Determination of IL-6, TNF-α and VEGF levels in the serums of patients with colorectal cancer.

Cytokines are multifunctional polypeptides synthesized by different body cells. They have clinical significance in terms of disease diagnosis, treatment and prevention. Cytokines TNF-α and IL-6 play an important role in the growth and differentiation of cells.Vascular Endothelial Growth Factor (VEGF) is excessively produced in epithelial, mesenchymal, and particularly in tumor cells. Studies have shown that the increased serum concentrations of IL-6, TNF-α, VEGF are strongly associated with colorectal cancer  and directly with the clinical stage of the disease. This can be used to diagnose cancer and to identify patients with a bad prognosis who can avail themselves of a more aggressive treatment. The present study investigated the role of cytokines in the development of cancer by comparing preoperative serum cytokine levels of patients suffering from colorectal cancer with those of the healthy control group. The prognostic significance of the data obtained has also been evaluated. For this purpose, IL-6, TNF-α and VEGF levels in 60 serums, 30 preoperatively taken from patients with colorectal cancer and 30 from a healthy control group at Çanakkale Onsekiz Mart University General Surgery Clinic, were determined by ELISA kits. The statistical analyses of the obtained data were evaluated on SPSS, a statistical package program. In this study, no significant difference was obtained between the mean scores concerning the IL-6 and VEGF serums of the colorectal cancer and healthy group (p>.05). But a statistically significant decrease was observed in the TNF-α serum level of the colorectal cancer group in comparison with the control group (p= .016; p < .05).

Effects of acute pancreatitis on plasma total and lipid bound sialic Acid levels: an experimental study in rats.

BACKGROUND: We investigated the relationship between serum levels of total sialic acid, lipid bound sialic acid and acute pancreatitis in a rat model of a common bile duct ligation induced acute pancreatitis. METHODS: Twenty five Sprague-Dawley male rats weighing 250-300 g were divided into two groups (n=10: control, n=15: experimental). In the control group only a sham laparotomy was performed. In the experimental group, acute pancreatitis was induced by common pancreatobiliary tract ligation. After 36 hours the rats were killed and amylase, serum total sialic acid, lipid bound sialic acid and lipid profiles were measured. Histopathological confirmation of acute pancreatitis was done using hematoxylin and eosin staining. RESULTS: Mean amylase, total sialic acid (TSA) and lipid bound sialic acid (LBSA) measurements in the experimental group were significantly higher than in the control group. There was no significant difference in the lipid profiles between the two groups. CONCLUSION: Increased levels of TSA and LBSA can be useful as specific markers in the diagnosis of acute pancreatitis independent of serum lipid profile.

Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients.

AIM: There is no definitive consensus on the best treatment for pilonidal sinus. The Bascom cleft lift technique has been reported to produce successful results. This study presents the results of a modified cleft lift procedure in which the sinus tissue was excised and the lower end of the incision was kept outside the intergluteal sulcus by extending the lower end of the incision laterally. METHOD: Between August 2010 and January 2012, 141 consecutive patients who presented with primary or recurrent pilonidal sinus disease were included in the study, which was conducted at a single tertiary academic medical centre. Prospectively collected data were recorded, including complications, pain score, satisfaction level, primary healing rate, length of hospital stay and early recurrence. RESULTS: The mean operating time was 30 min and the mean length of hospital stay was 1.2 days. The most common surgical-site complication was a collection followed by partial wound dehiscence and superficial infection. The primary healing rate was 88%, the mean time for functional recovery was 13 days and the mean follow-up time was 14 months. No recurrence was observed within this follow-up period. CONCLUSION: The modified Bascom cleft lift technique is effective and reliable. It is applicable to all pilonidal sinus cases and has low complication rates, high satisfaction scores, rapid early recovery and low recurrence rates.

Salvage repair of anastomotic dehiscence following colon surgery using an expanded polytetrafluoroethylene graft.

Anastomotic dehiscence is a serious complication of colorectal surgery that causes death in up to 40% of cases in which it occurs. Edema and inflammation due to abdominal sepsis can prevent the use of standard management (i.e., colostomy, ileostomy or Hartmann's procedure), in which case alternative salvage repair methods are required. The present report describes the treatment of a 73-year-old female patient at high risk of mortality because of intraabdominal sepsis due to suture dehiscence following a right hemicolectomy and ileo-transversostomy. Several surgical repair procedures were tried, but all failed. We then used an expanded polytetrafluoroethylene (ePTFE) graft in salvage repair, and this approach proved successful. This is the first report to describe clinical, macroscopic and histopathological findings, following use of an ePTFE graft in colorectal repair in humans.