The effect of Resveratrol and Octreotide on peritoneal adhesions in a rat model.

INTRODUCTION: The aim of this study was to investigate the efficacy of resveratrol and octreotide, agents that are used to prevent intra-abdominal adhesions in experimental models, in preventing intraperitoneal adhesions when used alone or in combination. MATERIALS AND METHODS: The study employed 28 young female Wistar albino rats weighing 250-300 grams. An experimental adhesion model was created in each rat using serosal abrasion and peritoneal excision. They were divided into four groups, each comprising seven rats: Group 1, adhesion induction only; Group 2, resveratrol administration only; Group 3, octreotide administration only; and Group 4, administration of resveratrol and octreotide combination. The rats were monitored under appropriate conditions for 14 days and then underwent laparotomy. Macroscopic intensity and extensiveness of adhesions and microscopic changes in the granulation tissue (cellular intensity, reticular and collagen fibers, capillaries, elastic and smooth muscle fibers, fibrosis) were evaluated and graded. Kruskal-Wallis and Mann-Whitney U-test were used in statistical analysis and the level of statistical significance was established as p <0.05. RESULTS: There was no significant difference between the groups in terms of the intensity and extensiveness of macroscopic adhesions (p=0.377 and p=0.319). There was a statistically significant difference between the microscopic scores of the groups according to Zühlke's classification (p=0.026). The Bonferroni correction used to test for the differences revealed that the rats in Group 1 achieved significantly higher scores than the rats in Group 3 (p=0.016). CONCLUSION: Octreotide showed higher efficiency compared to the control group in microscopic classification; however, the two agents were not superior to each other or their combination was not superior in preventing intra-abdominal adhesions.

Results of CAM therapy in amblyopic patients.

AIM: to evaluate changes in visual acuity and compliance after CAM therapy in patients that initially failed to respond to occlusion or were non-compliant. MATERIAL AND METHODS: Twenty nine patients aged 4-10 years that failed to improve under occlusion therapy were included in this prospective study. Patients were divided into two groups according to the age (16 patients of 4-7 years of age and 13 patients of 8-10 years of age) and two other groups according to the type of amblyopia (15 anisometropic and 14 strabismic cases). CAM stimulation was prescribed to all patients for six days. Occlusion therapy was then recommenced. Best corrected visual acuity was measured before the CAM course, immediately after, at 3- and 6-month follow-ups, and on the last visit. RESULTS: Visual acuities in all study groups increased significantly immediately after the CAM therapy with further improvement during the follow-up period. CONCLUSION: CAM therapy for amblyopia is helpful in improving visual acuity as well as patients' compliance to subsequent occlusion therapy.

Perforated gastric cancer complicating early postpartum period of pregnancy.

BACKGROUND: An unique association of gastric cancer with pregnancy and puerperium is rare. CASE: A 29-year-old woman had complained of epigastric pain, postprandial vomiting and weight loss during the last 3 months of pregnancy. She first applied to our centre for premature rupture of membranes at the 38th week of gestation and underwent an emergency caesarean section because of umblical cord prolapsus. The patient developed generalised abdominal pain, distention and fever on the 2nd postpartum day. She was operated on due to acute abdomen. During surgery, generalised peritonitis with a gastric ulcer perforation at the corpus was found. The perforation area was repaired primarily. Pathological examination revealed gastric adenocarcinoma. Definitive surgery was carried out 2 weeks later. The patient received 6 cycles of adjuvant chemotherapy. After completing chemotherapy the patient was re-explored because of developing intestinal obstruction. In surgical exploration, a disseminated peritonitis carcinomatosa and extensive adhesions were observed and the patient was therefore evaluated as incurable. Postoperatively, the patient developed a high output intestinal fistula which could not be treated with palliative care. The patient died 6 months after initial diagnosis of gastric cancer. CONCLUSION: When peritonitis symptoms exist in a postpartum woman in addition to other peritonitis causes, malignant gastro-intestinal perforations such as gastric cancer perforation should be kept in mind.

Comparison of biochemical composition of three aqua cultured fishes (Dicentrarchus labrax, Sparus aurata, Dentex dentex).

The moisture, ash, protein and fat content and amino acid, fatty acid and mineral compositions in the flesh of three commercially important fish species (Dicentrarchus labrax, Sparus aurata, Dentex dentex) from the aqua culture of Turkey were evaluated. Ranges of moisture, ash, protein and fat contents were 69.68-76.42%, 1.49-1.95%, 18.21-21.70% and 2.29-8.10%, respectively. Among them, those occurring in the highest proportions were aspartic acid (3238.91-5204.71 mg/100 g), glutamic acid (5256.60-5810.43 mg/100 g), arginine (198.07-414.91 mg/kg), phenylalanine (50.51-386.96 mg/100 g), leucine (375.84-574.94 mg/100 g) and lysine (3089.71-4711.98 mg/100 g). The fatty acid compositions of sea bass (D. labrax), sea bream (S. aurata) and common dentex (D. dentex) ranged from 28.01% to 32.41% saturated, from 25.88% to 28.62% monounsaturated, and from 24.75% to 27.42% polyunsaturated. The highest potassium, magnesium, phosphorus, iodine and selenium contents were found in these fishes.

Hydatid cysts with unusual localizations: diagnostic and treatment dilemmas for surgeons.

Although the liver and lung are by far the most common localizations for the larval cysts of Echinococcus granulosus in humans, the cysts may develop in other sites and there cause signs and symptoms that may be easily confused with those of other illnesses. In a retrospective study in Turkey, six male and 11 female cases of cystic echinococcosis, each with at least one cyst in an unusual site, were investigated. The patients, who had a mean age of 41.6 years, had cysts in the pancreas, intra-abdominal cavity, kidney, spleen, ovary, breast, mediastinum, chest wall, muscle and/or subcutaneous tissue. In terms of Gharbi's classification, 15 (75%) of the 20 cysts in these patients were type I and five (25%) were type II. Fourteen of the cases each had single cysts, two had multiple cysts, and one had an unknown number of cysts. All but one of the cases (who had a pancreatic cyst) were treated by total cystectomy. In areas where cystic echinococcosis is endemic, any patient presenting with a cystic mass, in any tissue or organ, should be considered a potential case of the disease and be carefully investigated by radio-imaging and/or ultrasonography.

Inflammatory pseudo-tumour as an unusual cause of colonic obstruction: a case report.

Inflammatory pseudo-tumour (IPT), also known as inflammatory myofibroblastic tumour or plasma cell granuloma, is a benign inflammatory solid tumour that may mimic malignancy. The etiology is obscure. Lung, spleen and mesentery are common sites of involvement. Colonic occurence is rare. Herein we report a case of IPT arising from the hepatic flexura with regard to its radiological, operative and histologic findings, that lead to colonic obstruction.

Effects of pressure- and volume-controlled inverse ratio ventilation on haemodynamic variables, intracranial pressure and cerebral perfusion pressure in rabbits: a model of subarachnoid haemorrhage under isoflurane anaesthesia.

BACKGROUND AND OBJECTIVE: An inverse I : E ratio (inspiratory time > expiratory time) may have benefits in patients suffering trauma who requiring lung ventilation. However, this application may be deleterious if there is concomitant head injury. We aimed to determine the physiological effects of pressure- and volume-controlled modes of inverse ratio (I : E = 2 : 1) ventilation of the lungs, while maintaining normocapnia, in a rabbit model of raised intracranial pressure (ICP). METHODS: New Zealand White rabbits were anaesthetized with isoflurane and a tracheostomy was performed. Subarachnoid haemorrhage was simulated in two groups by injecting blood into the cisterna magna. Groups 1 and 2 (n = 6, each), controls, were compared with Groups 3 and 4 (n = 6, each) with the simulated subarachnoid haemorrhage. Each ventilation mode was used with an I : E ratio of 2 : 1 for 30 min. Mean arterial pressure (MAP), ICP, cerebral perfusion pressure (CPP), mean airway pressure (P(AW)) and arterial blood-gas status were measured. RESULTS: Both modes increased mean P(AW) (P < 0.02). This increase was greater with the volume-controlled mode (P < 0.02). The baseline value averaged 5.8 +/- 0.4 and 5.6 +/- 0.3 mmHg in Groups 3 and 4, respectively, and increased to 7.8 +/- 0.3 and 10.8 +/- 0.4 mmHg. Inducing subarachnoid haemorrhage increased ICP and MAP (P < 0.02). Baseline ICPs were 10.3 +/- 0.5 and 10.3 +/- 0.4 mmHg in Groups 1 and 2, respectively, whereas they were 25.4 +/- 1.2 and 25.8 +/- 0.8 mmHg in Groups 3 and 4. However, ICP, MAP and CPP did not differ significantly according to the mode. CONCLUSIONS: An already raised ICP was altered by the application of induced mean PAW increases as a consequence of inverse ratio ventilation of the lungs with normocapnia.

[An evaluation of surgical techniques and oncologic results in early glottic cancers]. / Erken evreli glottik kanserlerde cerrahi tedavi seçimi ve onkolojik sonuçlar.

OBJECTIVES: We evaluated the surgical techniques employed and survival rates in patients who were treated for early glottic cancer. PATIENTS AND METHODS: The study included 29 patients (28 males, 1 female; mean age 59 years; range 47 to 73 years) who underwent surgery for early glottic cancer. Surgical techniques were employed in view of factors such as involvement of the anterior commissure, the extent of sub- or supraglottic invasion, and cord mobility. Two- and five-year survival rates were calculated. TNM classification was made according to the 1992 AJCC staging system. RESULTS: Preoperative tumor stages were TisN0 (n=2, 7%), T1N0 (n=20, 69%), and T2N0 (n=7, 24%). Surgical techniques included laryngofissure and cordectomy (n=9, 31%), frontolateral laryngectomy (n=18, 62%), and vertical hemilaryngectomy (n=2, 7%). Positive surgical margins were reported postoperatively in 10 patients, eight of whom remained tumor-free with (n=4) or without (n=4) radiation therapy during the follow-up period, while two patients underwent total laryngectomy because of local recurrences. Three patients died due to causes other than the primary disease. Two- and five-year survival rates were 88.8% and 80%, respectively. CONCLUSION: Involvement of the anterior commissure, and the extent of invasion to the subglottis, supraglottis, and the laryngeal ventricle seem to play a major role in selecting the most appropriate surgical technique in early glottic cancer.

Effects of normovolaemic haemodilution on middle cerebral artery blood flow velocity and oxygen delivery.

BACKGROUND AND OBJECTIVE: Assessment of the effects of normovolaemic haemodilution on middle cerebral artery blood flow velocity with transcranial Doppler ultrasonography, intracranial pressure, cerebral perfusion pressure, arterial oxygen content and cerebral oxygen delivery. METHODS: Normovolaemic haemodilution was induced in rabbits under general anaesthesia, and the haematocrit was allowed to decrease to 30% in Group 1 (n = 6) and to 20% in Group 2 (n = 6). Peak systolic and diastolic velocities, mean blood flow velocity, and pulsatility and resistance indices of the middle cerebral artery were measured by transcranial Doppler ultrasonography. Changes in intracranial pressure, cerebral perfusion pressure, arterial oxygen content and cerebral oxygen delivery were also assessed. RESULTS: In Group 2, middle cerebral artery blood flow velocity increased from 0.4 +/- 0.01 to 0.51 +/- 0.02 m s(-1) after the induction of normovolaemic haemodilution (P = 0.04), while arterial oxygen content decreased from 16.2 +/- 0.1 to 8.5 +/- 0.1 mLdL(-1) (P = 0.002). The decrease in cerebral oxygen delivery from 6.5 +/- 0.2 to 4.3 +/- 0.2 was also significant (P = 0.02). However, no associated changes in intracranial pressure and cerebral perfusion pressure could be demonstrated. CONCLUSIONS: Normovolaemic haemodilution resulted in an increase in the mean blood flow velocity of the middle cerebral artery. However, this increase did not compensate for the consequences of the altered oxygen delivery to the brain when the haematocrit was reduced to 20%.

Ocular blood flow in healthy and primary open-angle glaucomatous eyes.

PURPOSE: To evaluate blood flow parameters in the ophthalmic artery, in the posterior ciliary arteries and in the central retinal artery in eyes with primary open-angle glaucoma. METHODS: Hemodynamic parameters were evaluated by color Doppler imaging in 48 patients with primary open-angle glaucoma and 42 age-matched normal control subjects. Peak systolic velocity (Pv), end-diastolic velocity (Ev), and resistive index (RI) were calculated in the central retinal artery, short posterior ciliary arteries and the ophthalmic artery. RESULTS: The analysis of the ocular blood flow velocities in the central retinal artery, short posterior ciliary arteries and the ophthalmic artery revealed a significant reduction in peak systolic velocity and end-diastolic velocity with an increase in resistive index in primary open-angle glaucoma compared with controls (p < 0.05). CONCLUSION: Our data indicate primary open-angle glaucoma to be associated with a decreased flow velocity and increased resistive index in the ocular vasculature.

Vertical banded gastroplasty in the Aegean Region of Turkey.

BACKGROUND: Obesity is increasing in Turkey. The first experience with vertical banded gastroplasty (VBG) with regular intermediate-term follow-up in the Aegean Region of Turkey is presented. METHODS: From November 1993 to August 1999, 40 morbidity obese patients underwent VBG. The patients were evaluated on the basis of excess weight loss (EWL) and satisfaction with the operation. RESULTS: Regular follow-up was obtained in 38 patients (95%), with mean follow-up 27.2 months (14-85). Average preoperative body weight (BW) was 141.4 kg (93-238) and body mass index (BMI) was 52.3 kg/m2 (41-77.8). Average EWL was 64.1% (21.2-92.3). Average postoperative BW and BMI were 93.3 kg (70-145) and 34.4 kg/m2 (25.1-53) respectively. 35 of 38 patients (92%) lost more than 25% of EW and 28 of 38 (73.6%) lost more than 50% of EW. After weight loss, hypertension disappeared or improved in 86% of patients and diabetes resolved in 75%. Sleep apnea disappeared in 100% of patients. The early and late complication rates were 7.9% and 15.8% respectively. 33 of 38 patients (87%) were satisfied with the operation. CONCLUSION: VBG was safe and effective, resulted in acceptable weight loss, and the vast majority of patients were satisfied.

[The content of biogenic amines in canned fish from the Turkish market]. / Untersuchungen über den Gehalt biogener Amine in Fischkonserven des türkisches Marktes.

This paper describes the determination of biogenic amines in a number of canned fish of the Turkish market by means of HPLC. Over all 39 cans of sardine, tuna, sardel, mackerel, pelamide and trout were tested. The determination of agmatine, cadaverine, histamine, putrescine and tyramine was performed by HPLC with post column derivatization with ortho-phthaldialdehyde. Four samples contained higher amounts of biogenic amines (three sardine samples contained more than 1000 mg/kg histamine) while all other samples were acceptable. These results demonstrate the need of instrumental analyses in the quality control system of Turkish producers of canned fish. The quality of the products at least of some producers has to be improved, e.g. by cooperation between the official food control and the quality assurance system of the producers.

Effects of CO2 pneumoperitoneum on the basilar artery.

BACKGROUND: Laparoscopic surgery provides many benefits to the patients. The purpose of this study was to evaluate cerebral blood flow changes and the possibility of ischemia-reperfusion injury occurring during carbon dioxide (CO(2)) pneumoperitoneum. METHODS: Forty-eight New Zealand white rabbits were divided into four experimental and two control groups. Rabbits were subjected to CO(2) pneumoperitoneum with an intraabdominal pressure of 8 and 15 mmHg for 60 or 180 min as designed for experimental groups. We then assessed the changes in physiological and transcranial Doppler ultrasonographic parameters, as well as brain malondialdehyde levels. RESULTS: Transcranial Doppler sonography of the basilar artery revealed elevated mean velocity and decreased resistance index and pulsatility index values with the longer-duration and higher-pressure CO(2) pneumoperitoneum. However, there were no statistically significant difference in m alondialdehyde values. CONCLUSION: Elevated intraabdominal pressure by CO(2)-pneumoperitoneum, which does not lead to ischemia-reperfusion injury of the brain tissue, results in increased cerebral blood flow and reduced cerebrovascular resistance as an autoregulatory cerebral answer for CO(2).

[Occurrence of residues of organochlorine pesticides, nitromusk compounds and polychlorobiphenyls in Turkish canned fish products]. / Vorkommen von Rückständen an Organochlor-Pestiziden, Nitromoschusverbindungen und Polychlorierten Biphenylen in türkischen Fischdauerkonserven.

In our study we elaborated an overview on the contamination grade of fish from Turkish waters by selected organochlorine pesticides, nitromusks and chlorobiphenyl congenres. We could demonstrate, that the tested fish species, being prior processed to canned products and brought to the market, contained particularly unmistakable amounts of the above mentioned analytes. Sardines, sardelles and trout gave results generally far below the German regulatory limits. However total DDT in pelamides reached an order of magnitude near the German limit of 0.5 mg/kg (based on wet weight). The necessity of enhanced systematic measurements for monitoring pollutants in fish from Turkish waters thus becomes evident.

Primary non-Hodgkin's T-cell lymphoma of the thyroid gland complicating Hashimoto's thyroiditis: case report.

This case report presents an extremely rare case of primary non-Hodgkin's T-cell lymphoma of the thyroid gland complicating Hashimoto's thyroiditis and discusses the clinical history, findings, treatment, and prognosis. Although the place of surgery in the treatment of thyroid lymphoma is controversial, in this case, surgery followed by three rounds of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone, and radiation therapy to neck and mediastinum were a very effective treatment for the disease so that no relapse has been detected during 3-year follow-up.