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The coexistence of Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) is controversial. This study was conducted to evaluate the correlation between HT and PTC and to identify predictive factors for the coexistence of PTC and HT. A total of 922 patients underwent surgery for thyroid disorders between January 2001 and August 2005. In all, 199 patients had been diagnosed with PTC, 37 of whom had coexistent HT; in 689 patients, benign thyroid disease had been diagnosed. Patients' age and sex, as well as histopathology, tumor size, nodal involvement status, multicentricity, presence of metastasis, and serum thyroglobulin levels, were retrospectively reviewed. A significant correlation was observed between HT and PTC, although no statistical significance was noted between PTC and HT type (nodular or diffuse). Most patients with PTC+HT were female and younger (<40 y old) than those with PTC only. The rate of occult tumor in patients with PTC+HT was higher than that in patients with PTC alone. Data indicate the coexistence of PTC and HT and suggest that PTC may develop even in cases of diffuse HT. Total thyroidectomy is the surgical procedure of choice, especially in young, female patients with HT. [ABSTRACT FROM AUTHOR]

In this study, we aimed to clarify the factors that may effect long-term graft and patient survivals. We retrospectively evaluated the outcome of 112 renal transplant recipients who shared paired cadaveric kidneys between 1985 and July 2001. There were two study groups, each with 56 patients, according to the timing of the operations. The operations were performed by the same transplant team, so Group 1 represents the recipients of the first kidney and Group 2, the second. The same low-dose triple drug immunosuppression protocol with prednisolone, azathioprine and cyclosporine A was used in both groups. Cyclosporine A was converted to tacrolimus in seven patients in Group 1 and in five patients in Group 2. Demographic properties, number of acute-rejection episodes, serum creatinine levels, creatinine clearance values, graft and patient survival rates, postoperative complications, recipient body weights, cold ischemia times, and de novo malignancies were studied. To analyze our results the Chi-square and Wilcoxon Signed Ranks tests were used, differences, with P <0.05 were accepted as significant. Regarding the HLA matchings, the groups were similar. Mean cold ischemia times were 22.1±8.7 and 23.3±9.1 h in Groups 1 and 2, respectively (P >0.05). Acute-rejection rates within the first month following the transplantation were also similar in both groups. Serum creatinine levels and creatinine clearance values at 30 days post-transplantation showed no significant difference between the groups ( P >0.05). One, 2 and 5 years' graft survival rates (Group 1 vs. Group 2) were 97% vs. 92%, 74% vs. 77% and 27% vs. 24%, respectively. No statistically significant difference was observed on returning to the hemodialysis rates (10/56 vs. 13/56). In Group 2, the rate of proteinuria (over 200 mg/day) throughout the follow-up period was significantly higher than that in Group 1 (Chi-square, P =0.03). Three patients underwent re-transplantation: one in Group 1 and two in... [ABSTRACT FROM AUTHOR]

Palatal perforation is a very rare condition which may be congenital or acquired. A case of palatal perforation after a long intubation period is presented. [ABSTRACT FROM AUTHOR]

Perovskite-based oxides are used in electrochemical CO 2 and H 2 O reduction in electrochemical cells due to their compositional versatility, redox properties, and stability. However, limited knowledge exists on the mechanisms driving these processes. Toward this understanding, herein we probe the core level binding energy shifts of water-derived adspecies (H, O, OH, H 2 O) as well as the adsorption of CO 2 on LaCoO 3 and LaNiO 3 and correlate the simulated peaks with experimental temperature-programmed X-ray photoelectron spectroscopy (TPXPS) results. We find that the strong adsorption of such chemical species can affect the antiferromagnetic ordering of LaNiO 3 . The adsorption of such adspecies is further quantified through Bader and differential charge analyses. We find that the higher O 1 s core level binding energy peak for both LaCoO 3 and LaNiO 3 corresponds to adsorption of water-related species and CO 2 , while the lower energy peak is due to lattice oxygen. We further correlate these density functional theory-based core level O 1 s binding energies with the TPXPS measurements to quantify the decrease of the O 1 s contribution due to desorption of adsorbates and the apparent increase of the lattice oxygen (both bulk and surface) with temperature. Finally, we quantify the influence of adsorbates on the La 4 d , Co 2 p , and the Ni 3 p core level binding energy shifts. This work demonstrates how theoretically generated XPS data can be utilized to predict species-specific binding energy shifts to assist in deconvolution of the experimental results., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Background: Idiopathic granulomatous mastitis (IGM) is a benign and rare chronic inflammatory disease of the breast with unknown etiology. While there is no consensus regarding its post-diagnosis management, there are different treatment alternatives., Aims: In this study, it was aimed to question the effectiveness of follow-up strategy without administering any treatment., Methods: One hundred eighteen female patients diagnosed with IGM were retrospectively evaluated. Patients with histopathologically confirmed IGM were included in the study. Medical treatment was given only to patients who did not accept the follow-up option without treatment. The protocol used in steroid therapy was 16 mg prednisolone twice daily for 2 weeks, and then the dose was gradually reduced, and the treatment was stopped after 2 months. Patients were followed up with a physical examination every 3 months. The effectiveness of the systemic corticosteroid treatment and the follow-up approach without any treatment was compared. The recurrence rates and pre-treatment and post-treatment methods of the patients were examined., Results: While 30.5% of the patients recovered with corticosteroid treatment, 42.4% recovered under observation without any treatment. The mean recovery period of the patients in these two groups was calculated as 3.9 months and 5.6 months, respectively. However, no statistically significant difference was found in terms of recovery period (p = 0.064). The recurrence rate was 11.9%., Conclusion: For IGM, the "watch and wait" approach is an effective option. A chance should be given to the self-limiting nature of the disease with the addition of drainage when necessary., (© 2020. Royal Academy of Medicine in Ireland.)

Age-related cognitive decline arises from alterations in brain structure as well as in sleep-wake regulation. Here, we investigated whether preserved wake-dependent regulation of cortical function could represent a positive factor for cognitive fitness in aging. We quantified cortical excitability dynamics during prolonged wakefulness as a sensitive marker of age-related alteration in sleep-wake regulation in 60 healthy older individuals (50-69 y; 42 women). Brain structural integrity was assessed with amyloid-beta- and tau-PET, and with MRI. Participants' cognition was investigated using an extensive neuropsychological task battery. We show that individuals with preserved wake-dependent cortical excitability dynamics exhibit better cognitive performance, particularly in the executive domain which is essential to successful cognitive aging. Critically, this association remained significant after accounting for brain structural integrity measures. Preserved dynamics of basic brain function during wakefulness could therefore be essential to cognitive fitness in aging, independently from age-related brain structural modifications that can ultimately lead to dementia., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2019.)

Aim: The particular signals that start and orchestrate the regeneration process in pancreas are not well understood yet. We aimed to investigate the expression of nestin and chromogranin A in pancreatic regeneration zones and a secondary objective, we assessed the efficiency of pancreatic duct ligation method in creation of a pancreatic regeneration model in rats., Materials and Methods: Partial (90%) pancreatectomy and pancreatic duct ligation were performed in Wistar rats, in order to create pancreatic regeneration models. Pancreatic tissues were examined histologically. Expression profiles were investigated by immunohistochemistry for nestin and chromogranin A., Results: Nestin and chromogranin A expressions were observed in regeneration zones. Pancreatic regenerations zones were seen in pancreatic duct ligation group samples as well as partial pancreatectomy group. Nestin was expressed prominently in acinoductular metaplasia cells in regeneration zones. This was best demonstrated in the samples of pancreatic duct ligation group. In the subsequent sections of nestin positive sites, cytoplasmic positivity with chromogranin A was observed., Conclusion: This study confirms that nestin and chromogranin A can be detected in neogenesis-evoked pancreatic tissue, particularly in the acinoductular epithelium. Nestin and chromogranin A may be important markers to identify pancreatic stem cells. Pancreatic duct ligation can be used for creating pancreatic regeneration model in rats., Key Words: Chromogranin A, Nestin, Pancreas, Regeneration, Stem cells.

Background: A beautiful and appealing nose receives the greatest contribution from the nasal tip subunit, which should be regarded as the primary center of attention during a rhinoplasty procedure. In achieving the desired shape and position of the nasal tip during closed rhinoplasty, the septocolumellar suture functions as the major determinant together with the caudal portion of the septal cartilage, which has a significant influence on the versatility of the septocolumellar suture. The purpose of this study was to present the analysis of the indications, the technical steps, and the advantages of caudal septal graft and septocolumellar suture utilization in closed rhinoplasty., Methods: The septocolumellar suture with or without the caudal septal graft combination procedure has been performed in 2286 patients via a closed rhinoplasty approach. Intraoperatively, the septal cartilage at hand was thoroughly evaluated and one of the 5 types of caudal septal grafts was used when necessary. After the establishment of a strong and straight septal cartilage with sufficient height and length, 4 different septocolumellar sutures in a specific order were used to modify the relationship between the lower lateral cartilages and the nasal septum., Results: Of the 2286 cases, 1837 (80.3%) were primary and 449 (19.7%) secondary rhinoplasties, which have been followed up for 9 to 48 months. The caudal septal graft was combined to the septocolumellar suture in 621 (27.1%) patients. Of the caudal septal grafts, 69.7% were used for primary rhinoplasty cases, and 30.3% for secondary rhinoplasties. At the 18th month postoperatively, tip projection was found to be satisfactory for 98% of the patients., Conclusions: The septocolumellar suture combined with caudal septal graft in closed rhinoplasty substantially facilitates the achievement of a cosmetically and functionally pleasing end result, bringing the solution for a wide array of problems such as short nose, supratip deformity, nasolabial angle change, or columellar bowing. Nevertheless, the technique has a steep learning curve; therefore, a meticulous preoperative evaluation should be exerted, a precise surgical planning should be prosecuted, and an excessive reduction of the nasal tip or exaggerated columellar retraction should be avoided.

Background: GATA zinc finger domain containing 2B (GATAD2B) encodes a subunit of the MeCP1-Mi-2/nucleosome remodelling and deacetylase complex involved in chromatin modification and regulation of transcription. We recently identified two de novo loss-of-function mutations in GATAD2B by whole exome sequencing in two unrelated individuals with severe intellectual disability., Methods: To identify additional individuals with GATAD2B aberrations, we searched for microdeletions overlapping with GATAD2B in inhouse and international databases, and performed targeted Sanger sequencing of the GATAD2B locus in a selected cohort of 80 individuals based on an overlap with the clinical features in the two index cases. To address whether GATAD2B is required directly in neurones for cognition and neuronal development, we investigated the role of Drosophila GATAD2B orthologue simjang (simj) in learning and synaptic connectivity., Results: We identified a third individual with a 240 kb microdeletion encompassing GATAD2B and a fourth unrelated individual with GATAD2B loss-of-function mutation. Detailed clinical description showed that all four individuals with a GATAD2B aberration had a distinctive phenotype with childhood hypotonia, severe intellectual disability, limited speech, tubular shaped nose with broad nasal tip, short philtrum, sparse hair and strabismus. Neuronal knockdown of Drosophila GATAD2B orthologue, simj, resulted in impaired learning and altered synapse morphology., Conclusions: We hereby define a novel clinically recognisable intellectual disability syndrome caused by loss-of-function of GATAD2B. Our results in Drosophila suggest that GATAD2B is required directly in neurones for normal cognitive performance and synapse development.

Purpose: Lichtenstein repair has been the gold standard in inguinal hernia surgery. The aim of this study was to investigate the role of mesh fixation in terms of postsurgical chronic pain and recurrence., Methods: Sixty patients with primary inguinal hernias were treated between March 2007 and December 2008. Thirty patients underwent conventional Lichtenstein repair while a self-adhesive mesh was used for the second group. The primary outcome parameters were the rate of recurrence and chronic pain. The operating time, postoperative pain, complications, and time when patients returned to work were recorded., Results: Fifty-one patients completed the survey. Early pain scores were lower in the self-adhesive mesh group. The main advantage of the self-adhesive mesh was the shorter operating time (23.70 ± 5.57 vs 36.90 ± 11.36, P = 0.006). Both techniques were almost identical in terms of long-term chronic pain (P = 0.294), and the rates of recurrence at the end of a median of 31 months' follow-up were identical., Conclusion: Self-adhesive mesh repair of inguinal hernias is superior to the conventional Lichtenstein method in terms of shorter operative time and less pain in the early postoperative period. The rates of chronic pain and recurrence are similar with the suture-fixed repairs.

Prosthetic materials have gained popularity for ventral hernia repair. There are situations when the use of a mesh is either unnecessary or contraindicated. This study compares 51 patients with ventral hernia who underwent laparoscopic or open primary suture repair. Results were determined by a median follow-up of 33 months. Recurrence rates and operative time were the major parameters of outcome. Mean operative time was insignificantly shorter in the laparoscopic group (14.8 ± 4.3 vs. 15.6 ± 3.7 min). There were no short-term complications in groups. One patient in each group had recurrence. Conclusively, laparoscopic primary repair of small ventral hernias is simple and can be performed as an initial approach for small defects. Compared with open repair, it has the advantages of better exposure, reduced pain, and less morbidity. It can also be performed as a component of a combined laparoscopic operation. However, this technique is not recommended for repair of large ventral hernias.

Background: Auricular surgery is a challenging subject in plastic surgery due to the complicated surface topography of the external ear. Although various techniques for ear reduction and helical rim reconstruction have been reported in the literature, an ideal method is yet to be defined. Double helical rim advancement flaps with scaphal resection presented in this report represent a practical technique for correcting macrotia and reconstructing helical rim defects., Methods: The amount of full-thickness resection at the helical rim is planned according to the desired reduction or extent of tumor. After helical excision, an incision that transects all the layers of the ear is carried out along the helical sulcus inferiorly and superiorly to yield two advancement flaps. Using scissors, a crescent from the scapha is excised through the full thickness of the ear. The flaps are approximated and sutured to the scapha by means of stitches that pass through skin and cartilage., Results: The described technique has been performed successfully since 1998. It has been used for 12 cases of macrotia, 28 cases of tumor surgery, and 7 cases of ear reduction for asymmetric ears. No major complications have been encountered. Three cases are reported as examples of the procedure., Conclusions: Double helical rim advancement flaps with scaphal resection represent a versatile and safe technique that can be used for ear reduction, helical rim reconstruction, and correction for discrepancy in size of ears.

Chondroid syringoma is a rare eccrine tumor that is often benign but has the potential for malignant transformation and distant metastasis. Histopathological analysis may not be definitive, and any patient with atypical features, an accelerated clinical course, or high suspicion for malignant transformation is a candidate for immediate surgical intervention and close follow-up. The purpose of this article is to review the clinical features of this rare tumor with a special emphasis on its atypical presentation., (Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Losartan, a drug with antiinflammatory properties, has been shown to prevent ischemic injury in various organs. The purpose of the present study was to investigate the effects of losartan on ischemic skin flaps and on flap survival., Methods: A 3x9 cm dorsal flap was elevated in 24 Sprague-Dawley rats. Rats received the following treatment for seven days: Group I (n=8): 10 mg/kg losartan; Group II (n=8): 40 mg/kg losartan; and Group III (n=8): nonionized water. At the end of the seventh day, the viable flap areas were calculated, and histological analysis was conducted to count cells and capillaries in microscopic fields., Results: Mean flap survival was 61%, 56% and 60% in Groups I, II and III, respectively. Comparison of flap survival between groups did not yield any significant difference (p>0.05). Ischemic zones of the flaps in all groups demonstrated an increase in number of neutrophils, fibroblasts and capillaries (p<0.05), whereas no difference was seen in mast cells. The cell counts in the viable areas of the flaps showed a significant decrease in fibroblasts in the group treated with 40 mg/kg losartan (p<0.05). The number of neutrophils, mast cells and capillaries was not influenced by treatment., Conclusion: Losartan does not improve skin flap survival but it has a significant antiproliferative effect on fibroblasts.

Epigastric, umbilical, incisional, parastomal, and trocar site hernias are all classified as "ventral" hernias, which constitute a great portion of the surgery in a general surgical practice, and debate still continues regarding the optimal surgical strategy to correct these anatomical defects. Although repairing these hernias using a synthetic material, whether placed open or laparoscopically, has gained wide popularity, there are some situations where the use of a mesh is either unnecessary or contraindicated. This article presents the cases of 10 patients with some kind of ventral hernia which were all repaired laparoscopically with a primary suturing technique.

Background: Determining the most advantageous size of liposuction cannula and injection needles in terms of adipocyte viability could help to increase fat graft survival. When recurrent injections are necessary, storing fat tissue which is harvested during the first operation could be a practical solution if it is stored at an appropriate temperature providing the highest amount of viable fat cells., Methods: Fat tissue was removed from the abdomen of 10 consecutive female patients by 6-, 4- and 2-mm-diameter liposuction cannulas. Fat tissue harvested with the 6mm cannula was injected through 14, 16 and 20 g needles and collected in separate tubes. An additional three tubes of fat samples were prepared from fat tissue obtained with the 6mm cannula to be stored at +4, -20 and -80 degrees C for 2 weeks. Viability of the fat grafts was evaluated by fat cell isolation with collagenase digestion and staining with supravital dye and counting adipocytes with a haemocytometer., Results: The viability of fat grafts harvested with the 6mm cannula was higher than grafts obtained with smaller cannulas. The viability of fat grafts injected through 14, 16 and 20 g needles were similar to each other. The viability of fat grafts stored at +4 degrees C was similar to fresh tissue whereas freezing fat grafts caused significant loss of viable adipocytes compared to fresh tissue., Conclusions: The use of larger liposuction cannulas for fat tissue harvesting provides more viable fat grafts. A temperature of +4 degrees C could be proposed as an effective and easily available way of storing fat grafts for at least 2 weeks.

Background: In many plastic surgery operations that are undertaken through relatively small incisions resulting in deep-seated operating fields, sliding knots with a self-locking property are preferred by plastic surgeons for 3 reasons: simplicity, reliability, and versatility. We describe a new and versatile sliding knot that can be easily sledded and locked., Methods: The technique of knot tying is described in detail as a stepwise approach with photographs. The main advantages of the Peruvian fisherman's knot are compared with other methods and summarized., Results: In addition to its adjustment-related properties, knot security has been adequate with this knot as evidenced by its clinical performance and the authors' experiences to date., Conclusion: The Peruvian fisherman's knot is especially useful while working in deep seated operating fields through a small incision. Tension created during knot tying is adjustable, which makes it an ideal choice for various lifting procedures in plastic surgery.