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Aims. Acute cholecystitis is one of the most common emergencies of general surgery. Although there is an increase in the incidence of acute cholecystitis in the summer season when the temperature increases, its cause is not fully understood. The aim of this study is to determine the relationship between acute cholecystitis and temperature.Material and Methods: 271 patients admitted to the general surgery service in 2021 were included in this study. Patient data were obtained retrospectively from patient files and data from national centers were used for meteorological data. Conformity of continuous variables to normal distribution was evaluated using visual and analytical methods.Results: According to the percentage distribution of cases, acute cholecystitis was most common in summer and least in winter. A very strong positive correlation was found between monthly mean temperature values and monthly incidence of acute cholecystitis (correlation coefficient: r= 0.759 and p=0.004).Conclusions: The incidence of acute cholecystitis also increases with increasing ambient temperature, and this is important in terms of planning health services., Amaç: Akut kolesistit genel cerrahinin en sık görülen acillerinden biridir.Sıcaklığın arttığı yaz mevsiminde akut kolesistit insidansında bir atış olmasına rağmen nedeni tam olarak anlaşılamamıştır.Bu çalışmadaki amaç akut kolesistit ve sıcaklık arasındaki ilişkiyi belirlemektir.Gereç ve Yöntemler: Bu çalışmaya 2021 yılında genel cerrahi servisine başvuran 271 hasta dahil edildi. Hasta verileri retrospektif olarak hasta dosyalarından elde edildi ve meteorolojik veriler için ulusal merkezlerden alınan veriler kullanıldı. Sürekli değişkenlerin normal dağılıma uygunluğu görsel ve analitik yöntemlerle değerlendirildi.Bulgular: Olguların yüzde dağılımına göre akut kolesistit en sık yaz aylarında, en az ise kış aylarında görüldü. Aylık ortalama sıcaklık değerleri ile aylık akut kolesistit insidansı arasında çok güçlü bir pozitif korelasyon bulundu (korelasyon katsayısı: r= 0.759 ve p=0.004).Sonuç: Ortam sıcaklığı arttıkça akut kolesistit insidansı da artmaktadır ve bu durum sağlık hizmetlerinin planlanması açısından önemlidir.

Radioactive I131 (RAI) therapy is a standard method to ablate the remnant thyroidal tissue after total thyroidectomy and its metastases in differentiated thyroid carcinomas; however, I131 also accumulates in nonthyroidal tissue, which may cause adverse effects and limit the I131 dose required for treatment. We hypothesized that montelukast, a known agent with anti-inflammatory and anti-oxidant properties, would ameliorate the radiation-induced histopathological characteristics such as pneumonitis and fibrosis in rat lungs after RAI.Fifty female Wistar albino rats were randomly separated into five groups of 10. Group 1 was the control group; Group 2 was administered RAI only; Group 3 was administered RAI and montelukast, Group 4 was administered RAI after total thyroidectomy and Group 5 was administered RAI and montelukast after total thyroidectomy. All rats were sacrificed after 12 weeks and the lungs were evaluated in the histological examination to determine the degree of inflammation and fibrosis and for immunohistochemical (IHC) staining for tissue expression of IL-1, IL-6 and TNF-alpha and TGF-beta.The RAI-administered groups, Group 2 and Group 4, were significantly different from the control group, however, the groups medicated with both RAI and montelukast, Group 3 and Group 5, were not significantly different from the control group. All histopathological and IHC parameters were significantly less in the groups administered with montelukast compared to the groups not administered with montelukast.The results of this study demonstrated the radioprotective effect of montelukast in the pulmonary system through histopathological and IHC examination.

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 aim of this study was to evaluate the therapeutic effect of propolis on non-alcoholic fatty liver disease (NAFLD) in rats. The rats were randomly divided into 3 groups of 10 as the NAFLD, NAFLD + 100 and NAFLD + 200 groups. The rats were fed with a fatty diet (25 g/kg/day) to provoke NAFLD. Then after the formation of fatty liver, a standard diet (SD) (25 g/kg/day) was given to the NAFLD group and the other two groups were fed with SD and 100 mg/kg (NAFLD + 100 Group) or 200 mg/kg propolis (NAFLD + 200 Group) for two weeks. At the end of two weeks the animals were sacrificed. Blood and tissue samples were taken for biochemical and histopathological evaluations. The propolis-treated groups had better results in serum lipids (total cholesterol, non-HDL cholesterol, triglyceride), ALT, and ALP values. When compared with the NAFLD group, IL-6 and TNF-alpha values decreased in the NAFLD + 100 and NAFLD + 200 groups. The administration of propolis to the rats significantly reduced serum and tissue MDA and GPX values and increased SH in serum when compared with the NAFLD group. No difference was determined between the groups treated with two different doses of propolis in respect of biochemical values. When the mean histological scores of the groups were compared, statistically significant differences were found between the NAFLD group and the propolis-treated groups. No difference was determined between the groups treated with the two different doses of propolis in respect of histopathological results. Propolis had positive effects on histopathological and biochemical parameters of NAFLD and these effects were related to the anti-oxidant and anti-inflammatory effects of propolis. (C) 2017 Elsevier Masson SAS. All rights reserved.

We investigated the antioxidant and anti-inflammatory effects of propolis on bleomycin induced lung fibrosis and compared these effects to prednisolone treatment. Forty rats were divided into four groups of ten: group 1 was treated with intratracheal infusion of 0.2 ml physiological saline followed by daily treatment with 0.5 ml physiological saline for 20 days. In the remaining groups (groups 2 - 4), 5 mg/kg bleomycin was given via the trachea. Rats in group 2 were given 0.5 ml physiological saline. Rats in group 3 were treated with 100 mg/kg propolis, and 10 mg/kg prednisolone was given to rats in group 4. The treatments for all groups were continued for 20 days. On postoperative day 21, blood and lung samples were taken for biochemistry, histopathology and electron microscopy evaluation. We compared oxidative stress parameters and found lower malondialdehyde and myeloperoxidase levels, and higher total sulfhydryl levels and catalase activities for the bleomycin + propolis group than for the bleomycin and bleomycin + prednisolone groups. The highest mean fibrosis score was detected in the bleomycin group. Although the mean fibrosis scores of the bleomycin + propolis and bleomycin + prednisolone groups were not significantly different, electron microscopy revealed that propolis diminished bleomycin induced lung fibrosis more effectively than prednisolone. The effects of propolis might be due to its potent antioxidant and anti-inflammatory properties.

Meckel's diverticulum is the most common anomalous development of the gastrointestinal system that results from an incomplete vitelline canal. A diagnosis is usually made during the clinical examination of presentations such as unexplained gastrointestinal bleeding, obstruction, inflammation or perforation. The purpose of this review is to provide an adequate level of knowledge of the clinical and diagnostic features as well as the management of Meckel's diverticulum. Diagnosis of Meckel's diverticulum may be challenging as the condition remains asymptomatic or may mimic various diseases and obscure the clinical picture. Life-threatening complications include bleeding, obstruction, inflammation and perforation. Therefore, it is essential that anatomical and pathophysiological characteristics are known in detail in order to prevent complications which will result in morbidity and mortality.

Background Mastalgia is a common and enigmatic condition; the cause and optimal treatment are still inadequately defined. Cervical radiculopathy, which is the result of cervical nerve root pathology often caused by spaceoccupying lesions such as cervical disc herniation, spondylosis, or osteophytosis, is frequently encountered in physical therapy. Objectives The aim of the study was to evaluate the incidence of vertebral pathologies in patients with non-cyclic mastalgia and the efficacy of conservative treatment of these pathologies on relieving breast pain. Material and methods One hundred patients were included in the study, all with breast pain continuing throughout the day and lasting at least three months. Breast and axillary physical examinations, mammographic and/or ultrasonographic evaluations were normal in all the patients. The patients' pain levels were scored using a visual analog scale (VAS). Cervical and thoracic spine magnetic resonance imaging (MRI) was performed on all the participants. Results Among 96 patients that had pathological findings on magnetic resonance imaging (96%), 49 women had diffuse annular bulging of the cervical spine, and 47 had cervical disc protrusion. Additionally, 12 patients had thoracic disc protrusion. At the end of the three-month period, the patients who were given only conservative treatment returned for follow-up evaluations. According to the VAS scores, five patients had mild to moderate improvement, 55 showed significant improvement, and 29 achieved complete remission. Conclusions The authors concluded that if none of the known causes of breast pain are found in a patient, the patient should be evaluated for vertebral pathologies.

This study aimed to determine the possible preventive effects of dexmedetomidine on postoperative intra-abdominal adhesions. Dexmedetomidine is a highly selective and potent α2 adrenergic agonist with sedative, analgesic, anxiolytic, sympatholytic, hemodynamic, and diuretic properties. In recent years, investigations have shown that dexmedetomidine possesses secondary antioxidant and also anti-inflammatory effects. Thirty Wistar albino male rats were randomized and divided into 3 groups of 10 animals each: group 1, sham-operated; group 2, cecal abrasion + peritoneal dissection; group 3, cecal abrasion + peritoneal dissection followed by daily intravenous injection of 10 μg/kg dexmedetomidine for 10 days. The animals were killed on postoperative day 21. Blood and cecal samples were taken for biochemical and histopathologic evaluation. In this study, biochemical and pathologic parameters were significantly better in the cecal abrasion + peritoneal dissection + dexmedetomidine group when compared with the cecal abrasion + peritoneal dissection group. Tissue malondialdehyde, myeloperoxidase, total sulfhydryl, and catalase were found to be significantly different between the cecal abrasion/peritoneal dissection + dexmedetomidine and the cecal abrasion/peritoneal dissection groups. Plasma malondialdehyde and total sulfhydryl values were also statistically different between these groups (P < 0.05). Statistical analyses of mean pathologic scores showed that the histopathologic damage in the cecal abrasion/peritoneal dissection + dexmedetomidine group was significantly less than the damage in the control group (P < 0.05 for all pathologic parameters). The results of this study show that dexmedetomidine had a significant preventive effect on postoperative intra-abdominal adhesions. We concluded that these effects might be due to antioxidant and anti-inflammatory activities.

The purpose of this experimental study was to evaluate the potential effects on the healing of colorectal anastomoses of the rectal administration of Ankaferd Blood Stopper (ABS). Thirty Wistar-Albino male rats were randomly separated into 3 groups. In the sham group, only laparotomy and colonic mobilization was performed. In the other 2 groups, colon transection and anastomosis were carried out. Saline (2 mL, 0.9% NaCl) was given rectally via a feeding tube for 10 days after the surgical procedure in the sham and control groups. In Group 3 (ABS group), the rats were treated with rectally administered ABS (2 mL/day) for 10 days. In all groups, after the measurement of bursting pressures, tissue samples were collected for the measurement of tissue hydroxyproline and prolidase levels, and for histopathological evaluation on postoperative day 11. The rectal administration of ABS showed positive effects on bursting pressures, tissue prolidase and hydroxyproline levels, and the histopathological findings of colonic anastomosis. The rectal application of ABS had positive effects on the healing of colorectal anastomosis. As a natural product, it may be used effectively and safely to achieve better healing results after colorectal anastomosis.

Porcine acellular dermal collagen (PDC), which is a biological material derived from processing porcine dermis, has already been used for urologic, gynecologic, plastic, and general surgery procedures up to now. The aim of this study is to investigate the effectiveness of PDC on wound healing as a dermal substitute in the rat model. Twenty Wistar albino rats were divided into two groups. Standard full-thickness skin defects were created on the back of the rats. In the control group (Group 1), the dressings moisturized with saline were changed daily. In the study group (Group 2), porcine dermal collagen was implanted onto each wound and fixed with 4–0 polypropylene sutures. Contraction percentages of wound areas were calculated on the third, seventh, tenth, and fourteenth days by using the planimetric program. On fourteenth day, the wound areas were excised for histopathological examination, inflammatory scoring, and evaluation of collagen deposition. The study group was superior to the control group in terms of inflammatory scoring, type I/type III collagen ratio, and wound contraction rates. Porcine dermal collagen may be used effectively and safely on full-thickness wounds as a current dermal substitute.

Background: Meckel's diverticulum, which was first described by Johann Friedrich Meckel, is a congenital anomaly. It results from incomplete obliteration of the most proximal portion of the vitelline or omphalomesenteric duct. Its prevalence is ranging from 1 to 4% of the population. The lifetime risk of complications is estimated at 4-6%. One of them is intestinal obstruction which is a more common presentation among adults. Mesodiverticular band, as presented in this case report, is a rare cause of small bowel obstruction in Meckel's diverticulum. Case Report: We report the case of a 17-year-old male who had intestinal obstruction caused by a mesodiverticular band of Meckel's diverticulum. He presented with severe abdominal pain, nausea, and vomiting. The established diagnosis was mechanical intestinal obstruction. Laparotomy revealed an internal herniation and obstruction caused by a mesodiverticular band of Meckel's diverticulum. There was no evidence of necrosis or ischemia. The mesodiverticular band was released from the ileal mesentery and the Meckel's diverticulum was resected. The postoperative period was uneventful and the patient was discharged after 6 days. Conclusion: The incidence of an internal hernia caused by a mesodiverticular band of Meckel's diverticulum is rare. It may be overlooked in the case of intestinal obstruction because of nonspecific symptoms. Delay in the diagnosis can lead to significant morbidity and mortality. In the case of small bowel obstruction, Meckel's diverticulum should therefore be kept in mind.

Background: Montelukast is a cysteinyl-leukotriene type 1 (CysLT1) selective receptor antagonist. In recent years, investigations have shown that montelukast possesses secondary anti-inflammatory activities and also antioxidant effects. For this reason, we aimed to determine the possible effects of montelukast on liver damage in experimental obstructive jaundice. Methods: 30 Wistar-Albino male rats were randomized and divided into three groups of 10 animals each: group I, sham-operated; group II, ligation and division of the common bile duct (BDL) followed by daily intraperitoneal injection of 1 ml of saline; group III, BDL followed by daily intraperitoneal injection of 10 mg/kg montelukast dissolved in saline. The animals were killed on postoperative day 7 by high-dose diethyl ether inhalation. Blood and liver samples were taken for examination. Results: In this study, liver malondialdehyde (MDA) (p = 0.001), myeloperoxidase (p = 0.003), and total sulfhydryl (SH) (p = 0.009) were found to be significantly different between the BDL + montelukast and the BDL groups. Plasma total SH (p = 0.002) and MDA (p = 0.027) values were also statistically different between these groups. Statistical analyses of histological activity index scores showed that the histopathological damage in the BDL + montelukast group was significantly less than the damage in the control group (p < 0.05 for all pathological parameters). Conclusion: According to the results of this study, montelukast showed a significant hepatoprotective effect in this experimental obstructive jaundice model, which might be due to its antioxidant and anti-inflammatory activities.

This study was designed to evaluate the effects of 3 different forms of platelet-rich plasma (PRP) on the healing process, wound healing rate, and histopathological changes that occur during recovery of open dermal wounds.A 2 cm x 1 cm full-thickness skin defect was made on the backs of 40 Wistar female rats that were divided into 4 groups of 10. In group 1 (control group), the wounds were cleaned with saline; in group 2, the wounds were covered with PRP gel obtained by single centrifugation; in group 3, the wounds were covered with liquid PRP obtained by double centrifugation; and in group 4, PRP gel obtained by double centrifugation with added thrombin was applied on the dermal wounds. All treatments were applied on postoperative days 1, 4, 7, and 10.In all PRP groups, the wound closure was almost complete on day 14 while the wound contraction progressed more slowly in the control group. The mean histopathological scores of epithelialization, inflammation, and fibrosis were significantly better in all PRP groups than the scores in the control group.In conclusion, although all PRP preparations had positive effects on dermal wound healing, double centrifuged PRP topical treatments (with or without thrombin activation) are more effective than single centrifuged PRP, and double centrifugation methods should be preferred for the preparation of PRP.

In this study, nanocomposite collagen scaffolds incorporating gold nanoparticles (AuNPs) were prepared for wound healing applications. Initially, dose (20 nm) of AuNPs that were not cytotoxic on HaCat keratinocytes and 3T3 fibroblasts were determined. Both collagen sponges and AuNP-incorporated nanocomposites (CS-Au) were cross-linked with glutaraldehyde (CS-X and CS-AuX). Incorporation of AuNPs into cross-linked scaffolds enhanced their stability against enzymatic degradation and increased the tensile strength. Hydrolytic degradation of CS-Au group was also less than CS after seven days. Upon confirming in vitro biocompatibility of the scaffolds with cytotoxicity assays, cell attachment and proliferation tests and the in vivo efficacy for healing of full-thickness skin wounds were investigated by applying CS-X, CS-AuX or a commercial product (Matriderm®) onto defect sites and covering with Ioban® drapes. Defects were covered only with drapes for untreated control group. The wound areas were examined with histopathological and biomechanical tests after 14 days of operation. CS-AuX group was superior to untreated control and Matriderm®; it suppressed the inflammation while significantly promoting granulation tissue formation. Inflammatory reaction against CS-AuX was milder than CS-X. Neovascularization was also higher in CS-AuX than other groups, though the result was not significant. Wound closure in CS-X (76%), CS-AuX (69%), and Matriderm® (65%) were better than untreated control (45%). CS-AuX group had the highest tensile strength (significantly higher than Matriderm®) and modulus (significantly higher than Matriderm® and CS-X), indicating a faster course of dermal healing. Further studies are also needed to investigate whether higher loading of AuNPs affects these results positively in a statistically meaningful manner. Overall, their contribution to the enhancement of degradation profiles and mechanical properties, their excellent in vitro biocompatibility, and tendency to accelerate wound healing are encouraging the use of AuNPs in collagen sponges as potent skin substitutes in the future.

WOS: 000369546100056 This study aimed to fabricate 3D silk fibroin (SF) matrices for skin tissue engineering applications. SF/poly(ethylene oxide) solutions were wet electrospun to obtain a fibrous network (0.7-20 mm diameter), which were then lyophilized to obtain 3D porous nanofibrous matrices (SFM-E: ethanol treated silk fibroin matrices). SF matrices were loaded with citrate-capped gold nanoparticles (AuNPs, 14.27 ppm, D-average = 24 nm) (SFM-AuE: ethanol treated silk fibroin matrices incorporated with AuNPs) and investigated for structural and chemical properties, in vitro biocompatibility and in vivo full-thickness dermal wound healing efficacy in a rat model. AuNP incorporation enhanced the degradation profiles and mechanical properties significantly. SFM-E and SFM-AuE showed similar cell attachment and layer by layer proliferation behaviour, but cells had more spread and flattened morphology on SFM-AuE. Both matrix extracts had high cell viability (>90%), indicating good in vitro biocompatibility. Wound closure was statistically more than the untreated skin control (UTSC) in SFM-E and SFM-AuE applied groups. The recovered tensile strength and elastic modulus of SFM-E and SFM-AuE (40-60%) were not as high as the unwounded skin control (UWSC), but they had elongation at break values similar to UWSC. This was attributed to the still ongoing medium to high inflammation levels leading to a low and immature extent of collagen fibrils on postoperative 14th day. There was only a small amount of epithelialization due to scab formation and medium to high level inflammation for both SFM-E and SFM-AuE, but they were better than UTSC in terms of neovascularization and granulation tissue formation. As a whole, inclusion of AuNPs to SF matrices at 14.27 ppm loading brought some enhancement in the matrix properties and did not cause any toxicity in in vitro and in vivo conditions and even had potency to promote wound healing stages. Scientific and Technological Research Council of Turkey, TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [2120189] This investigation was financially supported by the Scientific and Technological Research Council of Turkey, TUBITAK (Project no. 2120189) in the framework of 1512-Entrepreneurship and Multistep R&D Funding Program. The commercialization potential of the SF matrices developed here was also investigated with the cooperation of METU and Remoderm Medical Ltd. Co. The authors express their gratitude to Tufan Emiroglu for his helps in construction of wet electrospinning system and Dr Temel Bilici for his valuable advices in the design of SF matrices. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

We evaluated the effects of the oral nutritional supplement containing arginine, glutamine, and hydroxymethylbutyrate (Abound®) on healing of colonic anastomoses in experimental rat model. Seventy Wistar-Albino male rats were divided into seven groups. Colon transection and anastomosis were performed in all groups except for the sham group. In groups 2 and 5, rats were fed with standard rat chow after the operation. Oral nutritional supplement was added to standard nutrition for 3 days postoperatively in group 3 and 7 days in group 6 and preoperative 7 days plus postoperative 3 days in group 4 and preoperative 7 days plus postoperative 7 days in group 7. Bursting pressures were measured, adhesions were evaluated, and tissue samples were taken for measurement of tissue hydroxyproline levels and for histopathological examination. The usage of oral nutritional supplement had positive effects on bursting pressures, tissue hydroxyproline levels, and histopathological findings of anastomoses, but feeding with oral nutritional supplement both preoperatively and postoperatively had no additive effect on these parameters when compared with the groups that were fed only postoperatively. The mixture of arginine, glutamine, and hydroxymethylbutyrate may be safely used for achieving better healing results after colonic anastomoses.

This study was designed to evaluate the efficiency of montelukast as a novel radioprotective agent against sodium [131I]iodide or potassium [131I]iodide (131I)-induced salivary gland damage in a rat model.The function and structure of salivary glands in 50 albino Wistar rats were evaluated with technetium-99m pertechnetate scintigraphies and histopathological examination. The animals were classified into five groups as follows: the control group (sham operated); group 1 (n=10; only 131I administration), group 2 (n=10; administration with 131I and montelukast); group 3 (n=10; 131I administration after total thyroidectomy); and group 4 (n=10; administration with 131I and montelukast after total thyroidectomy). All rats were killed at the end of the third month and three pairs of salivary glands were removed surgically.The scintigraphic evaluation revealed better results for groups administered montelukast than it did for other groups. Statistically significant differences (P0.05 or P0.001) were found between the control group and the other groups as well as between groups 1 and 3 (n=20) and groups 2 and 4 (n=20). However, there was no statistically significant difference (P0.05) between groups 1 and 2 (n=20) and groups 3 and 4 (n=20). Histopathological examinations showed that pathological changes were significantly high in the groups treated with 131I without montelukast when compared with the other groups.This is the first study on rats to assess the protective effect of montelukast on salivary glands after 131I therapy. According to our results, montelukast was found to be a potential protective agent against 131I-induced damage on salivary glands.

Ankaferd Blood Stopper(®) (ABS) is a folkloric medicinal plant extract used as a haemostatic agent in traditional Turkish medicine. The aim of this study was to investigate the efficacy of ABS on the healing of dermal wounds in a rat model. Twenty Wistar albino rats were divided into two groups. Standard full-thickness skin defects were created on the back of the rats. In the control group (group 1), dressings moisturised with saline were changed daily. In the study group (group 2), the wounds were cleaned daily with saline, Ankaferd solution was applied, then the wounds were covered with moisturised dressings. The contraction percentage of wound areas were calculated on the 3rd, 7th, 10th and 14th days using a planimetric programme. On day 14, the wound areas were excised for histopathological examination, inflammatory scoring and evaluation of collagen deposition. The study group was superior to the control group in terms of inflammatory scoring, type I/type III collagen ratio and wound contraction rates. ABS(®) may be used effectively and safely on full-thickness wounds as a natural product.