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Background: Sexual functions in women with lymphedema secondary to breast cancer surgery have not been investigated sufficiently. This study aimed to compare patients with and without lymphedema af...

Objective: The aim of this study was to evaluate the surgical method and systemic treatment results, recurrence, and mortality rates in patients whose histopathological results were ductal carcinoma in situ (DCIS) following breast surgery in our general surgery clinic.Methods: A retrospective review was made of the preoperative and postoperative histopathological results of all patients who underwent breast surgery in our general surgery clinic between January 2016 and January 2021. The demographic data, clinicopathological features, postoperative systemic treatments, local recurrence (LR) rate, and overall survival (OS) rate of patients whose histopathological results were reported as DCIS were obtained from the data system of our hospital and the national death reporting system. Results: The study group consisted of 24 female patients with a histopathology result of DCIS. The average age of the patients was 49.96 ± 10.61 years. In the localization of the lesions in the breast, 11 (45.8%) were observed as unifocal, 7 (29.2%) as multifocal, and 6 (25%) as multicentric. The most common type of operation was lumpectomy (n = 16, 66.7%). Sentinel lymph node biopsy was performed in 8 patients. The mean follow-up period of the patients after surgery was 32.20 ± 18.22 months. Anti-estrogen hormone therapy (HT) was applied to 21 (87.5%) patients and radiotherapy (RT) to 14 (58.3%) after the operation. There was no recurrence in any of the patients and no mortality was observed.Conclusion: With a multidisciplinary approach and good preoperative staging, as applied in our general surgery clinic, it can be recommended that the most appropriate surgical method is applied, and risk factors determined for DCIS patients. RT is recommended for eligible patients after BCS and HT in estrogen receptor+ patients., Amaç: Bu çalışmada genel cerrahi kliniğimizde meme cerrahisi yapılan hastalarda histopatolojik sonucu duktal karsinoma in situ (DKİS) gelen hastalarımızın cerrahi yöntem ve sistemik tedavi sonuçlarını, rekürens ve mortalite oranlarını değerlendirmeyi amaçladık .Yöntem: Ocak 2016 ile Ocak 2021 tarihleri arasında, genel cerrahi kliniğiniğimizde meme cerrahisi geçiren tüm hastaların preoperatif ve postoperatif histopatolojik sonuçları incelendi. Histopatolojik sonucu DKİS gelen hastaların demografik verileri, klinikopatolojik özellikleri, reoperasyon sayısı, postoperatif radyoterapi (RT), anti-östrojen hormon tedavisi (HT), lokal rekürens (LR) oranı, ve genel sağkalım (GS) oranı hastanemiz veri datasından ve ulusal ölüm bildirim sisteminden retrospektif olarak incelendi.Bulgular: Çalışma grubu histopaptolojk sonucu DKİS gelen toplam 24 kadın hastadan oluşmakta idi. Grubun ortalama yaşı 49,96 ± 10,61’dir. Lezyonların meme içinde yerleşiminde, 11 (45,8%) ‘ i tek odaklı, 7 (%29,2) ‘si multifocal ve 6 (%25)’ sı ise multisentrik olarak gözlenmiştir. En sık uygulanan operasyon tipi lumpektomidir (n=16, 66,7%). 8 hastaya sentinel lenf nodu biyopsisi yapılmıştır. Ortanca tümör boyutu 12,5 (4-70) mm’dir. En sık görülen moleküler tip Luminal A’ dır (n=14, 58,3%). Lezyona en yakın cerrahi sınır uzaklığı ortanca 5 (0-20) mm’dir. Hastaların cerrahi sonrası ortalama takip süresi 32,20 ± 18,22 aydır. Hastaların 87,5%’si (n=21) operasyon sonrası HT ve 58,3%’ü (n=14) RT almıştır. Hastaların hiçbirinde nüks gelişmemiştir ve mortalite gözlenmedi.Sonuç: Genel cerrahi kliniğimiz olarak multidisipliner yaklaşım ve iyi bir preoperatif evreleme ile DKİS hastalarına en uygun cerrahi yöntemi ve risk faktörlerini de değerlendirerek uygun hastalarda meme koruyucu cerrahi sonrası RT ve Östrojen reseptörü+ hastalarda HT ‘ yi öneriyoruz.

Aim: De Ritis ratio (aspartate transaminase/alanine transaminase) may be a useful prognostic biomarker for certain malignant tumors. However, the predictive value of the De Ritis ratio before treatment in preoperative staging in patients with breast cancer is unknown. This study aimed to evaluate the De Ritis ratio in benign and malignant breast diseases and investigate the predictive value of it for breast cancer. Methods: Retrospective analysis was made of the clinicopathological data of 301 patients with benign breast disease and breast cancer treated between April 2017 and April 2020 in a single center. 64 Patients were excluded from the study due to chronic illness or incomplete data. The relationship between the De Ritis ratio and clinicopathological findings before treatment was evaluated in patients. The Mann Whitney U test and Kruskal Wallis test were used in the comparisons between groups. Results: Of the total 237 patients, the number of patients with benign breast disease was 96 and the number of the patients with breast cancer was 141. No statistically significant results were determined between the benign breast disease and breast cancer groups, in respect of pre-treatment evaluation of the De Ritis ratio and as a predictive factor for preoperative staging in molecular subtyping, tumor diameter, lymph node metastasis, and Ki 67 index.Conclusion: It was concluded that the De Ritis ratio examined before treatment was not an independent predictive factor in breast cancer diagnosis and staging., Amaç: De Ritis oranı (aspartat transaminaz / alanin transaminaz) belirli malign tümörler için yararlı bir prognostik biyobelirteç olabilir. Bununla birlikte, meme kanseri olan hastalarda tedavi öncesi incelenen De Ritis oranının preop evrelemede prediktif değeri büyük ölçüde bilinmemektedir. Bu çalışmanın amacı, benign ve malign meme hastalıklarında De Ritis oranını değerlendirmek ve bunun meme kanseri için prediktif değerini araştırmaktır. Yöntemler: Nisan 2017- nisan 2020 yılları arasında benign meme hastalığı ve meme kanserli 301 hastanın klinikopatolojik verileri tek bir merkezde retrospektif olarak analiz edildi. Kronik hastalığı olan veya veri eksiği olan 64 hasta çalışmadan çıkarıldı. De Ritis oranının tedavi öncesi değeri ile, hastaların klinikopatolojik bulguları arasındaki ilişki değerlendirildi. Gruplar arası karşılaştırmalarda Mann Whitney U testi ve Kruskal Wallis testi kullanıldı. Bulgular: 237 hastada, benign meme hastalığı olan 96, meme kanseri olan hasta sayısı ise 141 idi. De ritis oranın tedavi öncesi değeri ile, benign meme hastalığı ve meme kanseri arasında, ayrıca meme kanserinde prognostik faktör olan moleküler subtiplendirme, tümör çapı, lenf nodu metastazı ve Ki 67 indeksinde preoperatif evrelemede prediktif faktör olarak istatisksel anlamlı sonuçlara ulaşılamadı. Sonuç: Tedavi öncesi incelenen De ritis oranın meme kanseri evrelemesinde bağımsız prediktif faktör olmadığı sonucuna ulaşıldı.

Background: Primary hyperparathyroidism (pHPT) caused by a single benign parathyroid adenoma is a common endocrine disorder that is affected by regional differences. Living in different geographical regions reveals differences in the laboratory results and pathological findings, but studies on this subject are not sufficient. The article focuses on biochemical and pathological effects of geographical differences in parathyroid adenoma. In addition, the present study seeks to elaborate on treatment methods and effectiveness of screening in geographical area of Bulgaria and Turkey. Method: In this prospective study, 159 patients were included from 16 centres. Demographic characteristics, symptoms, biochemical markers and pathologic characteristics were analysed and compared between 8 different regions. Results: Patients from Turkish Black Sea had the highest median serum calcium (Ca) level, whereas patients from Eastern Turkey had the lowest median serum phosphorus (P) level. On the other hand, there was no significant difference between Ca, parathormone (PTH) and P levels according to regions. Patients from Eastern Turkey had the highest adenoma weight, while patients from Bulgaria had the lowest adenoma weight. The weight of adenoma showed statistically significant differences between regions (p < 0.001). There was a correlation between adenoma weight and serum PTH level (p = 0.05) and Ca level (p = 0.035). Conclusion: This study has provided a deeper insight into the effect of the regional differences upon clinicopathological changing and biochemical values of pHTP patients with adenoma. Awareness of regional differences will assist in biochemical screening and treatment of this patient group. (c) 2021 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Aim: Breast cancer is the most common cancer among women and is one of the main causes of death in women. It is known that some metabolic components that are risk factors for non-alcoholic fatty liver disease are also risk factors for breast cancer. The aim of this retrospective cohort study was to show the prevalence of non-alcoholic fatty liver disease breast cancer patients and the effect of non-alcoholic fatty liver disease on breast cancer development through comparisons with a control group with normal mammography. Material and Method: The study included 108 patients who were operated on for breast cancer in the general surgery clinic of our hospital between January 2015 and December 2018 and who underwent abdominal ultrasound for breast cancer staging. A control group was formed of 102 women with benign breast lesions on routine mammography and who underwent abdominal ultrasound within 6 months before mammography. The prevalence of diabetes, hypertension and hyperlipidemia and body mass indexes were similar in both groups. Results: In the evaluation of all the study participants, an association was found between non-alcoholic fatty liver disease and breast cancer. In the obese and non-obese subgroups, non-alcoholic fatty liver disease was significantly associated with breast cancer in the non-obese subgroup. [OR 2.67%, 95% confidence interval [95% CI) 1.1-6.0, p=0.020]. Conclusion: Non-alcoholic fatty liver disease was seen to be significantly associated with breast cancer regardless of known risk factors. This relationship there was in non-obese women with NAFLD, but not in the obese group.

Purpose: To investigate the potential protective effects of erdosteine against the harmful effects of ischemia-reperfusion injury on the liver in an experimental rat model. Methods: Forty rats were divided into 4 groups. In the sham group, only the hepatic pedicle was mobilized. No other manipulation or treatment was performed. In the other groups, ischemia was achieved by clamping the hepatic pedicle for 60 min. After that, 90 min reperfusion was provided. In the control group, no treatment was given. In the perioperative treatment group, 100 mg/kg erdosteine was administered 2 hours before ischemia induction. In the preoperative treatment group, 100 mg/kg/day erdosteine was administered daily for ten days before the operation. At the end of the procedures, blood and liver samples were obtained for biochemical and histopathological assessment. Results: Treatment with erdosteine ameliorated the histopathological abnormalities when compared with the control group. Furthermore, this treatment significantly decreased the serum liver function test values. It was also found that erdosteine ameliorated the oxidative stress parameters in both the perioperative and preoperative treatment groups. Conclusion: The current study is the first to have shown the favorable effects of erdosteine on the harmful effects of experimental hepatic ischemia-reperfusion injury.

The extent of dissection for differentiated thyroid cancer in the neck is a balance between the greater morbidity of more extensive neck dissection and the possibility of leaving residual untreated metastatic lymph nodes. Therapeutic unilateral nodal dissection is performed for cN1b disease. In order to prevent morbidities and to prevent overtreatment, it is suggested that risk factors of ipsilateral and contralateral central lymph node metastases should be considered while planning the extent of central lymph node dissection in patients with cN0 and unilateral papillary thyroid cancer upon preoperative neck ultrasound.

WOS: 000396361900004, PubMed ID: 28251020, Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT. Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, as well as the presence of ectopia, presence of dual adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease. Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria. Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT.

Background Granulomatous mastitis (GM) is a rare inflammatory breast disease that may mimic the clinical characteristics and radiologic imaging findings of breast carcinoma. Considering the importance of making a correct diagnosis, careful radiologic evaluations and recognition of imaging features are necessary. Objectives The aim of this study was to review the radiological findings and diagnostic value of the imaging in GM. Patients and methods This retrospective study involved a total of 29 patients who were diagnosed with GM between 2009 and 2013 and who underwent mammography (MG) and/or ultrasound (US) examination in addition to magnetic resonance imaging (MRI) before diagnosis. Results Among 14 patients over 35 years of age who underwent MG imaging, focal asymmetric, ill-defined nodular, or diffusely increased densities were detected in nine (64.3%), two (14.3%), and one (7.1%) subjects, respectively, while there were no pathological findings in two (14.3%) patients. In the overall group of 29 patients, US showed heterogeneous hypoechoic lesions with tubular extensions in 16 (55.2%), well-demarcated heterogeneous hypoechoic lesions in eight (27.6%), parenchymal heterogeneous appearance in three (10.3%), and a heterogeneous hypoechoic lesion with irregular margins in one (3.4%), with another (3.4%) patient having normal US findings. MRI findings included lesions consistent with solitary or multiple separate or confluent abscesses with marked peripheral ring enhancement in 25 (86.2%) patients, accompanied by intensity changes suggesting edematous inflammation in the peripheral parenchyma, as well as non-mass-like heterogeneous segmental and regional contrast enhancement. Four (13.8%) patients had non-mass-like segmental and regional contrast enhancement only. A histopathological diagnosis of GM was established in all patients with biopsy. Conclusion GM presents with a wide range of conventional radiological findings, hampering the diagnosis. In patients with inconclusive conventional findings, MRI may assist in the differential diagnosis and assessment of the extent of disease. However, a definitive diagnosis and relevant treatment require histopathological confirmation.

Benign breast lesions (BBL) includes a wide variety of histologic entities, which have been broadly classified into non-proliferative lesions, proliferative lesions without atypia, and hyperplasia with atypia. With the increased use of mammography, more benign lesions are being detected, and in order to estimate the risk of breast cancer for specific histologic categories is of great importance to guide clinical management. Women with proliferative lesions without atypia are at slightly increased risk of subsequent breast cancer, whereas women with proliferative lesions with atypia have a higher risk. The risk is 1.5- 2-fold in women with proliferative lesions without atypia, 4-5-fold in women with proliferative lesions with atypia, and 8-10 fold in women with ductal carcinoma in situ. Age at diagnosis of BBL, menopausal status, family history of breast cancer in a first-degree relative, and time since BBL diagnosis on risk of breast cancer are important for risk evaluation. [Archives Medical Review Journal 2010; 19(3.000): 155-167]

In the present study, attempts have been made to determine the effects of honey on intestinal morphology, postoperative adhesions, and the healing of colonic anastomoses in the rats after colonic resection and anastomosis. Thirty-six rats were randomly divided into three groups each including 12 animals. Colonic resection and anastomosis were performed on all animals. Rats were fed with standard rat chow in group I, standard rat chow plus 10 g/kg/day honey in group II and artificial honey including the same caloric amount with honey in group III. Adhesion scores, bursting pressures and histopathological examinations were evaluated. Colonic bursting pressures of honey group were significantly better than control and artificial honey groups. Histological analysis of anastomotic site showed that submucosa and muscularis propria were nearly filled with granulation tissue and regular fibrin matrix in honey group. There was statistically significant difference between the adhesion scores of honey vs artificial honey and control groups. The scores of histological changes of ileum in honey group were significantly different from other groups. These results indicate a protective role of honey against intraabdominal adhesions and anastomotic dehiscence.

Background We planned to evaluate the effects of different enteral nutrients on the levels of serum leptin, protein and albumin changes and also to compare their effects on mucosal morphology of small intestine. Methods Rats were randomly divided into 5 groups each including 10 animals. Group I rats were given rat chow and water. Group II rats were fed with standard enteral nutrient. Group III rats were fed with calorie enriched enteral nutrient. Group IV rats were given enteral nutrition supplemented with fiber. Group V rats were fed with immunonutrient. Serum albumin, protein, leptin levels were measured. Terminal ileum of each rat was scored. Results We found no difference in serum leptin, protein and albumin levels. The average mucosal atrophy of rats fed with standard chow was significantly different than that of rats fed with standard and calorie enriched nutrients. Feeding with nutrients supplemented with fiber and immunonutrient did not cause significant distortion in mucosal integrity when compared with feeding with standard chow. Conclusion Low levels of leptin may show malnutrition but for determination of nutritional status of a patient receiving enteral nutrition, studies with long duration are required.

The incidence and potential risk factors for the recurrence of benign nodular goitre after unilateral thyroidectomy are not clearly defined. The aim of this study was to assess the rate of progression of nodular goitre in the contralateral thyroid lobe and of hypothyroidism requiring replacement therapy after unilateral thyroid lobectomy for benign nodular goitre.Patients who underwent hemithyroidectomy for benign nodular goitre between 2000 and 2009 were included in the study. The primary outcome of this study was the reoperation rate for recurrent goitre, the rate of progression of nodular goitre and the rate of hypothyroidism requiring L-T4 replacement therapy. Clinical factors that have an effect on progression were further analysed.259 patients were included for study. Progression of the nodular goitre in the remnant lobe was observed in 32% (n = 83) of the patients. However, over time, only 2% of these 83 patients underwent contralateral hemithyroidectomy due to this progression. Fifty-six (22%) patients required L-thyroxin replacement due to persistent hypothyroidism after hemithyroidectomy. The factors shown to affect progression of nodular goitre were advanced age, preoperative hyperthyroidism, preoperative diagnosis of toxic nodular goitre and the presence of surgical indication for a toxic goitre causing hyperthyroidism and a definitive pathological diagnosis of nodular hyperplasia.There was a progression of the nodular goitre in the remnant lobe in about one-third of the patients who underwent hemithyroidectomy. However, only 2% of these patients underwent complementary contralateral hemithyroidectomy due to clinical progression in 31 months of follow-up.

WOS: 000351540000004, PubMed ID: 26219937, Background: The incidence and potential risk factors for the recurrence of benign nodular goitre after unilateral thyroidectomy are not clearly defined. The aim of this study was to assess the rate of progression of nodular goitre in the contralateral thyroid lobe and of hypothyroidism requiring replacement therapy after unilateral thyroid lobectomy for benign nodular goitre. Patients and Methods: Patients who underwent hemithyroidectomy for benign nodular goitre between 2000 and 2009 were included in the study. The primary outcome of this study was the reoperation rate for recurrent goitre, the rate of progression of nodular goitre and the rate of hypothyroidism requiring L-T4 replacement therapy. Clinical factors that have an effect on progression were further analysed. Results: 259 patients were included for study. Progression of the nodular goitre in the remnant lobe was observed in 32% (n = 83) of the patients. However, over time, only 2% of these 83 patients underwent contralateral hemithyroidectomy due to this progression. Fifty-six (22%) patients required L-thyroxin replacement due to persistent hypothyroidism after hemithyroidectomy. The factors shown to affect progression of nodular goitre were advanced age, preoperative hyperthyroidism, preoperative diagnosis of toxic nodular goitre and the presence of surgical indication for a toxic goitre causing hyperthyroidism and a definitive pathological diagnosis of nodular hyperplasia. Conclusion: There was a progression of the nodular goitre in the remnant lobe in about one-third of the patients who underwent hemithyroidectomy. However, only 2% of these patients underwent complementary contralateral hemithyroidectomy due to clinical progression in 31 months of follow-up.

PubMed ID: 26219937, Background: The incidence and potential risk factors for the recurrence of benign nodular goitre after unilateral thyroidectomy are not clearly defined. The aim of this study was to assess the rate of progression of nodular goiter in the contralateral thyroid lobe and of hypothyroidism requiring replacement therapy after unilateral thyroidlobectomy for benign nodular goitre.Patients and Methods: Patients who underwent hemithyroidectomy for benign nodular goitre between 2000 and 2009 were included in the study. The primary outcome of this study was the reoperation rate for recurrent goitre, the rate of progression of nodular goitre and the rate of hypothyroidism requiring L-T4 replacement therapy. Clinical factors that have an effect on progression were further analysed.Results: 259 patients were included for study. Progression of the nodular goitre in the remnant lobe was observedin 32% (n = 83) of the patients. However, over time,only 2% of these 83 patients underwent contralateral hemithyroidectomy due to this progression. Fifty-six (22%) patients required L-thyroxin replacement due topersistent hypothyroidism after hemithyroidectomy. The factors shown to affect progression of nodular goiter were advanced age, preoperative hyperthyroidism,preoperative diagnosis of toxic nodular goitre and the presence of surgical indication for a toxic goitre causing hyperthyroidism and a definitive pathological diagnosis of nodular hyperplasia.Conclusion: There was a progression of the nodular goiter in the remnant lobe in about one-third of the patients who underwent hemithyroidectomy. However, only 2% of these patients underwent complementary contralateral hemithyroidectomy due to clinical progression in 31months of follow-up. © Van Zuiden Communications B.V. All rights reserved.

To the Editor, Breast-Cancer Risk in Families with Mutations in PALB2: A.C. Antoniou, S. Casadei, T. Heikkinen, et al. N Engl J Med. 2014;371:497-506. In a study published in N Engl J Med. August 2014, researchers from 14 centers in eight countries investigated information from 362 family members from 154 families who had an abnormal partner and localizer of BRCA2 (PALB2) gene, but did not have an abnormal BRCA1 or BRCA2 gene. Their aim was to demonstrate the importance of loss-of-function mutations in PALB2 as a cause of hereditary breast cancer. The study included 311 women with an abnormal PALB2 gene; 229 of these women had been diagnosed with breast cancer and 51 men with an abnormal PALB2 gene; seven of whom had been diagnosed with breast cancer. The researchers compared the breast cancer risk of the study population to the general population. They found out that overall, women with an abnormal PALB2 gene had a risk of breast cancer that was 9.47 times higher than average. Women with an abnormal PALB2 gene had a 14% risk of developing breast cancer by age 50 and a 35% risk of developing breast cancer by age 70. The average lifetime risk of breast cancer is about 12%. This increase in risk linked to an abnormal PALB2 gene was dependent on the women’s age and family history. They have demonstrated that the relative risk of breast cancer among PALB2 mutation carriers increased significantly as birth cohort became more recent (P

Akut kolon iskemisi yaşlılardaki kolitin yaygın bir nedeni olup, bu yaş grubunda morbiditenin önemli bir kısmını oluşturmaktadır. İskemik kolitin çok az görülen bir tipi olan çekum nekrozu sağ alt kadranda ağrıya neden olmaktadır. Bu nedenle özellikle yaşlı hastalarda sağ alt kadran ağrısı yapan akut apandisit, çekum divertiküliti, sterkoral perforasyon ve kolon karsinomları ayırıcı tanıda göz önünde bulundurulmalıdır. Yalnızca çekumu tutan iskemik kolit oldukça nadir olup çekal iskemi travma yada diyaliz sonrası hipotansiyona bağlı oluşabilmektedir. Bu yazıda hemodiyaliz sırasında şiddetli bir hipotansif atak sonrasında akut batın bulguları ortaya çıkan, spontan çekum nekrozu gelişmiş kronik böbrek yetmezliği olan 71 yaşındaki bir erkek hasta sunulmaktadır., Acute colonic ischaemia is a common cause of colitis in the elderly, in whom colonic ischaemia is a cause of morbidity. Necrosis of the caecum is a rare variant of ischaemic colitis causing right lower quadrant pain. Acute appendicitis, diverticulitis, stercoral perforation and colon carsinomas should therefore be taken into consideration in the differential diagnosis, especially in elderly patients. However, ischaemic colitis involving the caecum alone is quite rare, as is caecal ischaemia after hypotension caused by dialysis or trauma. We present in this article a 71-year-old woman who had acute abdominal symptoms following an episode of severe hypotension during haemodialysis and developed caecum necrosis spontaneously

PURPOSE This experimental study aimed at comparing the cyanoacrylate abdomen closure to the effectiveness of triclosan coated polidioxanone abdomen closure. METHODS The abdomen layers were closed with 3/0 polidioxanone suture in the first group. In the second group, the layers were closed with triclosan coated polidioxanone suture in a single layer. The abdomen layers of rats in the third group were attached with cyanoacrylates without sutures. The rats were sacrificed on the 14th day and the adhesive level was recorded. The incision resistance strength was measured. The tissue was examined blindly in the terms of inflammatory cell infiltration, capillary proliferation, fibrosis and micro-abscess by the pathologist. RESULTS No significant difference was determined between the 1st and 2nd groups in the terms of inflammatory cell infiltration, capillary proliferation, collagen deposition, fibroblast activity, adhesive and tissue distension strength. The fibrosis and adhesive rate of the 3rd group was significantly higher than the 1st and 2nd groups statistically. The tissue distension strength was lower than in the other groups and the differences between the groups were found to be significant (p < 0.05). No significant difference was determined between the groups in the term of micro-abscess. CONCLUSIONS Antibacterial suture is not superior to the conventional suture. It is concluded that cyanoacrylate is not an appropriate molecule for abdomen closure (Tab. 1, Fig. 3, Ref. 17).

PubMedID: 22146169 BACKGROUND: There is no debate that laparoscopic fundoplication has become the standard procedure for surgical management of gastroesophageal reflux disease. However, there is still no consensus on whether to use prosthetic material routinely and on the preferred kind of prosthetic material. The aim of this study was to evaluate polyglactin mesh and polypropylene mesh use in laparoscopic antireflux surgery (LARS) with particular regard to symptomatic relief, patient satisfaction, and complications. METHODS: This prospective randomized study included 75 patients who underwent LARS with polypropylene mesh prosthesis and 75 patients who underwent LARS with polyglactin (vicryl) mesh prosthesis between January 2005 and January 2010. Preoperative and postoperative assessments of symptomatic and functional outcomes of patients were recorded. Outcome data analyzed included length of hospitalization, operative time, complications, and recurrence. RESULTS: Laparoscopic repair of hiatal crura with a polyglactin mesh resulted in good symptomatic and clinical outcomes similar to that of polypropylene mesh. The recurrence rate with the use of polyglactin mesh is comparable to that of synthetic or biological materials reported in the literature. CONCLUSIONS: Closure of hiatal crura with a prosthetic polyglactin (vicryl) mesh at LARS is an effective and safe procedure. © 2011 by Lippincott Williams & Wilkins.

Background/aims We evaluated the effect of oral usage of honey and pollen, either separately or together, on postoperative intraabdominal adhesions. Methods Forty rats were randomly separated into 4 groups of 10 rats each. Abrasion was performed on the cecum, and a patch of peritoneum located opposite to the cecal abrasion was completely dissected. Group 1 rats received no treatment; Group 2 rats received 4 g/kg/day honey; Group 3 rats received 4 g/kg/day pollen; and Group 4 rats received 4 g/kg/day honey and pollen mixed in equal amounts, in addition to the standard feeding for postoperative 21 days. All the rats were sacrificed on the 21st day. Following the adhesion scoring, tissue specimens of the peritoneum and bowel were subjected to histopathological investigation. The tissue and blood specimens were also taken for biochemical analysis to investigate the antioxidant capacity. Results Adhesion scores were significantly different between the control and other groups. No dense adhesion was observed in the treatment groups. Tissue malondialdehyde levels were significantly different between the control and honey and honey+pollen groups. Superoxide dismutase and glutathione-peroxidase levels were significantly different between the control and other groups. Catalase levels were different between the control and honey groups. Plasma antioxidant levels were different between the control and other groups. The pathological scores for fibrosis and inflammation were significantly different between the control and other groups. Conclusions Honey and pollen were found to be effective in preventing postoperative intraabdominal adhesions, and these effects were thought to be a result of their antiinflammatory and antioxidant properties.

Aim Spinal Cord Injury (SCI) is routinely treated with standardized methyl prednisolone sodium succinate (MPSS) dose, so it is reassuring to find its effects on liver. We also evaluated the effects of albumin and immunoglobulin G (Ig G) therapies on liver if they are used in case of experimental SCI. Material and methods The rats were allocated into six groups as control, trauma, vehicle, MPSS, Ig G and albumin consisting 8 rats for each. The rats with SCI were assigned to 30mg/kg MPSS, 5 mg/kg albumin and 400 mg/kg Ig G treatments. Tissue samples from liver were obtained for light and electron microscopy examinations and determination of myeloperoxidase (MPO) activity. Results Trauma increased MPO activity and caused cellular changes of liver tissue. Both albumin and Ig G treatments decreased MPO activity significantly. The light and electron microscopic evaluations showed remarkable preservation of liver ultra-structure with all treatments including MPSS. Conclusions SCI resulted in neutrophil infiltration and changes in ultrastructure of liver. It was revealed that MPSS has no detrimental effects on liver. Although all treatments preserved liver tissue structure, Although all treatments preserved liver tissue structure, Ig G and albumin treatments also prevented neutrophil infiltration. To provide protection from secondary liver injury after SCI, use of albumin and Ig G treatments may be beneficial.

Background: Myoepithelial cells are widely present in the breast, and their hyperplasia may result in a spectrum of disease ranging from myoepitheliosis to myoepithelial carcinoma.

In hydatid cyst disease, perforation and spontaneous fistula formation are rare, yet very serious, complications. In this study we describe five cases of hydatid cyst disease in which the cysts perforated.In this retrospective study we evaluated five patients who were surgically treated for perforated hydatid cysts between 2002 and 2006. All patients were admitted to a local hospital with acute abdominal symptoms.The mean age of the patients (four males and one female) was 39 years. The perforations occurred spontaneously in four patients, and were the result of trauma in one. Three of the hydatid cysts were located in the liver and two in the spleen. Only one patient had a recurrent hydatid cyst. Diagnostic tools included ultrasonography (n=5), computerized tomography (n=1), and diagnostic peritoneal lavage (n=1). The cysts were treated by radical (n=2) or conservative (n=3) methods. There was no postoperative morbidity or mortality, and no recurrences of hydatid disease after follow-up (mean: 14 months).Cyst perforation in the peritoneal cavity is a serious complication of hydatid disease and should be treated immediately. The literature suggests that recurrences may be related to the operative technique, the location of the cyst, and inadequate irrigation of the peritoneal cavity with scolicidal agents. The findings of this study suggest that if treated promptly, cyst perforation can be successfully treated.

This study was designed to examine the effects of propolis on the liver and biliary system when used as a scolicidal agent. Thirty Wistar–Albino rats were divided into two groups. Propolis and 0.9% saline (NaCl) were injected into the biliary tract of the rats. Three rats from control group and four rats from propolis group died within 5 days after the procedure. Blood samples of remaining 23 rats were obtained 1 week after and at the end of the experimental study for liver function tests. Six months after the procedure, retrograde and magnetic resonance cholangiography were performed and liver, common bile duct, and duodenum were excised en bloc for histopathological examination. Liver function tests were slightly elevated 1 week after the procedure and were found to be normal at the end of the sixth month in both groups. No stricture in the biliary tree was found on the retrograde and magnetic resonance cholangiograms. The tissue samples of the propolis group showed no histomorphological difference from the control group. Propolis may be used as a scolicidal agent even in the case of cystobiliary communication with no side effects on liver and biliary tree.

AIM: To examine the effects of 10% diluted honey, which has been shown to be scolicidal, on the liver and biliary system and determine whether it could be used as a scolicidal agent in the presence of biliary-cystic communication. METHODS: Thirty Wistar-Albino rats were divided into two groups. Honey with 10% dilution in the study group and 0.9% saline (NaCl) in the control group were injected into the common bile ducts of rats through a 3-mm duodenotomy. The animals were sacrificed 6 mo after the procedure. Histopathological, biochemical, and radiological examinations were performed for evaluation of side effects. RESULTS: At the end of the sixth month, liver function tests were found to be normal in both groups. The tissue samples of liver and ductus choledochus of the honey group showed no histomorphologic difference from the control group. No stricture on the biliary tree was detected on the retrograde cholangiograms. CONCLUSION: According to these results,,we concluded that 10% diluted honey could be used as scolicidal agent safely in the presence of biliary-cystic communication. (c) 2008 WJG. All rights reserved.

Background: Propolis is a natural product collected by honey bees from various plant sources. We aimed to determine the possible effects of propolis on oxidative stress and hepatocyte apoptosis in experimental obstructive jaundice. Methods:Thirty rats were divided into three groups: group I, sham-operated; group II, ligation and division of the common bile duct (BDL); group III, BDL followed by oral supplementation of propolis in a daily dose of 100 mg/kg. Liver samples were examined under the light microscope and transmission electron microscope. Hepatocyte apoptosis was quantitated using the transferase-mediated uridine nick end labeling (TUNEL) assay. Plasma and liver malondialdehyde (MDA) levels and glutathione peroxidase (GSH-Px) activities were measured. Results: The plasma and liver levels of MDA were significantly lower in the propolis group than in the BDL group (p < 0.05 and 0.014, respectively). Although liver GSH-Px activities were significantly higher in the propolis group than in the BDL group (p < 0.001), there was no significant difference between the plasma GSH-Px activities of these groups (p > 0.05). In the propolis group, the enlargement of hepatocytes, dilatation of canaliculi and the edema regressed. The regenerating and normal hepatocytes were demonstrated. In the TUNEL assay, propolis administration reduced hepatocyte apoptosis. Conclusion: Propolis showed a significant hepatoprotective effect in this experimental obstructive jaundice model.

Bacterial translocation is the passage of bacteria or endotoxins from the gastrointestinal tract to extraintestinal sites, such as mesenteric lymph nodes, liver, spleen, and bloodstream. In this study, the investigators examined the effects of various enteral nutrients on bacterial translocation and intestinal morphology during the postoperative period. Sixty rats were randomly divided into 5 groups, each of which included 12 animals; cecal mobilization was performed in all groups. Group I rats were fed rat chow and water; group II was given standard enteral nutrients; group III, high-energy enteral nutrients; group IV, enteral nutrients supplemented with fiber; and group V, immunonutrients. Bacterial translocation was detected in mesenteric lymph nodes, spleen, liver, and blood cultures. Changes in the terminal ileum were scored from 0 to 4 with the morphologic scoring system. Bacterial translocation was predominantly detected in mesenteric lymph nodes. Rats fed immunonutrients (group V) showed a significant reduction in bacterial translocation compared with other groups. Although minor morphologic alterations in the villi were observed in groups IV and V, the histologic scores of these groups were not statistically different from the scores of control group members. In the present study, investigators evaluated the effects of various enteral nutritional solutions on bacterial translocation and intestinal morphology during the postoperative period. Enteral diets supplemented with arginine, nucleotides, and omega-3 fatty acids were found to reduce bacterial translocation. The investigators concluded that this effect might be related to improvement in immune function resulting from the use of immunonutrients.

To the Editor Crohn's disease is a disorder that is characterized by transmural inflammation and may involve any part of the gastrointestinal tract. Obstructive clinical presentations can be seen during the course of Crohn's disease. Free perforation of the intestine in Crohn's disease is an uncommon occurrence, with incidence of 1% to 3% in Western countries.1 Multiple intestinal perforations during the course of Crohn's disease have been reported very rarely. Herein, we present a patient, who was diagnosed with Crohn's disease after presenting with multiple intestinal perforations. A 37-year-old female was admitted to our hospital with complaints of fatigue and watery diarrhea occurring eight to ten times per day for 2 months. Her medical history revealed no use of …

Liver ischemia reperfusion injury (IRI) is an important pathologic process leading to bodily systemic effects and liver injury. Our study aimed to investigate the protective effects of diosmin, a phlebotrophic drug with antioxidant and anti-inflammatory effects, in a liver IRI model. Forty rats were divided into 4 groups. Sham group, control group (ischemia-reperfusion), intraoperative treatment group, and preoperative treatment group. Ischemia reperfusion model was formed by clamping hepatic pedicle for a 60 minute of ischemia followed by liver reperfusion for another 90 minutes. Superoxide dismutase (SOD) and catalase (CAT) were measured as antioaxidant enzymes in the liver tissues, and malondialdehyde (MDA) as oxidative stress marker, xanthine oxidase (XO) as an oxidant enzyme and glutathione peroxidase (GSH-Px) as antioaxidant enzyme were measured in the liver tissues and the plasma samples. Hepatic function tests were lower in treatment groups than control group (p

We describe a 42-year-old age woman who accidentally swallowed her lower denture, which was composed of eleven teeth. The daily descent of the denture was followed by plain abdominal radiography and physical examination. The image was localized at the left upper quadrant on admission day, but it stopped on its way at the right lower quadrant on day two and three. Since the patient's complaints increased we planned surgical removal of the denture. In this report, we had discussed the diagnosis, follow up and treatment options of swallowed partial denture with current literature review.

To evaluate the effects of honey on bacterial translocation and intestinal villus histopathology in experimental obstructive jaundice.Thirty Wistar-Albino rats were randomly divided into three groups each including 10 animals: group I, sham-operated; group II, ligation and section of the common bile duct (BDL); group III, bile duct ligation followed by oral supplementation of honey (BDL + honey) 10 g/kg per day. Liver, blood, spleen, mesenteric lymph nodes, and ileal samples were taken for microbiological, light and transmission electrone microscopic examination.Although the number of villi per centimeter and the height of the mucosa were higher in sham group, there was no statistically significant difference between sham and BDL + honey groups (P0.05). On the other hand, there was a statistically significant difference between BDL group and other groups (P0.05). The electron microscopic changes were also different between these groups. Sham and honey groups had similar incidence of bacterial translocation (P0.05). BDL group had significantly higher rates of bacterial translocation as compared with sham and honey groups. Bacterial translocation was predominantly detected in mesenteric lymph nodes.Supplementation of honey in presence of obstructive jaundice ameliorates bacterial translocation and improves ileal morphology.

To investigate the effects of propolis on bacterial translocation and ultrastructure of intestinal morphology in experimental obstructive jaundice.Thirty Wistar-Albino male rats were randomly divided into three groups, each including 10 animals: group I, sham-operated; group II, ligation and division of the common bile duct (BDL); group III, BDL followed by oral supplementation of propolis 100 mg/kg per day. Liver, blood, spleen, mesenteric lymph nodes, and ileal samples were taken for microbiological, light and transmission electron microscopic examination on postoperative 7th d after sacrification.The mean number of villi per centimeter and mean mucosal height of the propolis group were significantly different in the BDL group (P = 0.001 and 0.012, respectively). The electron microscopic changes were also different between these groups. Sham and BDL + propolis groups had similar incidence of bacterial translocation (BT). The BDL group had significantly higher rates of BT as compared with sham and BDL + propolis groups. BT was predominantly detected in MLNs and the most commonly isolated bacteria was Escherichia coli.Propolis showed a significant protective effect on ileal mucosa and reduced bacterial translocation in the experimental obstructive jaundice model. Further studies should be carried out to explain the mechanisms of these effects.