Xanthogranulomatous cholecystitis. Retrospective analysis of 12 cases.

Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in areas of destructive inflammation. The macroscopic appearance generally mimics a gallbladder carcinoma. Twelve cases of xanthogranulomatous cholecystitis were identified from a retrospective analysis of the patient records of 770 cholecystectomy cases operated on in our department from January 1996 to October 2001. There were four men and eight women. Mean age of presentation was 52.5 years. Eleven patients had gallbladder stones. Seven patients had a history of acute cholecystitis and five patients of biliary colicky pain. Five cases were presented with obstructive jaundice and five with acute cholecystitis. Right upper quadrant mass was palpable in three patients. All patients underwent cholecystectomy. Open surgery was planned and performed in three patients. Laparoscopic cholecystectomy was planned in nine patients but converted to open surgery in three cases. Nine patients had an uneventful postoperative course. One patient developed wound infection and one patient a postoperative pulmonary infection. One patient developed acute abdomen in the 2nd postoperative day and was re-operated for bile peritonitis. No mortality was seen in the series.

Prevention of intraabdominal adhesions produced by polypropylene mesh.

Polypropylene mesh (PPM) is widely used in ventral hernia repair, however is also associated with visceral adhesions when the mesh is exposed to intraabdominal organs. In this study, a composite mesh [ePTFE (expanded polytetrafluoroehylene) + PPM] and sodium hyaluronate/carboxymethyl cellulose (NaHA/CMC) membrane laid under PPM are evaluated in terms of adhesion formation in a rat model of ventral hernia repair. In this experimental study, a 2 x 1 cm of peritoneum and underlying muscle defect was created at the right side of the anterior abdominal wall of 37 male Wistar albino rats. These defects were repaired with 2.5 x 2 cm PPM in group 1 (n = 13), with composite mesh in group 2 (n = 12) and with PPM+NaHA/CMC in group 3 (n = 12). Rats were sacrificed after 14 days and the prosthetic materials were examined for the calculation of surface area percentage covered by adhesions, for organ involvement in the adhesions and for histological evaluation. There was a reduction in the adhesion-covered area in group 2 and group 3. Organ involvement was predominantly seen in group 1. Neoperitoneum was perfect in group 2. Fibrosis and inflammation were higher in group 1. All groups showed adhesiogenic potential to some extent. This potential was maximum with PPM. Both ePTFE and NaHA/CMC displayed similar effects in preventing adhesion formation.

Scolicidal agents in hydatid cyst surgery.

Injecting scolicidal solutions into the hydatid cyst and packing the operative field with sponges soaked in scolicidal agents have been used to avoid dissemination of the parasite during surgery. In the first part of this invitro study, we tried to determine the scolicidal property of various agents in different concentrations and exposure times. In the second part, we tested whether sponges soaked in different type and concentrations of scolicidal agents have any role beyond being a mechanical barrier. 20% saline, 3% hydrogen peroxide, 1.5% cetrimide-0.15% chlorhexidine (10% Savlon), 95% ethyl alcohol, 10% polyvinylpirrolidone-iodine (Betadine) and their further dilutions were used in this study. Protoscoleces were obtained from the cyst containing livers of the sheep and viability was determined with dye-uptake (0.1% Eosin) and flame cell activity. Savlon was found to be the least concentration dependent scolicidal agent among those studied. Scoleces sprayed on sponges soaked in 20% saline, 95% ethyl alcohol, Betadine and 3% hydrogen peroxide were killed after 15 minutes. 3% and 10% saline and normal saline were ineffective. Sponges work not only as a mechanical barrier but also as a chemical one if the agent is chosen correctly. In purely cystic hydatid liver disease, the risk of dissemination of the cyst contents can be avoided by injection of a potent scolicidal agent such as Savlon.

Thyroidectomy with and without drains.

Drainage after thyroid surgery has been widely used to prevent life-threatening complications. However, it is well known that drains do not always prevent haematoma formation. In this retrospective study, we reviewed our experience with 1057 thyroidectomies with and without drains in order to assess this issue. Between 1983 and 1993, 520 patients were closed with drains and 537 patients without drains after thyroid surgery. The indications for drainage of the selective period included wet operative field and large areas of dead space at the conclusion of the operation. Reoperation for bleeding was done in twelve patients in the drainage group and two patients in the non-drainage group (p < 0.05). Wound infection was seen in seven patients in the drainage group and none in the no-drainage group (p < 0.05). This study suggests that routine drainage after thyroid surgery is not necessary and a selective policy can be applied safely.

An investigation of the effects of the local use of 1:25 dihydroxycholecalciferol (1:25 D) on tension sites during experimental tooth movement in rats.

The aim of this work was to investigate the local effects of 1:25 dihydroxychole-calciferol, one of the most potent osteoclastic activity stimulants. Tests were conducted on 32 Wistar albino rats divided into 3 groups: an experimental (appliance + drug, n = 11), control (appliance only, n = 11) and a no therapy group (n = 10) which was used for purposes of interpreting histological findings in the others. A significantly higher area of unilateral apposition, relative to the control group, was observed in the experimental group local to the area of administration of the 1:25 D.

[Investigation of the vertical variations in the anterior region of Class II, division 1 malocclusions treated with different techniques]. / Farkli yöntemlerle tedavi edilmis Angle Class II, div. 1. anomalilerinde ön bölgedeki dikey degisimlerin incelenmesi.

In this study, vertical differences in the anterior region of Class II, division 1 patients treated with different techniques has been investigated. Sixteen (16) extraction cases treated with fixed appliances, twelve (12) treated with activator and twenty (20) cases for control group were examined. The age differed between 10 to 13 No sex difference was made. Tracings were made on 96 before and after treatment cephalometric radiographs and linear dimensions were measured by using Coben Coordinate Analysis. The findings were evaluated by statistical methods. As a result, it was found that there was no difference between two techniques in treatment.