-square test was used for categorical variables. Receiver Operating Characteristics Curve was used for bishop score and cervical length. Results: All vaginal deliveries were occurred within 24 hours. Eighth patients (8.2%) had nausea, 1 had (1%) vomiting, 9 had (9.3%) tachysystoly and 5 had (5.1%) hiperstimulation. Eight pregnant women (8.2%) were delivered with caesarean section. In nulliparous and multiparous women, Bishop score and cervical length showed correlation (r=0.752, p=0.000; r=0.691, p=0.000; respectively). Cervical length (r=0.490, p=0.000) and Bishop score (r=0.455, p=0.01) were correlated in nulliparae whereas only Bishop score (r=0.441, p=0.04) were correlated in multiparae. To determine the induction-to-delivery time using multiple linear regression, the cervical length for multiparae (t=3.850, p=0.000) and the Bishop Score for multiparae (t=11.222, p=0.000) were the only independent variables. Receiver operating characteristics for induction-to-delivery time curve showed that cervix length was better than Bishop score in nulliparae whereas the Bishop Score was better than cervical length in multiparae. Conclusion: Fifty g misoprostol intravaginally was found successful in induction of delivery. To determine induction-to-delivery time in pregnancies, cervical length in nulliparae and Bishop score in multiparae was found more suitable., Amaç: Nullipar ve multipar gebelerde indüksiyon öncesi ultrasonografik servikal uzunluk ve Bishop skorunun indüksiyon-doğum süresine etkisini araştırdık. Gereç ve Yöntem: Çalışmaya 35-44 gebelik haftaları arasında değişen 97 gebe (55 nullipar, 42 multipar) alındı; indüksiyon amacıyla intravaginal yoldan misoprostol 50 g tablet kullanıldı; Bishop skoru dijital muayene ile belirlendi; servikal uzunluk transperineal ultrasonografi ile ölçüldü. Sürekli değişkenler için Mann-Whitney U testi, Pearson korelasyon, Spearman korelasyon ve çoklu doğrusal regresyon kullanıldı. Kategorik değişkenler için ÷2 testi kullanıldı. Bishop skoru ve servikal uzunluk için Receiver Operating Characteristic (ROC) eğrisi çizildi. Bulgular: Bütün vaginal doğumlar 24 saat içerisinde gerçekleşti. Bulantı 8 (%8.2), kusma 1 (%1) taşisistoli 9 (%9.3), hiperstimülasyon 5 (%5.1) gebede görüldü. Sekiz olgu (%8.2) sezaryen ile doğurtuldu. Nullipar ve multipar gebelerde Bishop skoru ve servikal uzunluk (sırasıyla r=0.752, p=0.000; r=0.691, p=0.000) korelasyon gösterdi. Nullipar gebelerde indüksiyon-doğum süresi ile servikal uzunluk (r=0.490, p=0.000) ve Bishop skoru (r=0.455, p=0.01) korelasyon gösterdi, multiparlarda ise sadece Bishop skorunda (r=0.441, p=0.004) korelasyon bulundu. Çoklu doğrusal regresyon modeline göre nullipar gebelerde servikal uzunluk (t=3.850, p=0.000), multipar gebelerde ise Bishop skorunun (t=11.222, p=0.000) tek bağımsız değişken olduğu görüldü. ROC eğrisine göre nulliparlarda indüksiyon-doğum süresini belirlemede servikal uzunluğun, multiparlarda ise Bishop skorunun daha iyi olduğu bulundu. Sonuç: İntravaginal yoldan misoprostol 50 g uygulaması doğum indüksiyonunda başarılı bulundu. İndüksiyon-doğum süresini belirlemede nullipar gebelerde servikal uzunluğun, multipar gebelerde ise Bishop skorunun kullanılmasının daha uygun olduğu sonucuna varıldı.

Skin-sparing mastectomy with sentinel lymph node biopsy (SLNB) and synchronous breast reconstruction are widely used in breast cancer surgery nowadays. Difficulties in feeling confident in this technique and postoperative surgical complications are the major obstacles against the widespread usage of this technique. Compared with the other surgical techniques, the complications are hard to treat. Cutaneous necrosis because of methylene blue used for sentinel lymph node mapping in patients who underwent skin-sparing mastectomy and SLNB is already reported in the literature. We present here two cases with cutaneous necrosis because of isosulphane blue injection after skin-sparing mastectomy and SLNB as a rare complication of dye injection.

We investigated the relationship between serum levels of total sialic acid, lipid bound sialic acid and acute pancreatitis in a rat model of a common bile duct ligation induced acute pancreatitis.Twenty five Sprague-Dawley male rats weighing 250-300 g were divided into two groups (n=10: control, n=15: experimental). In the control group only a sham laparotomy was performed. In the experimental group, acute pancreatitis was induced by common pancreatobiliary tract ligation. After 36 hours the rats were killed and amylase, serum total sialic acid, lipid bound sialic acid and lipid profiles were measured. Histopathological confirmation of acute pancreatitis was done using hematoxylin and eosin staining.Mean amylase, total sialic acid (TSA) and lipid bound sialic acid (LBSA) measurements in the experimental group were significantly higher than in the control group. There was no significant difference in the lipid profiles between the two groups.Increased levels of TSA and LBSA can be useful as specific markers in the diagnosis of acute pancreatitis independent of serum lipid profile.

BACKGROUND Age-associated immune senescence is a catch-all phrase that has been used to describe a plethora of changes to the immune system across the lifespan. Aging is associated with a decline in immune function. Our aim in this study was to investigate how lymphocyte subgroups in peripheral blood are affected by aging among males and females. MATERIAL/METHODS Study participants were 70 healthy individuals from 3 different age groups, observed from January 2010 to January 2012. The average levels of CD3+, CD4+, CD8+, CD19+, CD16+/CD56+, CD3+/CD69+, and CD19+/CD69+ were determined for each group and compared in terms of age and sex. RESULTS We found significant reduction in the level of CD3+T cells related with age, but no significant changes in CD19+ B cell levels (p

The relationship between papillary thyroid carcinoma (PTC) and accompanying Hashimoto's thyroiditis (HT) has been investigated extensively. However, there is no agreement among the authors. We aimed with this study to investigate this relationship in a limited subtype of PTC called papillary thyroid microcarcinoma (PTMC).Between January 1999 and December 2012, 1923 thyroids were surgically resected in two referral centers and thoroughly inspected for evidence of PTMC. Of these patients, 172 who were diagnosed with PTMC had demographic and pathological features recorded.Fourteen patients (8.1%) were found to have CLN metastases. Eleven (78.6%) of the patients with CLN metastases had tumors larger than 5 mm, and 3 (21.4%) patients with CLN metastases had small tumors (≤ 5 mm), but there was no statistical significance (p0.05). Accompanying Hashimoto's thyroiditis (HT) was detected in 67 (39%) patients. The CLN metastasis rate was slightly higher in cases with HT in surrounding thyroid tissue. However, there was no statistical significance; the CLN rate was 6.7% (n=7) in patients without thyroiditis and 10.4% (n=7) with Hashimoto's thyroiditis. Insufficient FNA results in patients with thyroiditis were associated with HT (p0.05).Surgeons and other clinicians who play a role in the treatment of thyroid cancers should be aware that some PTMC cases may show a worse course, as with some PTCs, contrary to expectations.

AIM: The relationship between papillary thyroid carcinoma (PTC) and accompanying Hashimoto's thyroiditis (HT) has been investigated extensively. However, there is no agreement among the authors. We aimed with this study to investigate this relationship in a limited subtype of PTC called papillary thyroid microcarcinoma (PTMC).

OBJECTIVE: The aim of this study was to compare the LigaSure (R) Small Jaw Instrument (LSJI) with the conventional clamp-and-tie (CT) technique in thyroid surgery regarding complication rates (hematoma, hypocalcemia and recurrent nerve palsy), the duration of the operative procedure, and systemic and local inflammatory effects.

Cholangitis and pancreatitis are the most gruesome complications that can be potentially fatal for the mother and fetus. The management of bile stone disease complicated with duct stones during pregnancy is challenging. Conservative treatment instead of surgery has always been advocated due to the increased risk for fetal compromise. Minimally invasive therapy with ERCP has been suggested as an effective therapeutic option for the management of pancreaticobiliary diseases during pregnancy. The main topics of discussion are the risks stemming from the endoscopic procedure itself, drugs used for sedation and the adverse effects of radiation exposure on the fetus. In this manuscript, we want to present the efficiency and feasibility of the ERCP for the management of hepatobiliary and pancreatic diseases in pregnancy.

Background/Aims: The aim of this study is to present the advantages of LAGB (Laparoscopic adjustable gastric banding), its effects on weight loss and influence on comorbidities such as diabetes and hypertension. Methodology: 90 middle-aged obese patients with body mass index [BMI] of 35-50 kg/m(2) underwent LAGB between October 2007 and April 2010. Results: There were 33 men and 57 women underwent LAGB. The ages of the cases ranged from 22 to 39 years [mean 29.5 years]. The percentage of decrease on BMI at the 3, 6, 12, 24 month marks were 9.85%, 14.8%, 25.8% and 32.9%, respectively. No early operative complications were recorded. Pouch dilation occured in 6 patients and band erosion-migration was observed in 3 patient. Conclusion: LAGB is a safe and effective approach in short-term management of morbid obesity. Weight loss, complications and resolution of comorbidities are comparable with the other obesity procedures.

Cholangitis and pancreatitis are the most gruesome complications that can be potentially fatal for the mother and fetus. The management of bile stone disease complicated with duct stones during pregnancy is challenging. Conservative treatment instead of surgery has always been advocated due to the increased risk for fetal compromise. Minimally invasive therapy with ERCP has been suggested as an effective therapeutic option for the management of pancreaticobiliary diseases during pregnancy. The main topics of discussion are the risks stemming from the endoscopic procedure itself, drugs used for sedation and the adverse effects of radiation exposure on the fetus. In this manuscript, we want to present the efficiency and feasibility of the ERCP for the management of hepatobiliary and pancreatic diseases in pregnancy.

Background: Evidence indicates that Dickkopf-1 (DKK-1) levels may be a biomarker for cancer risk. The aim of this study was to assess DKK-1 and its correlation with clinic-pathological features in patients with bladder cancer. Materials and Methods: DKK-1 levels were determined in serum samples from 90 patients with bladder cancer before transurethral tumor resection. The concentrations of DKK-1 were determined by using enzyme linked immune-sorbent assay (ELISA). Results: Elevated preoperative DKK-1 levels were associated with tumor stage (p

TürkoloJi sahasıımı önemli bilim adamlanndan Prof. Dr. Lars Johanson 'a ilk arınağan altnuşıncı doğum yıldönümü olan 8 Mart 1996 ·da meslektaşları tarafından lıazırlaıup yayımlaıunıştı. (Taıutına için bkz.· Fikret Turaıı. ,~vmholae Turcologıcae: Studıes 111 Honour (~lLars Johanson On hıs Sıxtıeth Bırthelay 8 March 1996. Edited by Arpad Berta, Bernt Brendemoen aııd Claus Schönig. Swedish Research lnstıtute in Istanbul, Transactions Vol. 6, ISSN I 100-0333. Upsala. 246 sayfa. llmi Araştırmalar 6, s 361-364) Şımdi de öğrencilerınden Nurettin Denur ve Fikret Turan ·m hazırladığı mınağan kitabı elimizde. Kitapta değerli yimü yedi makale ve Johanson ·un eserlerinin tam bibliyografyası verildikten başka, hayatı ve çalışma yöntemleriyle ılgili Hocayı tanıtıcı bilgilerden oluşan bir hayat hikayesine de yer verilmiş. Makaleler genel olarak Türk Dili ve Türk Edebiyatı ıle ilgilidir ve on dördü Türkçe. yedisi Alımmca. altısı da İngilizcedir. Eser annağaımı hazırlanması için yazı gönderenlere teşekkür edilen Ingilizce ve olarak hazırlanmış önsozle başlar. Dalıa sonra vine İngılizce ve Türkçe olarak, Yazı Hayatı, Yeni Modeller, İşbirliği ve iletişime Verdi ğİ Önem, Turkologıca Serisi ve Hocalığı ·başlıkları altında Lars Johanson tanıtıl

Purpose Ventricular noncompaction/hypertrabeculation (NC/HT) is a rare form of congenital cardiomyopathy. We aimed to investigate the presence of serum tenascin-C (TN-C) in adult patients with NC/HT and evaluate its value. Methods and Results Serum TN-C levels were measured by ELISA in 50 NC/HT patients both with/without systolic dysfunction and in 23 normal controls. Systolic dysfunction was defined as ejection fraction (EF) ≤ 40. Mann–Whitney U-test and ROC curve analysis were done. Of 49 NC/HT patients, 24 (49%) patients had systolic dysfunction (mean age 36 ± 15) and 25 patients (51%) had normal systolic function (mean age 36 ± 17). The ages between groups were not different. The mean levels of serum TN-C in patients with or without systolic dysfunction were 26 ± 10 ng/mL and 26 ± 8 ng/mL respectively, compared to normal controls, 7 ± 2 ng/mL (P

Purpose Necrotizing enterocolitis (NEC) is a serious condition, predominantly observed in premature infants. We used an experimental NEC model to investigate the effects of vascular endothelial growth factor (VEGF) cloned into a plasmid. Materials and methods Twenty-four newborn Wistar albino rats were randomized equally into three groups as follows: control, NEC and NEC?VEGF. NEC was induced by hyperosmolar enteral formula feeding, exposure to hypoxia/reoxygenation and cold stress. In the NEC?VEGF group, VEGF (1 lg) incorporated into plasmid (2 lg) was administered subcutaneously once daily for a total of 3 days starting on the first day of the NEC procedure. All rats were sacrificed on the 4th day of life, and the specimens were harvested for histopathological and biochemical examinations [including tissue oxidative stress (malondialdehyde and nitric oxide), inflammation (myeloperoxidase, interleukin-6 and tumor necrosis factor alpha) and apoptosis (caspase-3 activity) parameters]. Results In the NEC?VEGF group, tissue malondialdehyde, nitric oxide, interleukin-6, tumor necrosis factor alpha levels and caspase-3 activity were significantly decreased. In addition, the myeloperoxidase level was increased compared to that of the NEC group (p \ 0.05). Histopathologically, VEGF overexpression enhanced angiogenesis, alleviated villous atrophy and tissue edema (p \ 0.05). Conclusion VEGF overexpression with plasmids seems to be a promising approach in the management of NEC.

Cardiac involvement in sarcoidosis has been associated with poor prognosis. We evaluated myocardial contractility quantitatively in a cohort of pulmonary sarcoidosis (PS) patients with and without cardiac involvement. We also studied markers of fibrosis (tenascin-C [Tn-C] and galectin-3 [Gl-3]) as diagnostic tools for PS and cardiac sarcoidosis (CS).Forty ambulatory patients with PS of grades 1-2 and 26 healthy subjects were prospectively enrolled. All patients with PS underwent cardiac magnetic resonance (CMR) to explore the presence of CS. The study population was divided into three groups: controls (n = 26), non-CS patients (n = 34), and CS patients (n = 6). Speckle-tracking strain echocardiography (STE) was performed on all patients, and Gl-3 and Tn-C values were measured in all patients and controls.PS patients had higher levels of Gl-3 and Tn-C than did controls, and the STE parameters of PS patients, including global longitudinal strain (GLS) and global circumferential strain (GCS), were lower than those of controls (p0.001 for all comparisons). GLS values were lower in CS patients than in the other groups (p = 0.05).PS patients demonstrate reduced cardiac contractility, independent of CMR-proven structural cardiac lesions, while patients with structural lesions have a more pronounced drop in strain parameters. Tn-C and Gl-3 are promising markers for the diagnosis of PS, but they are not specific for cardiac involvement.

OBJECTIVE: Our aim was to investigate the effects of growth hormone (GH), hyperbaric oxygen and combined therapy on normal and ischemic colonic anastomoses in rats. METHODS: Eighty male Wistar rats were divided into eight groups (n = 10). In the first four groups, non-ischemic colonic anastomosis was performed, whereas in the remaining four groups, ischemic colonic anastomosis was performed. In groups 5, 6, 7, and 8, colonic ischemia was established by ligating 2 cm of the mesocolon on either side of the anastomosis. The control groups (1 and 5) received no treatment. Hyperbaric oxygen therapy was initiated immediately after surgery and continued for 4 days in groups 3 and 4. Groups 2 and 6 received recombinant human growth hormone, whereas groups 4 and 8 received GH and hyperbaric oxygen treatment. Relaparotomy was performed on postoperative day 4, and a perianastomotic colon segment 2 cm in length was excised for the detection of biochemical and mechanical parameters of anastomotic healing and histopathological evaluation. RESULTS: Combined treatment with hyperbaric oxygen and GH increased the mean bursting pressure values in all of the groups, and a statistically significant increase was noted in the ischemic groups compared to the controls (p