Evaluation of angiogenic apelin/apelin receptor axis in normal prostate, high grade prostatic intraepithelial neoplasia and prostatic adenocarcinoma.

INTRODUCTION AND OBJECTIVES: Prostate cancer is one of the most commonly diagnosed cancers in American men. Apelin is an endogenous peptide identified as the ligand of the G protein-associated apelin receptor. Apelin and apelin receptor have many tissues distribution and they participate in pathological processes, such as cancer. Apelin stimulates cancer angiogenesis. However, there are insufficient data in the literature regarding the role of apelin/apelin receptor in normal tissue, highgrade prostatic intraepithelial neoplasia, and prostatic adenocarcinoma tissues. Therefore, this study aimed to investigate the apelin and apelin receptor expression levels in tissues of normal prostate tissue, high-grade prostatic intraepithelial neoplasia, and prostatic adenocarcinoma. MATERIALS AND METHODS: In this study, 38 samples of patients undergoing radical prostatectomy were used. Among 38 samples; 20 patients were with prostatic adenocarcinoma, 18 patients were with high-grade prostatic intraepithelial neoplasia and adjacent normal prostatic tissue areas. The immunolocalisation of apelin and apelin receptor in these tissues were determined immunohistochemically. RESULTS: Apelin and apelin receptor expressions were higher in prostatic adenocarcinoma than normal prostate tissue and high-grade prostatic intraepithelial neoplasia. Apelin receptor expression was also increased in high-grade prostatic intraepithelial neoplasia compared to normal tissue. CONCLUSION: Apelin and apelin receptor are increase in the process of prostate carcinogenesis. This increase may adversely affect the clinical course of prostate cancer patients by stimulating angiogenesis, which is important for invasion and metastasis in prostate cancer.

Quantifying gender inequalities in obesity: findings from the Turkish population-based Balcova Heart Study.

OBJECTIVES: Sparse evidence is available to explain obesity variations between genders in the Turkish population. To our knowledge, no previous study has analysed the magnitude of gender differences in obesity using common social determinants of health. We aimed to quantify gender inequalities in obesity in terms of education, employment status, occupation and perceived income in a Turkish population. STUDY DESIGN: The study design used is a cross-sectional study. METHODS: Population-based data from the Balcova Heart Study (n = 16,080) were analysed. Logistic regression models were used to calculate the crude and adjusted odds ratios (ORs) when comparing obesity prevalence in women vs men within each category of social determinants. RESULTS: Women had a higher risk of being obese than men (adjusted OR [aOR] = 2.04 [95% confidence interval {CI}: 1.7-2.1]). Gender inequality in obesity decreased as the level of education increased, from 'primary school' (aOR = 2.5 [95% CI: 2.2-2.8]) to 'university' (aOR = 0.9 [95% CI: 0.6-1.1]). Women had a higher risk of obesity within the 'unemployed' category compared with men (aOR = 2.2 [95% CI: 1.6-3.0]). Gender inequality in obesity decreased with a higher perception of income, from 'low' (aOR = 2.1 [95% CI: 1.6-3.0]) to 'high' (aOR = 1.5 [95% CI: 1.2-2.0]). CONCLUSIONS: These findings highlight the fact that gender inequalities in obesity are greatest within populations of low education, unemployment and lower perception of income. Reduced gender inequality in obesity prevalence was seen for the subpopulation with professional occupations, with women having decreased odds of obesity compared with men. Conversely, unemployed women had increased odds of obesity compared with unemployed men. Increasing the status of women should be prioritised in policies to tackle obesity in the Turkish population and in similar developing populations elsewhere.

Factors affecting the accuracy of 18F-FDG PET/CT in evaluating axillary metastases in invasive breast cancer.

BACKGROUND AND AIM: There are conflicting results of studies on accuracy of positron emission tomography (PET)/computed tomography (CT) for axillary staging. The aim of this study is to determine the factors affecting the efficacy of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in detecting axillary metastases in invasive breast cancer. MATERIALS AND METHODS: Data of 232 patients with invasive breast cancer who underwent 18F-FDG PET/CT examination before surgery between January 2013 and September 2017 were reviewed retrospectively. Histopathological examination of axillary lymph nodes (ALNs) was used as a reference to assess the efficacy of 18F-FDG PET/CT in detecting axillary metastases. RESULTS: While 134 (57.8%) patients had axillary metastases as detected in 18F-FDG PET/CT scans, histopathologically axillary metastases were detected in 164 (70.7%) patients. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 18F-FDG PET/CT in detection of axillary metastasis were 72.56%, 77.94%, 88.8%, 54%, and 74.1%, respectively. The false-negative and false-positive rates were 27.4% and 22%, respectively. In univariate analysis, patients' age, estrogen receptor positivity, higher ALN SUVmax, greater tumor size, and lymph node size determined by 18F-FDG PET/CT were all significantly associated with accuracy of 18F-FDG PET/CT for axillary metastasis. In multivariate analysis, tumor size determined by 18F-FDG PET/CT and ALN SUVmax were independent variables associated with axillary metastasis. The accuracy of 18F-FDG PET/CT for axillary metastasis was higher in patients with a larger tumor (≥19.5 mm) and a higher ALN SUVmax (≥3.2). CONCLUSION: 18F-FDG PET/CT should not be routinely used for axillary staging, especially in patients with small tumors. It cannot eliminiate the necessity of sentinel lymph node biopsy. When it is used, both visual information and optimal cut-off value of axillary node SUVmax should be taken into consideration.

An evaluation of cause-of-death trends from recent decades based on registered deaths in Turkey.

OBJECTIVES: Although cause-of-death analyses are very important to define public health policy priorities and to evaluate health programs, there is very limited knowledge about mortality profiles and trends in Turkey. The aim of this study was to measure the trends in mortality within three broad cause-of-death groups and their distribution by age groups and gender and to describe the changes of leading causes of death between 1980 and 2013 in Turkey. STUDY DESIGN: Descriptive study. METHODS: In the study, data on the number of deaths by year, gender, age and cause was obtained from the Turkish Statistical Institute. The causes of death were classified as group I: communicable, maternal, perinatal, and nutritional conditions; group II: non-communicable diseases (NCDs); and group III: injuries. Unknown or ill-defined causes of death were distributed within group I and group II. The percentage distribution of the cause-of-death groups by gender and age groups between 1980 and 2013 was identified. Age-standardized mortality rates (ASMRs) per 100,000 of broad causes-of-death groups were calculated using European Standard Population 1976 between 1980 and 2008. Changes in mortality rates per hundred were calculated using the formula ([the rate of last year of the period-the rate of the first year of the period]/the rate of the first year of the period). Gender and age-specific data were analyzed using the Joinpoint software to examine trends and significant changes in trends of mortality rates. RESULTS: Crude death rates for group I, group II, and group III were 157.3, 147.2, and 21.4 per 100,000 in 1980 and 35.3, 377.5, and 15.8 in 2008 for males; 161.8, 120.2, and 5.8 in 1980 and 38.6, 318.4, and 6.4 in 2008 for females, respectively. ASMRs for group I, group II, and group III were 146.3, 394.3, and 29.3 per 100,000 in 1980 and 49.7, 723.6, and 18.8 in 2008 for males; 138.0, 291.5, and 7.6 per 100,000 in 1980 and 47.7, 478.8, and 7.2 in 2008 for females, respectively. The mortality rates of group I for almost all age groups particularly below 5 years of age decreased significantly. CONCLUSION: This study indicates that Turkey is at an advanced stage in the epidemiological transition, with the majority of the causes of death from NCDs. Considering the regional differences, it is necessary to carry out studies on the specific details of epidemiological transition and the social determinants of deaths in Turkey.

Association between seroprevalence of measles and various social determinants in the year following a measles outbreak in Turkey.

OBJECTIVES: Despite an ongoing measles elimination programme, a measles outbreak occurred in 2013 in Turkey. Population-based seroprevalence studies are needed to determine seronegativity and explore the reasons for this outbreak. This study aimed to explore the seroprevalence of measles and its association with various social determinants in a provincial population in Turkey in the year following a measles outbreak. STUDY DESIGN: Cross-sectional study. METHODS: This study was conducted in Manisa Province in 2014 in a sample of 1740 people aged >2 years. The dependent variable was the seroprevalence of measles. Independent variables were sex, age, migration, household size, household density, income, education level, existence of chronic disease and occupational class. Blood samples were collected from participants at family health centres. The presence of specific measles antibodies in serum samples was determined using an anti-measles virus IgG enzyme-linked immunosorbent assay test. Chi-squared test and logistic regression analysis were performed. RESULTS: Overall, data from 1250 people were analysed. The seroprevalence of measles in the whole study population was 82.2% (95% confidence interval 80.0-84.2). Seroprevalence was 55.4% among subjects aged 2-9 years, 48.7% among subjects aged 10-19 years, 74.1% among subjects aged 20-29 years and 93.6% among subjects aged 30-39 years (P < 0.01). Seroprevalence in subjects aged >40 years was >95%. The lowest seroprevalence was found in primary school children (40.2%), followed by those below the age for primary education (69.8%) and secondary school graduates (75.1%). The prevalence of measles seronegativity was not associated with any of the social determinants when adjusted for age. CONCLUSIONS: The seroprevalence of measles was lower than expected in the study population and was particularly low in subjects aged <30 years of age despite previous vaccination. Seroprevalence was not associated with social determinants of health that confirmed either an even distribution of virus exposure or fair access to vaccination services. However, the current seroprevalence cannot be sufficiently effective to reach the measles elimination targets, suggesting that it may be necessary to re-evaluate the need for an extra dose of measles vaccine.

Predicting the health impact of lowering salt consumption in Turkey using the DYNAMO health impact assessment tool.

OBJECTIVE: To estimate the impact of three daily salt consumption scenarios on the prevalence and incidence of ischaemic heart disease (IHD) and cerebrovascular disease in 2025 in the Turkish population aged ≥30 years using the DYNAMO Health Impact Assessment tool. STUDY DESIGN: Statistical disease modelling study. METHODS: DYNAMO health impact assessment was populated using data from Turkey to estimate the prevalence and incidence of IHD and cerebrovascular disease in 2025. TurkSTAT data were used for demographic data, and national surveys were used for salt consumption and disease-specific burden. Three salt consumption scenarios were modelled: (1) reference scenario: mean salt consumption stays the same from 2012-2013 until 2025; (2) gradual decline: daily salt intake reduces steadily by 0.47 g per year by lowering salt intake from bread by 50% and from table salt by 40% by 2025; and (3) World Health Organization (WHO) advice: daily salt intake of 5 g per day from 2013 until 2025. RESULTS: The gradual decline scenario would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.3% and 0.2%, respectively, and a decrease in the incidence by 0.6 and 0.4 per 1000, respectively. Following WHO's advice would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.8% and 0.5%, respectively, and a decrease in the incidence by 1.0 and 0.7 per 1000, respectively. CONCLUSION: This model indicates that Turkey can lower its future cardiovascular disease burden by following the gradual decline scenario. Following WHO's advice would achieve an even greater benefit.

An experimental investigation of the frictional drag characteristics of nanostructured and fluorinated fouling-release coatings using an axisymmetric body.

The hydrodynamic performance of two, recently developed, nanostructured and fluorinated polymer coatings was explored in a systematic experimental study using the Newcastle University Cavitation Tunnel. The experiments consisted of testing the two coatings on an axisymmetric body apparatus to measure their boundary layer flow and frictional drag simultaneously. The tests also included a smooth reference surface as well as a state-of-the-art commercial fouling-release coating (Intersleek(®) 900). The boundary layer measurements were performed using a two-dimensional Laser Doppler Velocimetry (LDV) system whilst the direct frictional force measurements were taken using a special load cell installed in the testing body. Careful surface roughness measurements of the test surfaces were also performed including the use of a non-contact high precision laser profilometer. The tests and subsequent analysis of the data highlighted the exceptionally good frictional properties of all the coatings tested as well as some of the drag benefits of the new polymer coatings in the investigated Reynolds number range.

Effects of diabetes and ovariectomy on rat hippocampus (a biochemical and stereological study).

Oxidative stress is one of the main reasons of both menopause and diabetes. So, it plays crucial role in the pathogeneses of that condition and disease. Therefore, the objective of the present study was to investigate the effects of menopause and diabetes upon the hippocampus using a rat model. Adult female Sprague Dawley rats (n = 24) were allocated randomly as follows; control (C group) ovariectomized (O group), diabetic (D group) and ovariectomy plus diabetic groups (DO group) (n = 6; in each group), respectively. For evaluating the results, tissue biochemistry and stereological analysis were made. Biochemistry results (lipid peroxidase (LPO); catalase (CAT); superoxide dismutase (SOD); total glutatyon (GSH); and myeloperoxidase (MPO) values) in Group C-DO were determined as 12.27, 21.88, 23.08 and 29.90 nmol/gr tissue; 59.3, 70.06, 69.7 and 78.1 mmol/min/mg tissue; 174.2, 156.4, 159.7 and 154.6 mmol/min/mg tissue; 3.63, 3.61, 4.21 and 3.97 nmol/mg tissue; and 5.05, 5.68, 5.58 and 6.19 µmol/min/mg tissue, respectively. Moreover, both menopause and diabetes led to change of lipid profiles. There were significant differences between the control and other groups (Group C and D-DO) (p < 0.01) and among experimental groups (p < 0.01) in terms of neuron number. When the volumes of the hippocampus were compared, there were no significant differences between the all groups (P > 0.05). At this point, we suggested that diabetes could aggravate deleterious effects of ovariectomy.

Role of hyponatremia in differentiating complicated appendicitis from uncomplicated appendicitis: a comparative study.

OBJECTIVE: Some studies suggest that serum sodium level may decrease at a greater degree in complicated acute appendicitis (CA) because of the increased severity of inflammation. This study aimed to determine the predictive value of some inflammatory markers and hyponatremia in differentiating CA from uncomplicated acute appendicitis (UCA). PATIENTS AND METHODS: In this retrospective cohort study, the data of patients who underwent urgent appendectomy in Department of General Surgery, Eskisehir Osmangazi University from January 01, 2016 to January 01, 2021, were analyzed. Patients were divided according to appendicitis type, UCA and CA. RESULTS: In this study, 10.2% (n = 79) of 772 acute appendicitis cases were CA. Multiple logistic regression analysis revealed that high age (p = 0.001), male sex (p = 0.014), high leukocyte count (p = 0.045), low lymphocyte count (p = 0.023) and hyponatremia (p <0.001) were independently associated with CA. Patients with hyponatremia (sodium level ≤134 mEq/L) had 3.050-fold higher risk for CA than patients with normal sodium level (odds ratio: 3.050, 95% confidence interval: 1.668-5.576). The results of the ROC analysis performed to assess the role of sodium level in detecting CA showed a sensitivity of 27.8% and a specificity of 92.1% (cut-off: 133.5 meq/L) (p = 0.001; area under the curve: 0.612 [0.539-0.684]). CONCLUSIONS: Clinicians should be aware of the higher likelihood of CA occurrence in patients with appendicitis in whom hyponatremia, leukocytosis, or lymphopenia is detected in the laboratory examination.

Sildenafil treatment attenuates lung and kidney injury due to overproduction of oxidant activity in a rat model of sepsis: a biochemical and histopathological study.

Sepsis is a systemic inflammatory response to infection and a major cause of morbidity and mortality. Sildenafil (SLD) is a selective and potent inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase PDE5. We aimed to investigate the protective effects of sildenafil on caecal ligation and puncture (CLP)-induced sepsis in rats. Four groups of rats were used, each composed of 10 rats: (i) 10 mg/kg SLD-treated CLP group; (ii) 20 mg/kg SLD-treated CLP group; (iii) CLP group; and (iv) sham-operated control group. A CLP polymicrobial sepsis model was applied to the rats. All groups were killed 16 h later, and lung, kidney and blood samples were analysed histopathologically and biochemically. Sildenafil increased glutathione (GSH) and decreased the activation of myeloperoxidase (MPO) and of lipid peroxidase (LPO) and levels of superoxide dismutase (SOD) in the septic rats. We observed a significant decrease in LPO and MPO and a decrease in SOD activity in the sildenafil-treated CLP rats compared with the sham group. In addition, 20 mg/kg sildenafil treatment in the sham-operated rats improved the biochemical status of lungs and kidneys. Histopathological analysis revealed significant differences in inflammation scores between the sepsis group and the other groups, except the CLP + sildenafil 10 mg/kg group. The CLP + sildenafil 20 mg/kg group had the lowest inflammation score. Sildenafil treatment decreased the serum tumour necrosis factor (TNF)-α level when compared to the CLP group. Our results indicate that sildenafil is a highly protective agent in preventing lung and kidney damage caused by CLP-induced sepsis via maintenance of the oxidant-anti-oxidant status and decrease in the level of TNF-α.

Nanodomains due to phason defects at a quasicrystal surface.

Among the three coexisting types of terraces found on the twofold surface of the d-Al-Cu-Co quasicrystal, nanodomains are essentially observed on the transition-metal rich ones, with a coherent interface boundary. Both clean surface and Ag growth analyses, demonstrate that nanodomain surfaces are structurally identical to one of the two other terraces, which contains 85 at. % Al. We provide evidence that the nanodomains are a manifestation of phason defects that extend downward toward the bulk, and state that nanodomains develop because the energetic cost of creating the phason is outweighed by the change in surface energy. Consequently, the formation of nanodomains involves more than just the surface layer, but is driven by surface energetics.

The role of oxidative stress in diabetic cardiomyopathy: an experimental study.

BACKGROUND: Diabetes mellitus (DM) has a negative effect on cardiovascular functions. Little, however, is known of the overall effect of DM on the cardiac histology or the pathophysiological basis of this. AIM: We aimed to investigate the role of oxidative stress on the pathogenesis of diabetic cardiomyopathy in an experimental model. MATERIALS AND METHODS: 12 week-old female Sprague Dawley rats were randomly allocated into a healthy control group (n=6) and an DM group (n=6). After 12 weeks of alloxan induced DM, the groups' cardiac tissues were histopathologically analyzed and examined for determination of oxidant and antioxidant enzymes [activities of catalase (CAT), superoxide dismutase (SOD), and myeloperoxidase (MPO) and amount of reduced glutathione (GSH) and lipid peroxidation (LPO)]. RESULTS: When compared to the control group, the DM group showed cardiomyopathic changes. In the DM group, activities of CAT (144 +/- 0.9 vs. 112 +/- 1.4, p < 0.05) and LPO amount (27.0 +/- 0.74 vs. 14.4 +/- 0, 20, p < 0.05) were significantly increased whereas activities of SOD (142 +/- 0.2 vs. 146 +/- 0.7, p < 0.05) and amount of GSH (3.48 +/- 0.01 vs. 3.73 +/- 0.01, p < 0.05) were significantly decreased when compared to the control group. Besides, activities of MPO (7.3 +/- 0.02 vs. 8.6 +/- 0.11, p < 0.05) were comparable between groups. CONCLUSIONS: Using the experimental animal model, we were able to demonstrate that DM causes cardiomyopathic changes, and we propose that these changes could be mediated by an oxidative stress.

Evaluation of facial soft tissues by stereophotogrammetry method in patients with obstructive sleep apnoea: a morphological study.

BACKGROUND: We aimed to use the "SomnoMed MAS" device, which brings the mandible forward in obstructive sleep apnoea syndrome patients due to mandibular retrognathia, and to examine its effects on facial soft tissues by stereophotogrammetry (3dMD) method. MATERIALS AND METHODS: Thirty-one patients with a mean age of 44 years and 6 months were included in the study. SomnoMed MAS, one of the splint appliances that position the mandible in front, was applied to all patients and the changes in facial soft tissues were examined by overlapping the images taken at different times with the 3dMD face system. The obtained data were analysed statistically and the level of statistical significance was determined as p ≤ 0.05. RESULTS: Mouth width decreased statistically during T0-T1 period. In T0-T2 period, while crista philtri and labiale inferius points moved backwards, Mouth width, nose width decreased and nasal base width increased. In the T0-T3 period, nasal base width increased statistically, the philtrum width and the mouth width decreased, and the soft tissue nasion point came to the fore. CONCLUSIONS: Splint treatment, which positions the mandible in front in adult obstructive sleep apnoea syndrome patients, affected the middle and lower facial soft tissues with the forward and downward translational movement of the lower jaw.

Pneumonia severity indices predict prognosis in coronavirus disease-2019.

BACKGROUND: Early recognition of the severe illness is critical in coronavirus disease-19 (COVID-19) to provide best care and optimize the use of limited resources. OBJECTIVES: We aimed to determine the predictive properties of common community-acquired pneumonia (CAP) severity scores and COVID-19 specific indices. METHODS: In this retrospective cohort, COVID-19 patients hospitalized in a teaching hospital between 18 March-20 May 2020 were included. Demographic, clinical, and laboratory characteristics related to severity and mortality were measured and CURB-65, PSI, A-DROP, CALL, and COVID-GRAM scores were calculated as defined previously in the literature. Progression to severe disease and in-hospital/overall mortality during the follow-up of the patients were determined from electronic records. Kaplan-Meier, log-rank test, and Cox proportional hazard regression model was used. The discrimination capability of pneumonia severity indices was evaluated by receiver-operating-characteristic (ROC) analysis. RESULTS: Two hundred ninety-eight patients were included in the study. Sixty-two patients (20.8%) presented with severe COVID-19 while thirty-one (10.4%) developed severe COVID-19 at any time from the admission. In-hospital mortality was 39 (13.1%) while the overall mortality was 44 (14.8%). The mortality in low-risk groups that were identified to manage outside the hospital was 0 in CALL Class A, 1.67% in PSI low risk, and 2.68% in CURB-65 low-risk. However, the AUCs for the mortality prediction in COVID-19 were 0.875, 0.873, 0.859, 0.855, and 0.828 for A-DROP, PSI, CURB-65, COVID-GRAM, and CALL scores respectively. The AUCs for the prediction of progression to severe disease was 0.739, 0.711, 0,697, 0.673, and 0.668 for CURB-65, CALL, PSI, COVID-GRAM, A-DROP respectively. The hazard ratios (HR) for the tested pneumonia severity indices demonstrated that A-DROP and CURB-65 scores had the strongest association with mortality, and PSI, and COVID-GRAM scores predicted mortality independent from age and comorbidity. CONCLUSION: Community-acquired pneumonia (CAP) scores can predict in COVID-19. The indices proposed specifically to COVID-19 work less than nonspecific scoring systems surprisingly. The CALL score may be used to decide outpatient management in COVID-19.

Torsion of wandering spleen.

Wandering spleen is characterized by ectopic localization of spleen owing to the lack or weakening of the major splenic ligaments. In present study, two cases with torsion of wandering spleen were reported. The first case was a 30-year-old female who was admitted to emergency department with acute abdominal pain and vomiting. Abdominal Ultrasonography and computed tomography showed a round solid hypodense mass that was located in the left hypochondriac region of abdomen. At laparotomy, the patient was found to have torsion of a wandering spleen with complete infarction and pancreatic tail infarction. Splenectomy and distal pancreatectomy were performed. The second patient was a 19-year-old female. She was admitted to emergency department with abdominal pain. Axial computed tomography (CT) showed pelvic mass that indicated a possibility of a wandering spleen. The wandering spleen was removed with its long pedicle because of infarction. Torsion of wandering spleen must be considered in differential diagnosis of acute abdomen when a palpable painful abdominal mass is present on physical examination, and the spleen is absent in its normal anatomical location on radiological examination (Fig. 4, Ref. 8). Full Text (Free, PDF) www.bmj.sk.

Surgical treatment of phytobezoars causes acute small intestinal obstruction.

PURPOSE: Our aim was to perform a clinical analysis of small intestinal obstructions caused by surgically treated phytobezoars. METHODS: Twenty-four patients, with small intestinal obstructions caused by phytobezoars, underwent surgery in our department between 1998 to 2008, were reviewed retrospectively. RESULTS: Twenty (83.3%) of 24 patients had previous gastric surgery. Preoperative computed tomography (CT) was performed in nine patients and seven (77.8%) patients, showed results consistent with a bezoar and subsequently, underwent surgery on the same day. The remaining patients had no preoperative diagnosis of a phytobezoar were typically followed-up for postoperative adhesion intestinal obstruction. Only those patients who showed no response to nonoperative treatment options underwent surgery. The phytobezoar was fragmented and milked into the cecum in 11 (45.8%) patients or extracted via longitudinal enterotomy in 12 (50%) patients; the remaining patient (4.2%) was treated via laparoscopy. Three patients had gastric phytobezoars, which were extracted via gastrotomy. There was no postoperative mortality. Two patients with previous enterotomy had either postoperative wound infection or wound infection and evisceration. CONCLUSIONS: Phytobezoars should be considered in the differential diagnosis of acute small intestinal obstruction in patients with prior gastric surgery, poor dentition, or consume fiber-rich foods. Abdominal CT is useful for both diagnosis and for the decision to perform emergency surgery. When possible, the phytobezoar should be fragmented and milked into the cecum. Laparoscopic fragmentation may be useful in such cases (Tab. 3, Ref. 28). Full Text (Free, PDF) www.bmj.sk.

The Conductivity and Dielectric Properties of Neobium Substituted Sr-Hexaferrites.

The Nb3+ ion substituted Sr hexaferrites (SrNbxFe12-xO19 (x = 0.00-0.08) hexaferrites (HFs)) were fabricated via a citrate-assisted sol-gel approach. X-ray powder diffractometer analysis affirmed the pureness of all products. The crystallite sizes of the products which were estimated from Scherrer equation were in the 36-40 nm range. The chemical component of the samples was proved by Energy-dispersive X-ray spectroscopy (EDX) and Elemental mapping. The hexagonal morphology of all products was confirmed by Field Emission Scanning Electron Microscopy (FE-SEM). The electrical conduction mechanisms and dielectric properties of a variety of Nb3+ions-substituted SrNbxFe12-xO19 HFs were investigated by a complex impedance system. Dielectric parameters such as conductivity, dielectric constant, dielectric loss, dielectric tangent loss and complex modulus, were studied at temperatures up to 120 °C in a frequency range varying from 1.0 Hz to 3.0 MHz for several Nb ratios. The frequency dependence of the conductivity was found to comply with the power law with diverse exponents at all frequencies studied here. Subsequently, incremental tendencies in dc conductivity with temperature indicate that the substituted Sr-HFs leads to a semiconductor-semimetal like behavior. This could be attributable to a feature of conduction mechanism which is based on the tunneling processes. Additionally, the dielectric dispersion pattern was also explained by Maxwell-Wagner polarization in accordance with the Koop's phenomenological theory.

Early Hepatic Artery Thrombosis After Pediatric Living Donor Liver Transplantation.

AIM: Hepatic artery thrombosis is one of the major complications affecting patient and graft survival after liver transplantation. In this study, we analyzed the factors affecting the development of early hepatic artery thrombosis (eHAT) and its outcomes in pediatric liver transplantation. METHODS: A total of 175 pediatric patients underwent living donor liver transplantation between January 2013 and November 2018. Factors affecting eHAT and its outcomes were examined. RESULTS: Nine patients (5.1%) developed eHAT. In multivariate analysis, intraoperative hepatic artery revision and Roux-en-Y hepaticojejunostomy biliary reconstruction type were statistically significant (all, P < .05). Thrombectomy and reanastomosis was performed in 5 patients. Two of them were successful. In total, 3 retransplantations were performed and all of those patients are still alive. CONCLUSION: The factors affecting eHAT are still a matter of debate. Intraoperative hepatic artery anastomosis revision and Roux-en-Y hepaticojejunostomy reconstruction were independent risk factors for development of eHAT. In the present study, the confidence interval of the variables is high, therefore exact determination of the risk factors may not be possible. Early detection and thrombectomy and reanastomosis may be the first treatment of choice to rescue the patient and graft. When it fails, retransplantation must be an alternative. The results of the present study state that at least once a day the vascular anastomosis must be examined by Doppler ultrasonography in the post-transplant first week. It must be repeated when liver enzymes increase. The patients under high risk for eHAT may be followed up closer.

Models for predicting non-sentinel lymph node positivity in sentinel node positive breast cancer: the importance of scoring system.

BACKGROUND: Although delayed axillary lymph node dissection is the gold standard for evaluating axillary status after identification of a positive sentinel lymph node (SLN), between 40% and 70% of sentinel lymph node positive patients will have negative non-sentinel nodes and undergo a non-therapeutic axillary dissection. Accurate estimates of the likelihood of additional disease in the axilla can assist decision-making about further treatment. To predict non-SLN metastases in patients with a positive SLN biopsy, four different nomograms have been created. METHOD: This paper reviews the scoring systems and nomograms reported in the literature and compares their predictive probability of non-SLN involvement in patients with SLN positive breast cancer. RESULT: There are several published scoring systems that contain different parameters to estimate the rate of non-SLN metastases in SLN positive patients. We reviewed Memorial Sloan-Kettering Cancer Center (MSKCC), Tenon, Stanford and Cambridge nomograms published and used scoring systems including three to eight variables. We found that the MSKCC nomogram is the most validated model in the literature to predict non-SLN status accurately. The other three models have not yet been verified in outside institutions. CONCLUSION: Despite having some limitations, the MSKCC nomogram is the most validated model in the literature. These models should be tested and verified in different programs and different patient groups before they are widely accepted.