Subcutaneous and Intraosseous Fat Necrosis Associated with Chronic Pancreatitis.

Background: Extra-abdominal manifestations of fat necrosis, like subcutaneous fat necrosis, polyarthritis, and polyserositis may appear with an occurrence rate of about 0.8%, wherein intraosseous fat necrosis is a more rare complication of pancreatitis, with few reports in English literature. Case report: A 34-year-old male with a 15-year-history of alcohol abuse was hospitalized several times in the last few years because of attacks of relapsed chronic pancreatitis. After the last attack, pancreatitis came in a stable state ("burned out") with no symptoms and signs of the disease. The patient had been free of symptoms for 28 months since the last admission when he came with sub-febrile temperature, huge pain, swelling, and erythema in the area of the left lateral malleolar region with propagation in the foot. Blood biochemistry was normal. Conventional radiography showed multiple sites of osteolysis in the left calcaneus. Images on multislice computed tomography (MSCT) with 3D reconstruction revealed hypodense focuses that corresponded to osteonecrosis areas and bone marrow edema in the left calcaneus. Conclusions: The possibility of intraosseous fat necrosis should be considered in situations of unexplained polyarthritis or panniculitis, particularly in individuals with alcohol abuse or pancreatic disease.

Isolated Spleen Metastases of Endometrial Cancer: A Case Report.

BACKGROUND: Isolated splenic metastases from endometrial cancer, which is a relatively common malignancy, are extremely rare findings; to date, only 14 cases have been reported in the literature. CASE SUMMARY: We report a patient with isolated splenic metastases of endometrial cancer 3 years after radical surgery of the primary tumor. The patient was successfully treated by splenectomy and six cycles of paclitaxel. Fifty months after splenectomy, she was alive and well, and with no evidence of disease. CONCLUSION: Isolated spleen metastasis of endometrial cancer is very rare. Radical surgery and adjuvant therapy may offer excellent long-term survival.

Comparison of recurrence patterns of colorectal cancer in laparoscopic and open surgery groups of patients: A meta-analysis.

PURPOSE: The purpose of this meta-analysis was to evaluate differences between laparoscopic and open surgery and also the development of local and distant colorectal cancer (CRC) recurrences in treated patients. METHODS: 2,058 cases treated with laparoscopic surgery and 2,365 cases with open surgery from 20 included studies were analyzed, using the random-effects model. The mean difference and odds ratio (OR) with 95% confidence interval (95%CI) were calculated. An overall and a subgroup analysis was performed according to the type of cancer - colon or rectal, and we registered the operating time, number of dissected lymph nodes and need for intraoperative blood transfusion in the laparoscopic and open surgery group of patients. RESULTS: The operating time in the laparoscopic surgery group was significantly longer than in the open surgery group (mean difference 38.23 min). There was no significant differences in the number of dissected lymph nodes between the two groups when we pooled data for treatment of CRC (p=0.16). The OR of overall and local recurrences was significantly decreased in patients in the laparoscopic surgery group compared to those in the open surgery group (OR 0.83; 95%CI 0.70-0.98; p=0.03) and (OR 0.70; 95%CI 0.50-0.97; p=0.03), respectively. No significant differences were found between patients who underwent laparoscopic surgery and those that had open surgery for distant recurrences after CRC treatment. CONCLUSIONS: There was statistically significant difference between laparoscopic or open surgery and development of local and overall CRC recurrences.

The effect of age and compression strength on venous leg ulcer healing.

Objectives The aim of the study is to compare proportions of venous leg ulcers healed in patients treated with two different sub-bandage pressure values in relation to age. Methods The study included 102 outpatients with venous leg ulcers, one group with moderate compression pressure of 35-40 mmHg and the second with high pressure >45 mmHg. Each group was divided into two subgroups according to the age (≥65 vs. <65 years). Computerized planimetry was used to measure the size of the ulcers at 6, 12, 18 and 24 weeks. Results Kaplan-Maier analysis showed high pressure leads to higher proportion of healed venous leg ulcers, compared to moderate pressure, in patients aged ≥65 years (57.6% vs. 28%) and in patients <65 years (53.8% vs. 36%) (p < 0.05). Conclusion The study showed that higher compression pressure leads to higher proportions of venous leg ulcers healed, independent of age and could be safely preferred in older patients.

Antioxidant and proapoptotic effects of anthocyanins from bilberry extract in rats exposed to hepatotoxic effects of carbon tetrachloride.

AIMS: The aim of this research was to determine the hepatoprotective effects of anthocyanins from bilberry extract in rats exposed to carbon tetrachloride (CCl4) by monitoring the parameters of oxidative stress and apoptosis, and by performing the histopathological and morphometric analyses. MAIN METHODS: Animals were divided into four groups: Group I (0.9% NaCl-10days), Group II (bilberry extract, 75mg/kg-10days), Group III (0,9% NaCl-9days, and on the tenth day CCl4-2ml/kg), Group IV (bilberry extract, 75mg/kg-10days and on the tenth day CCl4-2ml/kg). KEY FINDINGS: Bilberry extract led to a significant decrease in the activity of biochemical parameters in serum (AST, GGT, LDH, and ALT), the activity of pro-oxidative enzyme xanthine oxidase, as well as the level of lipid peroxidation in the liver in Group IV compared to Group III (p<0.01). Bilberry extract resulted in a significant increase in the activity of the antioxidant markers-catalase (p<0.05), superoxide dismutase, glutathione S-transferase and glutathione peroxidase (p<0.01), and the concentration of reduced glutathione (p<0.05) in Group IV in relation to Group III. The application of bilberry extract resulted in an increase in the number of apoptotic hepatocytes and the activity of caspase-3 in the liver tissue (p<0.01). The reduction of coagulation necrotic areas was proved (p<0.001) as well as the number of macrovesicular hepatocytes (p<0.01), along with an increased mitotic activity (p<0.01) in Group IV compared to Group III. SIGNIFICANCE: Anthocyanins from bilberry extract have strong antioxidant properties and therefore can be considered as powerful hepatoprotectives in natural products.