Presence of free cancer cells in the peritoneal cavity of patients who underwent curative gastrectomy with lymph node dissection.

BACKGROUND/AIMS: The aim of this study was to determine the ratio of patients with positive peritoneal cytology who underwent radical gastrectomy for gastric cancer, to evaluate the factors effecting risk of positive cytology and to analyze the effects cytology findings on survival. METHODOLOGY: Peritoneal lavage samples were obtained from 255 patients who underwent radical gastrectomy with D2 (184 patients) or D3 (71 patients) lymph node dissection between January 2000 and December 2007. RESULTS: Thirty-six (14.1%) of 255 patients had free cancer cells in the wash cytology samples. T stage (T4) and differentiation were found to be independent risk factors for positive peritoneal cytology in multivariate analysis. Survival rate of cytology negative patients was significantly higher, however cytology findings were not found to be an independent prognostic factor for survival. T stage, lymph node metastasis and Borrmann classification (Borrmann type 4) appeared to be independent prognostic factors for survival in multivariate analyses. CONCLUSIONS: Peritoneal cytology does not provide additional information according to the TNM (1997) staging system. However, it should be employed intraoperatively before potentially curable serosa involved gastric carcinomas, especially for T4 tumors. Surgery alone will not be enough for patients with positive cytology and further therapies should be employed.

Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis scores for diagnosis of acute appendicitis.

AIM: To assess the reliability and practical applicability of the widely used Alvarado, Eskelinen, Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring systems in patients with suspected acute appendicitis. METHODS: Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group. Patients were divided into two groups. appendicitis group (Group A) consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis, and non-appendicitis group (Group N-A) consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively. The operative findings for the patients, the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms. RESULTS: One hundred and thirteen patients with suspected acute appendicitis were included in the study. Of the 113 patients (62 males, 51 females), the mean age was 30.2 ± 10.1 (range 18-67) years. Of the 113 patients, 94 patients underwent surgery, while the rest were followed non-operatively. Of the 94 patients, 77 patients were histopathologically diagnosed with acute appendicitis. Our study showed a sensitivity level of 81% for the Alvarado system when a cut-off value of 6.5 was used, a sensitivity level of 83.1% for the Ohmann system when a cut-off value of 13.75 was used, a sensitivity level of 80.5% for the Eskelinen system when a cut-off value of 63.72 was used, and a sensitivity level of 83.1% for the RIPASA system when a cut-off value of 10.25 was used. CONCLUSION: The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.

The effect of glutamine on pancreatic damage in TNBS-induced colitis.

Ulcerative colitis is a multifactorial inflammatory disease of the colon and rectum with an unknown etiology. The present study was undertaken to investigate the effect of glutamine administration on oxidative damage and apoptosis in 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. Rats received 1 g/kg/day glutamine for intragastric gavage for 7 days before TNBS solution administration and 3 days following TNBS solution administration until sacrifice. Then colonic and pancreatic malondialdehyde (MDA) and glutathione (GSH) levels, and colonic caspase-3 activities of the sacrified rats were measured. TNBS-induced colitis caused significantly increased in the caspase-3 activity and colonic and pancreatic MDA levels and decreased colonic and pancreatic GSH levels compared to those in the sham group. Glutamine treatment was associated with decreased MDA levels and caspase-3 activity and increased GSH levels in the colinic and pancreatic tissue. Histopathological examination revealed that the colonic mucosal structure was preserved and pancreatic inflammation decreased in the glutamine-treated group. In conclusion, glutamine appears to have protective effects against TNBS-induced colonic and pancreatic damage. These results imply a reduction in mucosal damage due to anti-inflammatory and antiapoptotic effects of glutamine.