Novel mitochondrial and DNA damaging fluorescent Calix[4]arenes bearing isatin groups as aromatase inhibitors: Design, synthesis and anticancer activity.

Breast cancer causes a high rate of mortality all over the world. Therefore, the present study focuses on the anticancer activity of new lower rim-functionalized calix[4]arenes integrated with isatin and the p-position of calixarenes with 1,4-dimethylpyridinium iodine against various human cancer cells such as MCF-7 and MDA-MB-231 breast cancer cell lines, as well as the PNT1A healthy epithelial cell line. It was observed that compound 6c had the lowest values in MCF-7 (8.83 µM) and MDA-MB-231 (3.32 µM). Cell imaging and apoptotic activity studies were performed using confocal microscopy and flow cytometry, respectively. The confocal imaging studies with 6c showed that the compound easily entered the cell, and it was observed that 6c accumulated in the mitochondria. The Comet assay test was used to detect DNA damage of compounds in cells. It was found that treated cells had abnormal tail nuclei and damaged DNA structures compared with untreated cells. In vitro human aromatase enzyme inhibition profiles showed that compound 6c had a remarkable inhibitory effect on aromatase. Compound 6c displayed a significant inhibition capacity on aromatase enzyme with the IC50 value of 0.104 ± 0.004 µM. Thus, not only the anticancer activity of the new fluorescent derivatives, which are the subject of this study, but the aromatase inhibitory profiles have also been proven.

Discrimination of Pd-species by an ultra-fast, long wavelength and biocompatible fluorescent sensor: Its on-site kit assay, drug, and cancer/epithelial cell studies.

Extensive use of palladium in many catalysts and catalytic converters causes a high degree of pollution of water and soil resources. Therefore, there is an urgent need to develop rapid and sensitive palladium probes. Herein, a novel "turn-on" near-infrared (NIR) fluorescence and colorimetric probe for Pd has been designed on the basis of the deallylation of the probe, followed by the release of NIR emissive fluorophore through the Tsuji-Trost reaction. The probe can selectively discriminate between the oxidation states of Pd0 and Pd2+. Sensing results demonstrates that the probe has excellent selectivity, sensitivity, fast response time, NIR fluorescence, high biocompatibility, and low detection limit for the Pd detection over a series metal ion. The probe has been successfully applied in visualization of residual Pd content from water, soil, drug and living cell samples by fluorescence observation with the naked eye.

A NIR fluorescent sensor based on thiazoline-isophorone with low cytotoxicity in living cells for Hg2+ detection through ICT associated hydrogen bonding effect.

Mercury (Hg) is a toxic pollutant and may cause serious health and environmental threats even at low concentrations. Thus, sensitive, efficient, and accurate techniques for the detection of Hg2+ ions in biological systems are in particular demand. In the current paper, a new, red emitting fluorescence probe (THI) based on electron deficient dicyanovinyl, electron-rich diethylamino, and receptor thiazoline toward Hg2+ has been developed. It has been determined that the recognition behavior of the probe toward Hg2+ is reversible with S2-. The probe not only shows perfect selectivity toward Hg2+ with a low detection limit over a series of metal ions, but it also displays positive solvato-chromism among the tested solvents via modulation of intramolecular energy transfer from the diethylamino to a dicyanovinyl moiety. Furthermore, it has been shown that the probe can be applied as a fluorescent probe for visualizing Hg2+ in living HeLa cells through a confocal laser scanning microscope. Also, the probe THI has not shown any toxic effect in cervical cancer and epithelial cells. Thus, the probe demonstrates high promise for Hg2+ detection in biomarker screening, disease diagnosis, and clinical medicine with low cytotoxicity.

Formation of the inclusion complex of water soluble fluorescent calix[4]arene and naringenin: solubility, cytotoxic effect and molecular modeling studies.

Naringenin is considered as an important flavonoid in phytochemistry because of its important effect on cancer chemoprevention. Unfortunately its poor solubility has restricted its therapeutic applications. In this study, an efficient water-soluble fluorescent calix[4]arene (compound 5) was synthesized as host macromolecule to increase solubility and cytotoxicity in cancer cells of water-insoluble naringenin as well as to clarify localization of naringenin into the cells. Complex formed by host-guest interaction between compound 5 and naringenin was analyzed with UV-visible, fluorescence, FTIR spectroscopic techniques and molecular modeling studies. Stern-Volmer analysis showed binding constant value of Ksv 3.5 × 107 M-1 suggesting strong interaction between host and guest. Binding capacity shows 77% of naringenin was loaded on compound 5. Anticarcinogenic effects of naringenin complex were evaluated on human colorectal carcinoma cells (DLD-1) and it was found that 5-naringenin complex inhibits proliferation of DLD-1 cells 3.4-fold more compared to free naringenin. Fluorescence imaging studies show 5-naringenin complex was accumulated into the cytoplasm instead of the nucleus. Increased solubility and cytotoxicity of naringenin with fluorescent calix[4]arene makes it one of the potential candidates as a therapeutic enhancer. For deep understanding of host-guest interaction mechanisms, complementary multiscale molecular modeling studies were also carried out.Communicated by Ramaswamy H. Sarma.

Synthesis and evaluation of the antitumor activity of Calix[4]arene l-proline derivatives.

The unique conformational properties, functionality, low toxicity, and low cost make calixarene-based compounds a valuable candidate against cancer. The aim of the present study is the synthesis of the upper rim and lower rim-functionalized l-proline-based calix[4]arene derivatives and evaluation of their cytotoxic potential for human cancerous cells as well as to determine the death mechanism. Synthesized calix[4]arene (3, 8a, 8b 13a, and 13b) derivatives were characterized by different spectroscopic techniques such as 1HNMR, 13CNMR, and FTIR. In vitro effects of compounds 3, 8a, 8b, 13a and 13b were tested on human cancerous cells (HEPG2, PC-3, A-549, and DLD-1) as well as human healthy epithelium cell (PNT1A). Results show that compounds 3, 8a, 8b and 13b have cytotoxic potential on human colorectal carcinoma cells (DLD-1) with IC50 values of 43 µM, 45.2 µM, 64.57 µM, and 29.35 µM respectively. Apoptosis ratios of cell death were investigated with flow cytometer using 7-AAD and Annexin-V as markers. Cytotoxic potential of 8a was found to be higher due to increased apoptosis, when compared with healthy cells the apoptotic cell death was significantly (p < 0.0001) increased up to 1.7-fold and 2.4-fold in DLD-1 and A549 cells, respectively. In conclusion, these l-proline derived calix[4]arenes with their selective cytotoxic potential on human cancerous cells may be a potential candidate for the treatment of human CRC and lung cancer.

Dose Ginger Have Preventative Effects on PONV-Related Eye Surgery? A Clinical Trial.

BACKGROUND: Postoperative nausea and vomiting (PONV) is considered a common complication of anesthesia, which, particularly in eye surgery, may exert pressure on stitches and open or leak the surgical wound, leading to bleeding. OBJECTIVES: We aimed to study the effect of ginger on PONV and changes in vital signs after eye surgery. METHODS: In this triple-blind randomized controlled trial, 120 candidate patients for eye surgery were divided into group A (n = 40) and group B (n = 40). Patients in group A received the capsules of ginger 1 g while patients in group B received a placebo one hour before the procedure with 30 mL water. The incidence of nausea and the frequency of vomiting were evaluated at 0, 15, 30 minutes, and 2 hours after the operation. Also, the vital signs of the participants were recorded at certain times. RESULTS: The results demonstrated a statistically significant difference in the frequency of nausea between group A and group B (P < 0.05). The severity of nausea was lower in group A than in group B immediately and 2 hours after recovery (P < 0.05). The incidence of vomiting was significantly lower in group A than in group B (P < 0.05). The vital signs were not significantly different between group A and group B (P > 0.05). CONCLUSIONS: Ginger was effective in the prevention of PONV after eye surgery but had no impact on vital signs. Hence, ginger is proposed to use as a low-cost, prophylactic measure for PONV reduction.

Inclusion of Quercetin in Gold Nanoparticles Decorated with Supramolecular Hosts Amplifies Its Tumor Targeting Properties.

Despite the anticancer potential of natural products (NPs), their limited bioavailability necessitates laborious derivatization or covalent conjugation to delivery vehicles. To unleash their potential, we developed a nanohybrid delivery platform with a noncovalently tunable surface. Initially, the active compound was encapsulated in a macrocycle, p-sulfonatocalix[4]arene, enabling a 62 000-fold aqueous solubility amplification as also a 2.9-fold enhancement in its cytotoxicity with respect to the parent compound in SW-620 colon cancer cells. A pH stimuli responsive behavior was recorded for this formulate, where a programmable release of quercetin from the macrocycle was monitored in an acidic environment. Then, a nanoparticle gold core was decorated with calixarene hosts to accommodate noncovalently NPs. The loaded nanocarrier with the NP quercetin dramatically enhanced the cytotoxicity (>50-fold) of the parent NP in colon cancer and altered its cell membrane transport mode. In vivo experiments in a mouse 4T1 tumor model showed a reduction of tumor volume in mice treated with quercetin-loaded nanoparticles without apparent toxic effects. Further analysis of the tumor-derived RNA highlighted that treatment with quercetin-loaded nanoparticles altered the expression of 27 genes related to apoptosis.

Comparative Venomics of the Vipera ammodytes transcaucasiana and Vipera ammodytes montandoni from Turkey Provides Insights into Kinship.

The Nose-horned Viper (Vipera ammodytes) is one of the most widespread and venomous snakes in Europe, which causes high frequent snakebite accidents. The first comprehensive venom characterization of the regional endemic Transcaucasian Nose-horned Viper (Vipera ammodytes transcaucasiana) and the Transdanubian Sand Viper (Vipera ammodytes montandoni) is reported employing a combination of intact mass profiling and bottom-up proteomics. The bottom-up analysis of both subspecies identified the major snake protein families of viper venoms. Furthermore, intact mass profiling revealed the presence of two tripeptidic metalloprotease inhibitors and their precursors. While previous reports applied multivariate analysis techniques to clarify the taxonomic status of the subspecies, an accurate classification of Vipera ammodytestranscaucasiana is still part of the ongoing research. The comparative analysis of the viper venoms on the proteome level reveals a close relationship between the Vipera ammodytes subspecies, which could be considered to clarify the classification of the Transcaucasian Nose-horned Viper. However, the slightly different ratio of some venom components could be indicating interspecific variations of the two studied subspecies or intraspecies alternations based on small sample size. Additionally, we performed a bioactivity screening with the crude venoms against several human cancerous and non-cancerous cell lines, which showed interesting results against a human breast adenocarcinoma epithelial cell line. Several fractions of Vipera a. transcaucasiana demonstrated a strong cytotoxic effect on triple negative MDA MB 231 breast cancer cells.

New water soluble Hg2+ selective fluorescent calix[4]arenes: Synthesis and application in living cells imaging.

The present study demonstrates the synthesis of water-soluble fluorescent calix[4]arenes (6 and 7) and its application in living cell imaging for Hg2+ detection at a low level. The synthesized fluorescent ligands 6 and 7 were characterized by 1H NMR technique. The fluorescent study showed both water soluble ligands were Hg2+ selective and follow photo-induced electron transfer (PET) process. From the fluorimeter titration experiment detection limit was calculated as 1.14×10-5 and 3.42×10-5 for ligand 6 and 7, respectively. From the Benesi-Hildebrand plot binding constant values were evaluated as 666.7 and 733.3M-1 for 6 and 7, respectively. The interactions between ligands 6 and 7 and Hg2+ were also demonstrated in living cells, SW-620, using Fluorescent Cell Imager. While ligands 6 and 7 alone show fluorescent properties, they loss their action with the presence of Hg2+ in SW-620 cells.

Nutritional risk of hospitalized patients in Turkey.

BACKGROUND & AIMS: We conducted a multicentre study to assess nutritional risk at hospital admission, hospital-associated iatrogenic malnutrition and the status of nutritional support in Turkish hospitals. METHODS: A database which allowed for online submission of hospital and patient data was developed. A nutritional risk screening system (NRS-2002) was applied to all patients and repeated weekly in patients with hospital stays greater than one week and no invasive procedures. Patient-specific nutritional support was recorded during the study period. RESULTS: Thirty-four hospitals from 19 cities contributed data from 29,139 patients. On admission, 15% of patients had nutritional risk. Nutritional risk was common (52%) in intensive care unit patients and lowest (3.9%) in otorhinolaryngology patients. Only 51.8% of patients with nutritional risk received nutritional support. Nutritional risk was present in 6.25% of patients at the end of the first week and 5.2% at the end of the second week, independent of nutritional support. In patients with nutritional risk on admission who were hospitalized for two weeks and received nutritional support, the NRS-2002 score remained > or =3 in 83% of cases. CONCLUSIONS: Nutritional risk is common in hospitalized Turkish patients. While patients at nutritional risk often do not receive nutritional support when hospitalized, nutritional risk occurs independent of nutritional support.

Does sodium nitroprusside decrease the incidence of atrial fibrillation after myocardial revascularization?: a pilot study.

BACKGROUND: Atrial fibrillation (AF) often occurs after coronary artery bypass grafting and can result in increased morbidity and mortality. In the present pilot study, our aim was to investigate whether sodium nitroprusside (SNP), as a nitric oxide donor, can reduce the frequency of post-coronary artery bypass grafting AF. METHODS AND RESULTS: To investigate the effectiveness of SNP in the prophylaxis of AF, we conducted a prospective, randomized, placebo-controlled clinical study on 100 consecutive patients in whom we performed elective and initial CABG operations. A control group of 50 patients were treated with placebo (dextrose 5% in water), whereas the SNP group (n=50 patients) was treated with SNP (0.5 microg x kg(-1) x min(-1)) during the rewarming period. High-sensitivity C-reactive protein levels were measured before surgery and 5 days postoperatively. All patients were monitored postoperatively with telemetry. Baseline characteristics were similar in both treatment groups. AF occurred in 12% of the SNP group and 27% of the control group. The occurrence of AF was significantly lower in the SNP group (P=0.005). The duration of AF in the SNP group was significantly shorter than that in the control group (5.33+/-1.86 and 7.55+/-1.94 hours, respectively; P=0.023). C-reactive protein levels were higher postoperatively in the control group than in the SNP group (P<0.05). Postoperative AF significantly prolonged postoperative hospital stay (P<0.05). CONCLUSIONS: The incidence of postoperative AF in the SNP group was reduced significantly. Further studies are needed to better delineate the anti-AF profile of SNP.

Retrorectal tumors: a case series.

BACKGROUND/AIMS: Retrorectal masses are rarely encountered in surgical practice, and they arise from congenital remnants, and from osteogenic, neurogenic, inflammatory, or metastatic processes. The majority of these masses are benign but many can be malignant, so they need to be treated with aggressive surgical management. METHODS: In this case series, eight patients with retrorectal masses of various etiologies are described, with particular emphasis on diagnosis and surgical treatment. RESULTS: In our series, we noted one duplication cyst, one tailgut cyst, one epidermoid cyst, one teratoma, one gastrointestinal stromal tumor, one epithelial malignant tumor, one inflammatory mass, and one retrorectal mass of as yet unknown origin. In three patients, complete excision via posterior sagittal approach was performed, one underwent abdominoperineal en-block proctectomy, two were only biopsied for neoadjuvant therapy, and two are waiting for operation. CONCLUSIONS: Surgery is the main treatment of choice, and the surgical strategy should be decided according to the localization and nature of the retrorectal mass.

Haemorrhoidectomy with electrocautery or ultrashears and stapled haemorrhoidopexy.

BACKGROUND: This study evaluated in a randomized, prospective manner the possible differences in operative time, postoperative pain and analgesic requirement, early complications, time off-work and patient satisfaction between patients undergoing haemorrhoidectomy using the electrocautery (ECH), UltraShears (ultrasonically activated scalpel; USH) or stapled haemorrhoidopexy (SH). METHODS: Patients with symptomatic third-degree or fourth-degree haemorrhoids were randomized into one of the three groups: ECH, SH (PPH stapler; Ethicon Endo-Surgery, Cincinnati, OH, USA) or USH groups. The operative times and complications, if any, were recorded. An identical anaesthetic technique was used for all patients, and postoperative analgesia was also standardized according to the pain scores. Pain was evaluated preoperatively and at 8 and 24 h and 2, 7, 14 and 28 days, postoperatively, by means of a visual analogue scale. The numbers of narcotic and non-narcotic analgesics used, the time required for full return to daily activities and the incontinence scores at 4 months postoperatively were evaluated, as well as patient satisfaction. RESULTS: No significant differences with respect to age or sex existed between the three groups, each consisting of 20 patients. USH was significantly faster than both ECH and SH (P < 0.0001 for both comparisons) in operation time, and SH was faster than ECH (P < 0.0001). Comparing any two groups, the mean pain scores in the ECH group were significantly higher than in the SH and USH groups at postoperative 8 and 24 h, and day 2, but the groups reached comparable pain scores at day 7, 14 and 28. The numbers of narcotic and non-narcotic analgesics used in the ECH group were significantly higher than in the SH and USH groups (P < 0.0001 for all comparisons). The early postoperative complication rate was higher in the ECH group (25%), compared with the SH (P = 0.017) and USH (P < 0.0001) groups. Only 12 patients (60%) in the ECH group could be discharged within the first postoperative 24 h, whereas all of the patients (100%) in the SH and 17 patients (85%) in the USH groups could be treated as day cases. The time required for full return to daily activities was similar in the SH and USH groups (P = 0.841), but it was significantly longer in the ECH group (P < 0.0001 for both comparisons). The 70% patient satisfaction rate in the ECH group was significantly lower than in the SH (95%; P = 0.008) and the USH (100%, P = 0.002) groups. CONCLUSION: Our short-term results have shown that SH and ultrasonic dissector haemorrhoidectomies were superior to ECH haemorrhoidectomy, in terms of surgical utility, postoperative pain, analgesic intake, time off-work and patient satisfaction. Some advantages of USH over SH also appeared.

Effect of timing of glutamine-enriched enteral nutrition on intestinal damage caused by irradiation.

Intestinal mucosal damage and bacterial translocation are clinical problems that may be caused by the use of ionizing radiation. Glutamine (Gln) support reduces the mucosal barrier in several ways. This study was undertaken to investigate the effect of timing of Gln-enriched enteral nutrition (EN) on bacterial translocation and mucosal damage due to radiotherapy (RT). A rat model of whole body irradiation was designed in which a single dose of 485 cGy was given. A total of 50 rats were randomly assigned to the following 5 groups, each of which comprised 10 rats: (1) balanced rat chow given for 8 days without RT (group 1); (2) balanced rat chow given 4 days before and 4 days after RT (group 2); (3) Gln-enriched EN given 4 days before RT (group 3); (4) Gln;enriched EN given 4 days after RT (group 4); and (5) Gln-enriched EN given 4 days before and 4 days after RT (group 5). Mesenteric lymph node and ileum samples were removed for evaluation of bacterial translocation (BT) and histopathologic investigation, respectively. BT and intestinal mucosal injury scores in all rats that received RT were higher than in rats without RT. No difference was seen in parameters between groups 3 and 4 (P>.05, P>.016, respectively); BT and intestinal mucosal injury scores of group 5 were significantly lower than those of groups 3 and 4 (P<.05, P<.016, respectively). Meanwhile, the BT and mesenteric injury scores of group 5 were significantly lower than those of group 2 (P<.05, P<.016, respectively). As a result, intestinal injury due to RT was significantly decreased by Gln-enriched EN support given before and after whole body RT.

The effect of sodium nitroprusside infusion on renal function during reperfusion period in patients undergoing coronary artery bypass grafting: a prospective randomized clinical trial.

OBJECTIVE: Acute renal failure remains a common and serious complication of cardiac surgery. In this randomized trial, we aimed to assess whether sodium nitroprusside (SNP) infusion during cardiopulmonary bypass (CPB) could prevent renal dysfunction after coronary artery bypass grafting (CABG) surgery. METHODS: Between October 2004 and May 2006, 240 consecutive patients with stable angina undergoing elective CABG for multi-vessel coronary artery disease were prospectively randomized into control (n=116, 72 men, mean age 61.3+/-9.7 years) or SNP groups (n=124, 81 men, 60.8+/-10.8 years). SNP group received SNP after initiation of rewarming period during CPB at a dose of 0.1mg/kg/h and the infusion was concluded by weaning from CPB. The anesthetic and CPB regimes were standardized. Blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR), creatinine clearance (C(Cr)), urine output, serum cardiac specific troponin I (cTnI), creatine kinase cardiac isoenzyme (CKMB), and CPK were measured preoperatively and daily until day 5 after surgery. RESULTS: There were no differences in baseline levels of BUN, SCr, eGFR, C(Cr), cTnI, CKMB, CPK levels and EuroSCORES between the groups. Although the durations of cross clamp, CPB times, and postoperative cardiac enzymes were similar in both groups; in the control group, there was a significantly lower urine excretion during CPB (p=0.002) and the operation (p=0.041). Peak postoperative SCr levels were significantly (p=0.001) lower in the SNP group than in the control group (1.29+/-0.28 vs 1.42+/-0.34mg/dl). The incidence of >or=50%DeltaSCr was significantly higher in the control group when compared with the SNP group (35.3 vs 13.7%, p<0.001). Development of new C(Cr) less than 50ml/min postoperatively was significantly higher in the control group compared with the SNP group (14 vs 38%, p<0.001). CONCLUSION: SNP administration during rewarming period of non-pulsatile CPB in patients undergoing CABG surgery is associated with improved renal function compared with conventional medical treatment providing adequate preload and mean arterial pressures.

Desmoid tumor arising at the colostomy site after abdominoperineal resection for rectal carcinoma: report of a case.

A 69-year-old male who developed a desmoid tumor at the site of his end colostomy after abdominoperineal resection for rectal carcinoma is reported. The tumor was resected with wide margins. Histopathology revealed desmoid tumor of the anterior abdominal wall with no malignant features. The patient had an uneventful postoperative course. To our knowledge, this is the first case of solitary desmoid tumor of anterior abdominal wall at the colostomy site reported in the literature.

Effects of soluble fiber on matrix metalloproteinase-2 activity and healing of colon anastomosis in rats given radiotherapy.

BACKGROUND AND AIMS: Soluble fiber is fermented by colonic microflora yielding short-chain fatty acids (SCFAs) in the colon. We aimed to investigate the effect of oral administration of soluble fiber on healing of anastomosis and matrix metalloproteinase-2 activity in radiotherapy received colonic anastomosis. METHOD: Eighty-four Wistar rats were divided into six groups. All rats were performed a left colonic resection with end-to-end anastomosis. Group I received rat cow. Group II received soluble fiber orally for five consecutive days preoperatively as well as 3rd and 6th days postoperatively. Group III received SCFAs via rectum for five consecutive days preoperatively. Group IV received irradiation to the pelvis at a total dose of 24 Gy on the 10th and 5th days before the operation. Group V was exposed to irradiation like the rats in Group IV and oral treatment like the rats in Group II. Group VI received irradiation like the rats in Group IV and transrectal treatment like the rats in Group III. On the 3rd and 7th postoperative days, all the rats were anesthetized to evaluate the anastomosis healing clinically, histologically and biochemically. RESULTS: Third and 7th day bursting pressures of the rats that were fed with a normal diet and exposed to radiotherapy were significantly decreased (P<0.001). Bursting pressures of Groups V and VI on the 7th day were significantly higher than the control group's bursting pressures (P<0.05). Hydroxyproline levels of Group IV were significantly decreased (P<0.001). Following oral soluble fiber and transrectal administration of SCFAs, these low levels reached to the levels of control radiotherapy group. Matrix metalloproteinase-2 activity of all the rats that were exposed to radiotherapy was higher than the control group (P<0.001). Matrix metalloproteinase-2 enzyme levels in the Groups V and VI were lower than the ones in the Group IV (P<0.001). The histologic parameters of anastomotic healing such as epithelial regeneration, exudate, necrosis, and fibroblast levels were significantly improved by the use of oral soluble fiber and transrectal SCFAs treatment. CONCLUSION: Undesirable effects of preoperative radiotherapy on mechanical, histological and biochemical parameters can be overcome by oral soluble fiber. Oral soluble fiber administration has similar positive effects like the transrectal administration of the SCFA's.

Evaluation of nutritional status in cancer patients receiving radiotherapy: a prospective study.

OBJECTIVES: The purpose of the present study was to evaluate the nutritional status of cancer patients receiving radiotherapy (RT) and to assess the possible contributions of nutritional support to patients with malnutrition. METHODS: Prospectively, 207 patients referred to our outpatient radiotherapy department were included. The patients were classified according to tumor site (head/neck, breast, lung, stomach, or colorectal). Nutritional status at the onset, at the end of RT, and 3 and 6 months after irradiation was evaluated with the subjective global assessment (SGA). All of the patients were supported with additional portions of meal or standard enteral feeding formula during and after the irradiation period as long as they were in the moderately or severely malnourished groups, respectively. RESULTS: At the onset, malnutrition was present in 31% of all patients, and it increased to 43% at the end of RT. This difference predominated in head/neck cancer patients. Malnutrition ratios in head/neck cancer patients at the onset and after RT were 24% and 88%, respectively. By a 6-month follow-up, the ratio of patients with malnutrition decreased to 8%. Nutritional status of all groups was found to improve during the 6-month follow-up period, except for the breast cancer group, which included no patients with severe malnutrition at any time. CONCLUSION: The results of the present study may be helpful in planning an appropriate nutritional support for cancer patients undergoing radiotherapy according to the irradiation site.

Torsion of the greater omentum: preoperative computed tomographic diagnosis and therapeutic laparoscopy.

Primary or idiopathic segmental infarction of the greater omentum is a rare surgical condition. We describe a case of omental torsion in an adult patient who was diagnosed preoperatively by contrast-enhanced computed tomography and managed by laparoscopy.