Restoring Function of the Flexor Tendons of the Hand: State of the Science in Kazakhstan.

We conducted a literature review to highlight the diagnosis and treatment of hand flexor tendon injuries and discuss the current state of the science of hand surgery in the Republic of Kazakhstan. We reviewed the Google Scholar, PubMed, Web of Science, Elsevier, and National Center for Biotechnology Information databases and other printed sources for open access articles in three languages. We accepted relevant scientific articles that reflected the peculiarities of restoring function of the tendon flexors of the hand. We reviewed articles from the present to the previous 20 years and included 31 of these sources in our literature review. The medical examination of a patient who has sustained a flexor tendon injury should be thorough and gradual, supported by ultrasound and X-ray examination. For effective restoration of hand function following a hand injury, it is important for the surgeon to conduct a step-by-step assessment of the damage that has occurred to soft tissues, superficial and deep tendons, bones, nerves, and blood vessels. The main goal of tendon repair is to preserve tendon function. It is also known that early postoperative tendon movement leads to faster healing. The most frequent complications associated with flexor tendon repair include the development of adhesions, wound infection, tendon rupture, impaired hand function, and scar formation. Relative to the state of the science in the Republic of Kazakhstan, we conclude that hand surgery should be performed by highly skilled specialists in the field of microsurgery in a specialized department with microsurgical equipment.

Chronic appendicitis: the process from pre-diagnosis to pathology.

OBJECTIVE: Chronic appendicitis (CA) is a rare medical condition. CA is characterized by a less severe and almost continuous abdominal pain. It has a clinical picture lasting longer than 1-2 days and extending over weeks, months, even years. The exact etiology of CA is unclear. Certain resources have reported it as the cause of partial obstruction in the lumen of the appendix. PATIENTS AND METHODS: Our study was carried out with the approval of the Clinical Research Ethics Committee. A retrospective analysis was performed between August 2018 and March 2020. RESULTS: It was determined that 207 appendectomies were performed during the retrospective scan period. The data of 182 of these patients could be accessed fully and we could get answers to the criteria we thought. Only 8 of the patients screened were likely to be diagnosed with chronic appendicitis in the preoperative period. CA was found in 1 of the 8 patients (12.5%) who underwent surgery after a preliminary diagnosis of CA. Two patients were reported as malignant (25%), 3 patients (37.5%) as reactive lymphoid hyperplasia, and 1 patient as peri appendicitis (12.5%). Bleeding and congestion were reported in the last patient (12.5%). CONCLUSIONS: The diagnosis of chronic appendicitis is made by pathological examination. It may not always be possible to consider "chronic appendicitis" as a preliminary diagnosis. This should still be kept in mind. In our opinion, it is a bit difficult to make a preliminary diagnosis of chronic appendicitis and make a surgical decision. We believe that controlled and prospective studies can shed more light on chronic appendicitis.

Irisin immunohistochemistry in gastrointestinal system cancers.

Cancer is the leading cause of morbidity and mortality worldwide. Some studies have shown that high heat kills cancer cells. Irisin is a protein involved in heat production by converting white into brown adipose tissue, but there is no information about how its expression changes in cancerous tissues. We used irisin antibody immunohistochemistry to investigate changes in irisin expression in gastrointestinal cancers compared to normal tissues. Irisin was found in human brain neuroglial cells, esophageal epithelial cells, esophageal epidermoid carcinoma, esophageal adenocarcinoma and neuroendocrine esophageal carcinoma, gastric glands, gastric adenosquamous carcinoma, gastric neuroendocrine carcinoma, gastric signet ring cell carcinoma, neutrophils in vascular tissues, intestinal glands of colon, colon adenocarcinoma, mucinous colon adenocarcinoma, hepatocytes, hepatocellular carcinoma, islets of Langerhans, exocrine pancreas, acinar cells and interlobular and interlobular ducts of normal pancreas, pancreatic ductal adenocarcinoma, and intra- and interlobular ducts of cancerous pancreatic tissue. Histoscores (area × intensity) indicated that irisin was increased significantly in gastrointestinal cancer tissues, except liver cancers. Our findings suggest that the relation of irisin to cancer warrants further investigation.

Investigation of the relationship between serum hormones and pilonidal sinus disease: a cross-sectional study.

AIM: The aim of this cross-sectional study was to determine whether pilonidal sinus is influenced by hormones that stimulate body hair growth. Currently, there are insufficient data on the presence of hormonal abnormalities in pilonidal sinus disease. METHOD: Hormone levels (including those of thyroid-stimulating hormone, follicular-stimulating hormone, luteinizing hormone, prolactin, progesterone, oestradiol, testosterone, cortisol and dehydroepiandrosterone) were measured in 39 patients with pilonodal sinus presenting between February 2013 and March 2013. The results were compared with those of 39 volunteers without this disease. RESULTS: There was no statistically significant difference between men with pilonidal sinus disease (P > 0.05). The prolactin levels of women with pilonoidal sinus were significantly higher than those of women in the control group (P < 0.05). CONCLUSION: Raised serum prolactin levels in women may be related to the development of pilonidal sinus disease.

The effects of different prosthetic materials on the formation of collagen types in incisional hernia.

OBJECTIVE: The aim of this study was to determine the rate of collagen Type I/Type III for different meshes. METHOD: Fifty rats were used. Five groups were formed: prolene (n = 10), mersilene (n = 10), parietex (n = 10), e PTFE (n = 10) and control group (n = 10). In all animals, laparotomy was performed using a midline incision. After that four different kinds of meshes are placed into the retro-rectus plane and fixed with a non-absorbable suture. Rectus superficial fascia and skin are closed. In the control group, repairment is done primarily. Thirty days later, meshes are found through the incisions that were done previously. Scar tissues above and near by meshes and also in the control group are taken, and in these tissue samples, the ratio of Type I/III is evaluated histochemically. RESULTS: The Prolene mesh was found to contain more collagen fibers than e PTFE. As a result of the histopathologic evaluation, it was seen that Group I contained statistically significantly more collagen density than the other four groups (p < 0.05). Moreover, the collagen Type I/III ratio in the specimen taken from the top part and the surrounding area of Group I was found significantly higher than the collagen Type I/III ratios of the rest of the groups (p < 0.05). CONCLUSION: As a conclusion, the ratio of collagen Type I/III is the highest in the prolene group.