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The purpose of this study was to prospectively compare the measurement of skin-to-fascia distances in the neutral state, during manual elevation and by fascial elevation in patients who underwent laparoscopic surgery. In 53 patients, the distance between the skin and anterior wall of the rectus sheath was measured prospectively in following three different ways: (1) in neutral position, (2) during manual elevation and (3) during elevation of the fascia using forceps following an infraumbilical vertical skin incision. In all patients, subcutaneous tissue up to the fascia was dissected after a vertical skin incision. The skin-to-fascia distance of 30.9 mm (14.0-52.0 mm) in the neutral position decreased to 11.1 mm (0.0-26.0 mm) during the fascial elevation, while the mean distance increased to 40.1 mm (19-70 mm) during manual elevation (p < 0.001). In the closed laparoscopic entry technique in which a Veress needle is inserted into the peritoneum through a small incision, the needle should be introduced from the shortest distance between the skin and the peritoneum. Lifting the fascia with a proper surgical instrument in suitable patients could enable us to achieve this goal.
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OBJECTIVE: Acute limb ischemia is a common clinical manifestation of embolism or thrombosis, which can lead to amputation. Increasing evidence suggests that various biomarkers can predict amputation at the time of admission. Identifying an easily obtainable and inexpensive indicator has always been a major objective. The aim of this study was to determine the predictive value of the admission monocyte count to the HDL-C ratio for a lower extremity amputation in patients undergoing embolectomy for acute limb ischemia. PATIENTS AND METHODS: This retrospective, single-center study included 269 patients who underwent an emergent embolectomy. The study population was divided into two groups according to early amputation: the non-amputation group (n = 220) and the amputation group (n = 49). Two groups were compared based on various data. RESULTS: According to the multivariate regression analysis, patients with a higher CRP and MHR have a significantly higher amputation rate (HR: 1.148; CI: 1.075-1.225; p < 0.001 and HR: 1.547; CI: 1.003-2.387; p = 0.04, respectively). Patients with arterial back bleeding have a significantly lower amputation rate (HR: 0.106; CI: 0.02-0.558; p = 0.008). CONCLUSIONS: Our study demonstrated that preoperative CRP, MHR, and no arterial back bleeding after surgery were found to be independent predictors of amputation as a poor prognostic factor within 30 days after an embolectomy.
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Arteriopatias Oclusivas , Doenças Vasculares Periféricas , HDL-Colesterol , Embolectomia , Humanos , Isquemia/diagnóstico , Isquemia/cirurgia , Extremidade Inferior/cirurgia , Monócitos , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
PURPOSE: To reveal the clinical significance of preoperative haematological inflammatory markers in the diagnosis of abdominal wall hernias with strangulation. METHODS: The data of 200 patients who underwent surgery for incarcerated hernia were retrospectively analysed. The patients were grouped into three groups; Group 1; only surgical reduction and hernia repair, Group 2; small bowel resection and Group 3; omentum resection. Age, gender, hernia type, the presence of radiological bowel obstruction and preoperative complete blood count data were obtained. Neutrophil-leukocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), haematological inflammatory index (HII) and systemic immune-inflammation index (SII) values were calculated. RESULTS: The study was consisted of; Group 1: 119 patients (59.5%), Group 2: 46 patients (23%) and Group 3: 35 patients (17.5%). Advanced age (p = 0.001), female gender (p = 0.036), incisional hernias (p = < 0.001) and the presence of bowel obstruction (p = < 0.001) were found to be statistically significant in terms of strangulation. NLR, PLR and SII values were significantly higher in Group 2 compared to Group 1, and PLR values were significantly higher in Group 2 compared with Group 3 (p < 0.05). CONCLUSION: The preoperative elevated NLR, PLR and SII values may indicate strangulation and possible intestinal resection, in incarcerated abdominal wall hernias.
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Hérnia Ventral , Obstrução Intestinal , Biomarcadores , Feminino , Hérnia Ventral/cirurgia , Herniorrafia , Humanos , Inflamação , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Linfócitos , Estudos RetrospectivosAssuntos
Linfoma de Zona Marginal Tipo Células B , Mastocitose Sistêmica , Neoplasias Cutâneas , Humanos , Linfoma de Zona Marginal Tipo Células B/complicações , Linfoma de Zona Marginal Tipo Células B/patologia , Mastocitose Sistêmica/complicações , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/patologiaRESUMO
BACKGROUND: Esophagojejunostomy (EJ) is frequently performed after total gastrectomy for proximal gastric tumors. Despite evolving surgical techniques and improving perioperative care, the EJ leak is one of the most severe life-threatening complications. This study investigated the preventability of postoperative anastomotic complications by performing intraoperative endoscopy. METHODS: We included 86 patients who underwent total gastrectomy and Roux-en-Y esophagojejunostomy anastomosis in the study. Patients were divided into two groups and analyzed retrospectively. Group 1 consisted of 43 patients who did not undergo intraoperative endoscopy between 2017 and 2019, and Group 2 included 43 patients who underwent intraoperative endoscopy between 2019 and 2020. RESULTS: Esophagojejunostomy anastomotic leak (EAL) was observed in 2.3 % of patients in Group 1 but not in Group 2. Anastomosis-related abnormal findings (anastomotic defect, bleeding, air leak, mucosal separation) were recorded in seven patients of Group 2 during endoscopy. When such findings were observed, additional full-thickness sutures were placed on the anastomosis line and strengthened. Complication related to anastomosis was not observed in the postoperative period in Group 2. DISCUSSION: After a total gastrectomy, the most severe complication affecting mortality, morbidity, and consequently the cost of the disease is esophagojejunal anastomotic leakage. Most of these complications are induced by technical errors not noticed during surgery. The crucial advantage of performing intraoperative endoscopy is the technically detailed evaluation of anastomosis. CONCLUSION: Intraoperative endoscopy is a safe method to evaluate the strength of anastomosis. This procedure provides detailed information regarding anastomotic integrity. HIPPOKRATIA 2021, 25 (3):108-112.
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OBJECTIVE: The members of the matrix metalloproteinase (MMP) family and cannabinoids (CBs) are reportedly associated with hippocampus-dependent memory functions. However, the effects of endogenously formed CBs on hippocampal long-term potentiation remain unknown. The present study aimed to investigate the changes in the gene and protein expression levels of matrix metallopeptidase 9 (MMP-9), phosphatase and tensin homolog (PTEN), and NOTCH receptor 1 (NOTCH1) in rat hippocampal tissues treated with anandamide (AEA), AM251, 6-iodopravadolin (AM630), and N-[4-{[(3,4-Dimethyl-5-isoxazolyl)amino]sulfonyl}phenyl] (ML193). MATERIALS AND METHODS: The subjects were divided into 10 groups (n = five per group). The pharmaceuticals were administered via intraperitoneal injection once a day for seven days, except for the control group. The resected hippocampal tissues were then evaluated using a quantitative real-time polymerase chain reaction (RT-qPCR) and Western blot analysis. The data obtained were statistically analyzed, and p < 0.01 was considered statistically significant. RESULTS: Contrary to the literature, the changes in MMP-9 expression were not statistically significant, but the changes in PTEN and NOTCH1 were. The findings of this in vivo experimental study revealed that the agonists and antagonists acting on the CB system have significant molecular effects on hippocampal tissue. CONCLUSIONS: The changes in gene and protein expressions may be one of the reasons for the neurodegenerative processes observed in patients using these agonists and antagonists, whose effects on the CB system have not been fully explained yet. Our study can contribute to the literature as it is the first study investigating the MMP-9, PTEN and NOTCH1 gene and protein expression.
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Ácidos Araquidônicos/farmacologia , Agonistas de Receptores de Canabinoides/farmacologia , Endocanabinoides/farmacologia , Hipocampo/efeitos dos fármacos , Alcamidas Poli-Insaturadas/farmacologia , Animais , Ácidos Araquidônicos/administração & dosagem , Agonistas de Receptores de Canabinoides/administração & dosagem , Método Duplo-Cego , Endocanabinoides/administração & dosagem , Hipocampo/metabolismo , Injeções Intraperitoneais , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , PTEN Fosfo-Hidrolase/genética , Alcamidas Poli-Insaturadas/administração & dosagem , Ratos , Ratos Wistar , Receptor Notch1/genéticaRESUMO
Pleuropulmonary blastoma (PPB) is a potentially aggressive, rare childhood neoplasia. We investigated histopathological features, survival, and DICER1 hotspot mutations among PPB patients. Archive records at our institution were reviewed, covering a 20-year period. Thirteen children (6 males and 7 females) with a mean age of 30.5 (range 6-83) months were included. The tumor subtypes were type I in 6 (46%), type II in 4 (31%), and type III in 3 (23%). Only tumors with type II and type III histology showed anaplasia (4/7, 57%). Median follow-up was 28 (range 9-216) months. Three-year overall survival rate was 83.3% and 3-year progression-free survival rate was 25%. Progression was seen in 60% (3/5) of type I and 66.7% (4/6) of type II and type III cases. Two patients died of disseminated disease at 9 and 44 months. Hotspot missense mutations on DICER1 gene were detected in all 11 patients with available tumor tissue. We found an additional novel germline loss-of-function mutation (c.5436dupT; p.E1813*) in 1 case. To the best of our knowledge, this is the first study to investigate hotspot missense mutations on DICER1 gene among the largest series of Turkish children with PPB.
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RNA Helicases DEAD-box/genética , Blastoma Pulmonar/genética , Ribonuclease III/genética , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Mutação , Blastoma Pulmonar/patologiaAssuntos
Asma , Produtos Biológicos , Pólipos Nasais , Anticorpos Monoclonais Humanizados , Eosinófilos , HumanosRESUMO
OBJECTIVE: This study aimed to analyze the effect of human Dental Pulp-Neural Crest Stem Cells (hDP-NCSCs) delivery on lesion site after spinal cord injury (SCI), and to observe the functional recovery after transplantation. METHODS: Neural Crest Stem Cells (NCSCs) were isolated from human Dental Pulp (hDP). The experimental rat population was divided into four groups (n = 6/24). Their behavioral motility was scored regularly. After 4-weeks, rats were sacrificed, and their spinal cords were examined for Green Fluorescent Protein (GFP) labeled hDP-NCSCs by immunofluorescence (IF) staining. RESULTS: In early post-injury (p.i) period, the ultrastructure of spinal cord tissue was preserved in Group 4. The majority of cells forming the ependymal region around the central canal were found to be hDP-NCSCs. While the grey-and-white-matter around the ependymal region was composed of e.g. GFP cells, with astrocytic-like appearance. The scores showed significant motor recovery in hind limb functions in Group 4. However, no obvious change was observed in other groups. CONCLUSION: Cells e.g., mesenchymal (Vimentin+) which express GFP+ cells in the gray-and-white-matter around the ependymal region could indicate the potential to self-renewal and plasticity. Thus, transplantation of hDP-NCSCs might be an effective strategy to improve functional recovery following spinal cord trauma (Fig. 10, Ref. 32).
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Locomoção , Células-Tronco Neurais/transplante , Neurônios/ultraestrutura , Regeneração da Medula Espinal , Medula Espinal/ultraestrutura , Adolescente , Adulto , Animais , Polpa Dentária/citologia , Humanos , Masculino , Crista Neural/citologia , Ratos , Ratos Sprague-Dawley , Recuperação de Função Fisiológica , Regeneração , Medula Espinal/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Transplante de Células-Tronco , Adulto JovemRESUMO
OBJECTIVE: To evaluate the efficacy and safety of segmental superficial parotidectomy in the surgical treatment of benign parotid tumours. METHODS: Patients who underwent parotidectomy for benign primary parotid tumours limited to the superficial lobe were retrospectively reviewed. Tumour location, size, surgical procedure, follow-up period, complications and recurrence rates were noted. RESULTS: The study included a total of 39 patients: 22 underwent segmental superficial parotidectomy (group 1) and 17 underwent superficial parotidectomy (group 2). The mean follow-up period was 41.79 months (range, 13-85 months). There were no recurrences in either group during the follow-up period. No significant differences were found between the two groups in terms of tumour size, complications or recurrence rates. CONCLUSION: Segmental superficial parotidectomy is a safe and effective option in the surgical treatment of benign parotid tumours.
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Adenoma Pleomorfo/cirurgia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Glândulas Salivares/cirurgia , Adenoma Pleomorfo/patologia , Adulto , Idoso , Traumatismos do Nervo Facial/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Parótida/patologia , Neoplasias Parotídeas/patologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/patologia , Estudos Retrospectivos , Glândulas Salivares/patologia , Resultado do TratamentoRESUMO
OBJECTIVE: Diabetic peripheral neuropathy is a common complication of type-2 diabetes mellitus. Endocan, apelin and endoglin are thought to be associated with endothelial dysfunction, angiogenesis and inflammation. In this study, we planned to evaluate these markers in diabetic peripheral neuropathy patients. PATIENTS AND METHODS: This single-blind, controlled clinical study was conducted on 99 type 2 diabetic patients with or without diabetic peripheral neuropathy and 53 healthy volunteer controls. Physical and laboratory examinations were done in all groups. In these groups, Endoglin, apelin and endocan levels were measured with ELISA method. RESULTS: Endoglin, apelin and endocan concentrations in diabetic peripheral neuropathy patients were higher than other diabetes mellitus patients and healthy controls. Similarly, diabetes mellitus patient's endoglin, apelin and endocan levels were higher than healthy controls. The differences were statistically significant. We detected a significant positive correlation between endoglin, apelin and endocan levels in all groups. CONCLUSIONS: Endoglin, apelin and endocan may reflect angiogenesis and endothelial dysfunction in diabetic peripheral neuropathy and they may be used as a marker in the future.
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Antígenos CD/sangue , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/diagnóstico , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Proteínas de Neoplasias/sangue , Proteoglicanas/sangue , Receptores de Superfície Celular/sangue , Adulto , Apelina , Biomarcadores/sangue , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Neuropatias Diabéticas/sangue , Endoglina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-CegoRESUMO
OBJECTIVE: This study was performed to investigate the levels of platelet activation marker SCUBE-1 and sCD40L which plays some role in the progression of atherosclerosis, in patients with hypothyroidism due to Hashimoto's thyroiditis. PATIENTS AND METHODS: The cohort of this study includes 90 patients and 35 healthy volunteers, who admitted to the internal medicine out-patient. Simultaneously in the same samples; SCUBE-1 and sCD40L measurements were accomplished by enzyme-linked immunosorbent assay (ELISA). The data obtained were analyzed statistically. RESULTS: Hypothyroidism due to Hashimoto's thyroiditis in comparison to the control group that includes healthy volunteers; SCUBE-1 and sCD40L, were increased. And these results were statistically significant (p < 0.05). CONCLUSIONS: SCUBE-1 and sCD40L levels were increased in Hashimoto's hypothyroidism patients. This may indicate an increased endothelial dysfunction, platelet activation and cardiovascular risk in hypothyroidism. SCUBE-1 and sCD40L may be helpful in cardiovascular risk assessment of hypothyroid patients.
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Ligante de CD40/sangue , Hipotireoidismo/sangue , Proteínas de Membrana/sangue , Biomarcadores/sangue , Proteínas de Ligação ao Cálcio , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Doença de Hashimoto/sangue , Doença de Hashimoto/complicações , Humanos , Hipotireoidismo/etiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Método Simples-CegoRESUMO
BACKGROUND: The differentiation capacity of embryonic stem cells (ESCs) has great promise for type-1 diabetes for cellular treatment. Therefore, different strategies have been reported so far for derivation of insulin producing cells (IPCs) from ESCs. Providing similar microenvironmental conditions as in vivo, functional differentiation of stem cells into desired cell types could be obtained in vitro. The aim of the present research was to utilize differentiation potential of ESCs to IPCs by co-culture with mouse pancreatic islets (mPIs) for the first time. METHODS: We present an in-direct differentiation protocol which compared with a conventional differentiation protocol. Novel in-direct co-culture differentiation protocol in which mPIs induced differentiation of ESCs into IPCs was used. This technique was compared with the chemical differentiation protocol that involved supplementing the differentiation media with specific growth factors. We analyzed differentiated cells in both groups by immune labelling, gene expression and protein secretion. RESULTS: IPCs were obtained with in-direct co-culture within 30 days. Differentiated ESCs were found to be positive for IPC specific markers, Pdx1, Insulin, C-peptide, Glut2 and MafA. The results of immunocytochemical and gene expression analysis showed higher differentiation efficiency in co-culture group than chemical differentiation group. These results were confirmed by the response assay to high glucose levels with ELISA for insulin. DISCUSSION: Our findings illustrate the significant effect of co-culture in different stages of differentiation and maturation of ESCs in vitro. We have developed an efficient and easy way to differentiate ESCs into IPCs, which possess similar characters of mature insulin positive cells.
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Diferenciação Celular , Células Secretoras de Insulina/metabolismo , Células-Tronco Embrionárias Murinas/metabolismo , Nicho de Células-Tronco , Animais , Antígenos de Diferenciação/biossíntese , Linhagem Celular , Meios de Cultura/química , Meios de Cultura/farmacologia , Células Secretoras de Insulina/citologia , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Camundongos , Células-Tronco Embrionárias Murinas/citologiaRESUMO
OBJECTIVE: This study examined the effects of thiamine and thiamine pyrophosphate on oxidative damage developing in association with hepatic injury caused by alcohol toxicity in rats and on hepatic injury markers. MATERIALS AND METHODS: Four groups of rats were used; control, a group receiving thiamine+ethanol, a group receiving thiamine pyrophosphate+ethanol and a healthy group. The experimental protocol was repeated over 30 days. Malondialdehyde, glutathione and DNA damage product levels in liver tissue were measured at the end of the study. Alanine amino transferase and aspartate amino transferase, markers of liver damage, levels were determined. The results were then compared among the groups. RESULTS: A statistically significant difference between antioxidant markers and markers of liver damage was determined between the group given thiamine pyrophosphate ethanol and the group given ethanol alone (p < 0.01) No statistically significant difference was observed between the group given thiamine and ethanol and the group given ethanol alone (p > 0.01). CONCLUSIONS: Our results suggest that thiamine pyrophosphate may have a protective effect against liver damage caused by alcohol toxicity.
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Antioxidantes/farmacologia , Biomarcadores/metabolismo , Etanol/toxicidade , Hepatopatias Alcoólicas/metabolismo , Fígado/metabolismo , Tiamina Pirofosfato/farmacologia , Tiamina/farmacologia , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Citoproteção/efeitos dos fármacos , Dano ao DNA/efeitos dos fármacos , Glutationa/metabolismo , Fígado/efeitos dos fármacos , Hepatopatias Alcoólicas/prevenção & controle , Masculino , Malondialdeído/metabolismo , Oxirredução/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos WistarRESUMO
Cyclophosphamide (CYC) and doxorubicin (DOX) are among the most effective and widely used anticancer chemotherapeutic drugs. Potential chemopreventive and chemotherapeutic functions have recently been attributed to flavonoids. We hypothesized that Quercetin (QR) would protect against the toxic effects of chemotherapeutic agents applied prior to pregnancy. Rats were treated with the chemotherapeutic drugs CYC (27 mg/kg) and DOX (1.8 mg/kg) applied in a single intraperitoneal dose once every 3 weeks for 10 weeks. QR was administered at a dose of 10 mg/kg/day by oral gavage. 48 h following the experimental chemotherapy exposure, female rats were transferred to cages containing male rat for mating. Fetal brain tissues were removed from fetuses extracted by cesarean section on the 20th day of gestation for evaluation of antioxidant parameters. A significant increase in superoxide dismutase and malondialdehyde activity was observed in CYC and DOX treatment groups relative to the control group (p < 0.05). Similarly, carnitine acylcarnitine translocase and Glutathione activity was significantly reduced in the CYC and DOX groups relative to the control group (p < 0.05). Our results indicate that the use of chemotherapeutic drugs before pregnancy can result in oxidative damage to fetal brain tissue. Therefore, women who have been exposed to chemotherapy and may become pregnant should be treated with antioxidant compounds such as QR to reduce the risk of damage to fetal brain tissues.
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OBJECTIVE: To assess the authors' experiences in en bloc pelvic resection with concomitant rectosigmoid colectomy and primary anastomosis as a part of primary cytoreductive surgery for patients with advanced ovarian cancer. MATERIALS AND METHODS: Atotal of 22 patients with FIGO Stage IIB-IV epithelial ovarian cancer who underwent en bloc pelvic resection with anastomosis were retrospectively reviewed. Data analyses were carried out using SPSS 10.0 and descriptive statistics, Kaplan-Meier survival curves, and Log Rank (Mantel-Cox) test were used for statistical estimations. RESULTS: Median age was 58.8 years. FIGO stage distribution of the patients was; one (4.5%) IIB, three (13.7%) IIC, three (13.7%) IIIA, six (27.3%) IIIB, and nine (40.9%) IIIC. Median peritoneal cancer index (PCI) was 8 (range 5-22) and optimal cytoreduction was achieved in 18 patients (81.8%) of whom 13 (59.1%) had no macroscopic residual disease (complete cytoreduction). There was no perioperative mortality. A total of nine complications occurred in seven (31.8%) patients. Anastomotic leakage was observed in one (4.5%) patient. There was no re-laparotomy. Mean follow-up time was 60 months. There were 15 (68.2%) recurrences of which 12 (80%) presented in extra-pelvic localizations. Mean disease-free survival (DFS) and overall survival (OVS) were estimated as 43.6 and 50.5 months, respectively. Patients with complete cytoreduction had a better DFS (p = 0.006) and OVS (p = 0.003) than those with incomplete cytoreduction. CONCLUSION: En bloc pelvic resection, as a part of surgical cytoreduction, seems to be a safe and effective procedure in many patients with advanced ovarian cancer if required. Despite relatively high general complication rate, anastomosis-related morbidity of this procedure is low as 0.8%. Nevertheless, surgical plan and perioperative care should be personalized according to medical and surgical conditions of the patient.
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Adenocarcinoma/cirurgia , Colo Sigmoide/cirurgia , Neoplasias Epiteliais e Glandulares/cirurgia , Neoplasias Ovarianas/cirurgia , Exenteração Pélvica/métodos , Peritônio/cirurgia , Reto/cirurgia , Adenocarcinoma/patologia , Adenocarcinoma de Células Claras/patologia , Adenocarcinoma de Células Claras/cirurgia , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Anastomose Cirúrgica , Carcinoma Endometrioide/patologia , Carcinoma Endometrioide/cirurgia , Carcinoma Epitelial do Ovário , Estudos de Coortes , Colectomia/métodos , Intervalo Livre de Doença , Feminino , Humanos , Histerectomia/métodos , Estimativa de Kaplan-Meier , Excisão de Linfonodo , Pessoa de Meia-Idade , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/patologia , Ovariectomia/métodos , Proctocolectomia Restauradora/métodos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To investigate the role of Langerhans cells in the pathogenesis and clinical picture of middle-ear cholesteatoma. SUBJECTS AND METHODS: The study included 40 patients operated upon for a diagnosis of chronic otitis due to acquired cholesteatoma. RESULTS AND ANALYSIS: A closed surgical technique was used in 20 per cent of patients and an open technique in 80 per cent. Langerhans cells were more densely accumulated in cholesteatoma epithelium, compared with external ear canal skin (p < 0.001). Staining for Ki-67 protein was greater in cholesteatoma epithelium (p < 0.001) and Apo2.7 protein staining (indicating apoptosis) was more prominent (p < 0.001), compared with ear canal skin. Regarding significant relationships between clinical and pathological findings, staining for Ki-67 (p = 0.046) and Apo2.7 (p = 0.037) was more prominent in patients undergoing open versus closed surgery. CONCLUSION: Using cell proliferation and apoptosis markers, a dense Langerhans cell infiltration was found to occur as a host response to middle-ear cholesteatoma.
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Apoptose , Colesteatoma da Orelha Média/patologia , Antígeno Ki-67/metabolismo , Células de Langerhans/patologia , Adolescente , Adulto , Biomarcadores Tumorais/metabolismo , Proliferação de Células , Criança , Colesteatoma da Orelha Média/metabolismo , Colesteatoma da Orelha Média/cirurgia , Doença Crônica , Feminino , Humanos , Antígeno Ki-67/análise , Células de Langerhans/metabolismo , Masculino , Pessoa de Meia-Idade , Otite Média/diagnóstico , Otite Média/cirurgia , Estudos Prospectivos , Coloração e Rotulagem , Adulto JovemRESUMO
The use of mesh has become the gold standard in hernia operations recently due to advantages such as lower recurrence rates, lower post-surgical pain and earlier return to work. Plug mesh application, first described by Robins and Rutkow [Robbins AW, Rutkow IM (1993) The mesh-plug hernioplasty. Surg Clin North Am 73:501-512], is a popular method of hernia repair. Although rare, there may be complications of surgery using plug mesh. This report presents a case of mechanic bowel obstruction due to mesh migration, 3 years after a left inguinal hernia repair with plug mesh method.
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Migração de Corpo Estranho/complicações , Hérnia Inguinal/cirurgia , Obstrução Intestinal/etiologia , Complicações Pós-Operatórias/etiologia , Adulto , Humanos , Obstrução Intestinal/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: There are no country-based data focused on aspirin (ASA)-exacerbated respiratory disease (AERD) in Turkey. OBJECTIVE: To assess the prevalence of AERD in adult patients with asthma. METHODS: A structured questionnaire was administered via face-to-face interview by a specialist in pulmonology/allergy at seven centres across Turkey. RESULTS: A total of 1344 asthma patients (F/M: 1081/263: 80.5%/19.5%, mean age: 45.7 ± 14.2 years) were enrolled. Atopy rate was 47%. Prevalence of allergic rhinitis, chronic rhinosinusitis/rhinitis, and nasal polyposis (NP) were 49%, 69% and 20%, respectively. Of 270 patients with NP, 171 (63.3%) reported previous nasal polypectomy and 40 (25%) had a history of more than three nasal polypectomies. Aspirin hypersensitivity was diagnosed in 180 (13.6%) asthmatic patients, with a reliable history in 145 (80.5%), and oral ASA provocation test in 35 (19.5%) patients. Clinical presentations of ASA hypersensitivity were respiratory in 76% (n=137), respiratory/cutaneous in 15% (n=27), and systemic in 9% (n=16) of the patients. Multivariate analysis indicated that a family history of ASA hypersensitivity (p: 0.001, OR: 3.746, 95% CI: 1.769-7.929), history of chronic rhinosinusitis/rhinitis (p: 0.025, OR: 1.713, 95% CI: 1.069-2.746) and presence of NP (p<0.001, OR: 7.036, 95% CI: 4.831-10.247) were independent predictors for AERD. CONCLUSION: This cross-sectional survey showed that AERD is highly prevalent among adult asthmatics and its prevalence seems to be affected by family history of ASA hypersensitivity, history of rhinosinusitis and presence of NP.