The Effects of Ankaferd on Liver Regeneration after Partial Hepatectomy in Rats.

Background: In this study, we aim at investigating the effect of post partial hepatectomy Ankaferd blood stopper (ABS) on liver regeneration in rats. Methods: Twenty-four rats were included in our study divided into three groups. (Group A = (Sham) 8 rats, Group B = (control) 8 rats, Group C = (experimental) 8 rats). Two-thirds hepatectomy was employed in all rats. Intraperitoneal 0.9% saline was administered to the rats in the control group, and intraperitoneal 1 ml Ankaferd was administered to the rats in the experimental group. The rats were sacrificed on the 7th day. Tissue samples were taken from the liver tissue for histopathological evaluation. Results: The number of mitosis and the cytoplasmic vacuolization/hdyropic degeneration scores were statistically different between the groups (Group A: 11.63 vs Group B: 17.00 vs Group C: 8.88 (p:0.028) and Group A: 8.56 vs Group B: 16.63 vs Group C: 12.31 (p:0.034), respectively). The presence of binuclear hepatocytes score was p: 0.258 and disorganized distribution in cell proliferation in the parenchyma score was :0.076; There was no statistical difference between the groups. The number of mitosis was p:0116 for Group A-B, p:1.00 for Group A-C and p:0.017 for Group B-C Conclusions: Positive results indicating an increase in liver regeneration due to Ankaferd were not obtained in our study.

Reactions of Subcutaneous Connective Tissue to Mineral Trioxide Aggregate, Biodentine®, and a Newly Developed BioACTIVE Base/Liner.

AIM: There is an increasing interest in the application of BioACTIVE materials to achieve hard tissue formation and maintain pulp vitality. Mineral trioxide aggregate (MTA) and Biodentine® are BioACTIVE materials used for pulp capping. Recently, dental researchers have produced BioACTIVE glass-incorporated light-curable pulp capping material. The study is aimed at evaluating the subcutaneous connective tissue reactions to MTA, Biodentine®, ACTIVA BioACTIVE Base/Liner. These materials were placed in polyethylene tubes and implanted into the dorsal connective tissue of Sprague Dawley rats. The presence of inflammation, predominant cell type, calcification, and thickness of fibrous connective tissue was recorded by histological examination 7, 30, and 60 days after the implantation procedure. Scores were defined as follows: 0 = none or few inflammatory cells, no reaction; 1 = <25 cells, mild reaction; 2 = 25 to 125 cells, moderate reaction; and 3 = ≥125 cells, severe reaction. Fibrous capsule thickness, necrosis, and formation of calcification were recorded. ANOVA and post hoc Dunnett's tests were used for statistically analyses (p < 0.05). RESULTS: In terms of oedema, inflammation, fibrous capsule, and necrosis, no significant differences were found in any time period for any material. MTA and Biodentine® showed higher calcification than in the ACTIVA BioACTIVE on day 30, and the difference was statistically significant (p < 0.05). After 60 days, while calcification was not seen in the control group, it was observed in the test groups. There was a statistically significant difference between the control and the others. CONCLUSION: All materials were well tolerated by the tissues in the 60-day evaluation period. One notable finding is the presence of dystrophic calcification in the connective tissue adjacent to the newly developed BioACTIVE Base/Liner material. Therefore, this new BioACTIVE Base/Liner material may be safely recommended to clinicians as a pulp capping material.

Neuroendocrine tumors of the urinary bladder A case series and review of the literature.

Neuroendocrine carcinoma cases, more frequent in the GI tract, have rarely been reported in extrapulmonary areas. Neuroendocrine carcinoma of the bladder is one of the malignancies with a poor prognosis, which is expected to cause rapid metastases. In addition, neuroendocrine carcinoma of the bladder constitutes < 1% of all bladder carcinomas. In this study, we present two rare cases, a combined small cell neuroendocrine carcinoma-high-grade urothelial carcinoma and a large cell neuroendocrine carcinoma, diagnosed at Çanakkale Onsekiz Mart University, Research and Practice Hospital Pathology Clinic, between November 2016 and January 2017. KEYWORDS: Bladder, L cell neuroendocrine carcinoma, Pathological features, Small cell neuroendocrine carcinoma.

The effect of Allium sativum in experimental peritoneal adhesion model in rats.

PURPOSE: To evaluate the effect of garlic on formation of postoperative adhesions in rats. METHODS: Twenty-four Sprague dawley rats were divided into three groups. In Group 1 (sham), laparotomy was performed and stitched up. In Group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and 2 cc of saline was intraperitoneally administered to each rat. In Group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Allium sativum derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum. RESULTS: In Group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. CONCLUSIONS: No positive outcomes indicating that Allium sativum reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, allium sativum increased the production of free oxygen radicals in the tissue.

Synchronous pancreas and liver resection during CRS ± HIPEC. Results of 35 consecutive patients.

AIM: To evaluate the results of synchronous pancreas and liver resection in patients with metastatic carcinoma accompanied by peritoneal carcinomatosis (PC) who underwent cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC). MATERIAL AND METHODS: Overall, 35 patients with PC who underwent CRS/HIPEC at Umraniye Education and Research Hospital owing to different etiological causes were evaluated for operation procedure, age, sex, comorbid diseases, ASA score, systemic chemo/radiotherapy, duration of surgery, chemotherapy (CT) protocol applied in HIPEC, amount of bleeding, synchronous hepatobiliary resection interventions during operation and short/long-term mortality and morbidity. RESULTS: Fifteen patients were male and 20 were female. Mean age was 58.375 ± 13.02 (range, 27-85) years. CRS/HIPEC was performed in 12 patients (34.3%), whereas only CRS was performed in 23 (65.7%) patients. The lowest and highest perioperative bleeding amount was 50 cc and 2000 cc, respectively, and 6 (17.1%) patients had intraoperative bleeding of ≥1000 cc. Synchronous isolated pancreatic resection, hepatic + pancreatic resection and isolated liver resection was performed in 3 (8.6%), 5 (14.3%) and 27 (77.1%) patients treated with CRS/HIPEC. Two patients died within postoperative day 30, and the mortality rate was 5.7%. CONCLUSION: Hepatopancreatobiliary surgery is a difficult intervention and is associated with serious morbidities. Synchronisation of hepatopancreatobiliary surgery with CRS/HIPEC may be challenging for the surgeon and clinician. Here we emphasise that this combination can be performed safely by an experienced team with a multidisciplinary approach and good patient preparation. KEY WORDS: Cytoreductive surgery, HIPEC, Hepatopancreatobiliary surgery, Peritoneal carcinomatosis.

The effect of Allium sativum in experimental peritoneal adhesion model in rats

Abstract Purpose: To evaluate the effect of garlic on formation of postoperative adhesions in rats. Methods: Twenty-four Sprague dawley rats were divided into three groups. In Group 1 (sham), laparotomy was performed and stitched up. In Group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and 2 cc of saline was intraperitoneally administered to each rat. In Group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Allium sativum derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum Results: In Group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. Conclusions: No positive outcomes indicating that Allium sativum reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, allium sativum increased the production of free oxygen radicals in the tissue.

Splenic abscess is extremely rare after amoebic dysentery. A case report and review of the literature.

Splenic abscess is a rare condition, which is often asymptomatic in the absence of comorbidity and is associated with high mortality rates. Given the importance of the differential diagnosis of patients who present to the emergency department with fever or septic shock, we report the case of a patient with amoebic splenic abscess who presented to our clinic with widespread skin rash and signs of septic shock following amoebic dysentery caused by Entamoeba histolytica, which is rarely reported in the literature. KEY WORDS: Amoebic Spleen Abscess, Amoebic Abscess, Entamoeba Histolytica, Splenic Abscess.

Evaluation of risk factors for complications after colostomy closure.

OBJECTIVE: The goal of the study is to describe postoperative complications observed after colostomy reversal and to define possible risk factor(s) for complication.s after colostomy closure PATIENTS-METHODS: Patients who underwent colostomy closure in Department of General Surgery, Dr Lutfi Kirdar Kartal Education and Research Hospital between January 2007 and January 2015 were enrolled. Patients with double-barrel ileo-colostomy, Devine's colostomy and tube cecostomy were excluded from study. Demographics, data regarding the first operation and those regarding the reversal operation were analyzed and compared. RESULTS: Total 168 patients [118 (70.1%) male, average age=52.8±15.6] were included. Most common reasons for stoma formation were malignancy [n=63 (37.5%)] and diverticular perforation [40 (23.8%)]. Index operation was performed under emergency conditions in 142 (84.5%) patients. End colostomy was the most common stoma type in emergent cases and loop sigmoidostomy in elective cases. Postoperative complication was observed in 36 (21.4%) patients. Nine (5.3%) patients developed anastomotic leak. Of those, 8 (4.8%) was necessitated reoperation and 1 (0.6%) was treated conservatively. Postoperative mortality was 5 (2.9%). At multivariate analysis, DM was the independent risk factor for surgical site infection and evisceration (p<0.01). DM was present in 6 (66.7%) cases who had had an anastomotic leak and leak was more common compared to non-diabetics (p<0.05). Patients waiting more than 3 months before stoma reversal had experienced more anastomotic leak compared to those waiting less (p<0.05). CONCLUSION: Closure of colostomy has a significant morbidity and mortality, and the physician should be more careful in postoperative follow-up in patients who had comorbidities, especially diabetes mellitus. KEY WORDS: Anastomotic leak, Colostomy, Postoperative complication.

Necrotizing fasciitis after intramuscular self-injection A case report.

Necrotizing fasciitis (NF) is a rare, life-threatening soft tissue infection that affects the skin, subcutaneous tissue, fascia, and muscle, and is characterized by rapid spread and invasion of pathogens. Treatment is possible with early diagnosis, appropriate antibiotic therapy, and quick surgical intervention. Nevertheless, despite all interventions, it is sometimes difficult to manage NF. The Authors present the case of a patient with extensive NF caused by multidrug-resistant Acinetobacter baumannii (A. baumannii) that developed following an intramuscular injection of diclofenac sodium administered at home by someone who was not a healthcare professional. Wound sample culture revealed multidrug-resistant A. baumannii. The patient was treated using negative-pressure wound therapy along with antibiotic treatment and extensive surgical debridement. KEY WORDS: Multidrug-resistant acinetobacter baumannii, Necrotizing fasciitis, Negative-pressurelf-injection, Wound therapy.

A case of hepatocellular carcinoma mimicking hepatic adenoma.

Hepatocellular adenomas (HA) are benign naturally occurring masses that are rarely reported, and rarely reaching tumor size up to 30 cm. Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and usually caused by cirrhosis and more commonly reported tumors in males. It has been reported that presentations may occur with masses that are often less than 5 cm or rarely more than 10 cm. We aimed to present a case of hepatocellular carcinoma 72-years old man with fatigue and pain spread on the right upper quadrant; a histopathologic image similar to both telangiectatic variant hepatic adenoma and false diagnosis as "cavernous hemangioma" in the first biopsy specimen. KEY WORDS: Hepatocellular carcinoma, Liver Adenoma.