Incidence of cereblon protein in intensive care patients: a cross-sectional study.

OBJECTIVE: Sepsis remains a common cause of death. The cereblon (CRBN) protein, which is involved in important cellular processes, plays a role in sepsis. This cross-sectional study aimed to show the CRBN protein expression and its effects on patients in the intensive care unit. PATIENTS AND METHODS: Samples were taken by deep tracheal aspiration from patients. The presence of CRBN was pathologically investigated using immunohistochemical tests and polyclonal antibodies against CRBN. The relationship between gender, sepsis, steroid, survival and the presence of CRBN was examined. RESULTS: Respiratory and neurologic diseases were the most common reasons for admission. Acinetobacter was the most frequent microorganism. In patients with more than normal inflammatory cells, a negative correlation was observed between CRBN expression and leukocyte rate (p=0.031). In patients with CRBN, there was no correlation between steroid and mortality, APACHE/Glasgow score, hospital stay length, and ICU. CONCLUSIONS: Although the prognosis for sepsis is better in CRBN-deficiency animals, the presence of CRBN in humans does not affect it. In our study, CRBN decreased as inflammatory cells increased in the patient's aspiration material. The response to steroids, an immunomodulator, did not change with the presence of the immunomodulator target molecule, CRBN. Therefore, using immunomodulators in the treatment of sepsis should be reconsidered.

Usage of neck circumference as novel indicator of erectile dysfunction: a pilot study in Turkish population.

Erectile dysfunction (ED) is the most common male sexual problem worldwide. The association between ED and components of metabolic syndrome (MtS) is well established. This study examined neck circumference (NC) as a possible indicator of MtS and also of ED. Ninety-two patients were included and divided into two groups. Group 1 consisted of 47 patients with ED and Group 2 consisted of 45 healthy volunteers. Questionnaires, differences in anthropometric and laboratory measurements between patients with ED and the control group, and a cut-off value for NC were investigated. The mean NC in ED patients was higher in Group 1 than in Group 2 (P = 0.001), and Group 1 also demonstrated more MtS criteria than Group 2 (P < 0.001). The cut-off point of NC was defined as 34.75 cm for ED and MtS. The cut-off values of waist circumference for ED and MtS were 105.5 and 102.5 cm respectively. In the light of these findings, NC may be a new component of MtS in ED patients. Additionally, NC may be a novel indicator of central obesity and ED. We suggest that NC values of 35 cm and over may predict ED in patients with MtS.

Indications for intraoperative frozen section in robot assisted radical prostatectomy: a pilot study.

INTRODUCTION: To evaluate indications for intraoperative frozen section (IFS) during robot assisted laparoscopic radical prostatectomy (RALRP) in our series. PATIENTS AND METHODS: Prospectively documented 80 patients with prostate cancer (PCa) who underwent RALRP were evaluated between June 2010 and July 2012. Patients were divided into 2 groups according to whether systematically IFS was performed or not. Group 1 (n=66) consisted of patients on whom systematic IFS was performed, Group 2 (n=14) consisted of patients on whom IFS was not performed. All recorded data evaluated and statistical analyses were performed for determining indications and predictive factors for IFS during RALRP. All patients were operated by single surgeon and IFS, pathological assessments were performed by experienced uro-pathologist. Statistical significant p value was p < 0.05. RESULTS: Mean follow-up was 15±6 (25-4) months. Pre-operative prostate volume in trans- rectal ultrasonography (TRUS) was statistically higher in Group 1 than Group 2 (p = 0.037). The other parameters were statistically similar in both groups. According to outcomes of our study IFS was a dependent factor for positive surgical margin. Additionally, the cut off value of prostate volume in TRUS for IFS was 55.5 cc for IFS. CONCLUSIONS: Preoperative measured prostate volume in TRUS may be an indicator of IFS. Therefore, more accurate information may be given to patients with prostate cancer (Pca) before RALRP by using preoperative prostate volume in TRUS.

[Heart wounds]. / Kalp yaralanmalari.

In our study, we aimed to present our cases with heart wounds and to determine the factors influencing mortality. We retrospectively evaluated 23 cases with cardiac injuries who were treated among years 1986-99 in our clinic. There were 4 female and 19 male cases, and the average age was 32 years (range 12-52). Heart wounds were caused by blunt trauma in 6 cases, and penetrating trauma in 17 cases. Penetrating heart wounds was caused by gunshot wounds in four patients and stab wounds in 13 patients. Our cases were underwent to rapid resuscitation and emergency surgery. Mortality rate was 17% with 3 cases. Blunt cardiac wounds was caused by motor vehicle accidents in all cases. Diagnosis with immediate echocardiography and efficient treatment was performed. Mortality rate was 33% with 2 cases. We think that emergent resuscitation and immediately surgical exploration in patients with penetrating heart wounds and immediate diagnosis by echocardiography and prompt treatment in patients with blunt heart injuries may improve overall survival.

Coronary artery bypass grafting nine months after pneumonectomy.

We performed coronary artery bypass grafting on a 58-year-old man who only 9 months earlier had undergone right pneumonectomy for bronchial carcinoma. Although his preoperative pulmonary function had been poor, coronary artery bypass surgery was successful, and the patient was discharged on the 9th postoperative day Two years after surgery, he remained in New York Heart Association functional class I. We attribute this success to special management before, during, and after the operation. On the 32nd postoperative month, this patient died of multiple tumor metastases.

[Ventricular septal aneurysm in a patient with Marfan syndrome]. / Ventrikelseptumaneurysma bei einer Patientin mit Marfan-Syndrom.

This is the first description of a patient with Marfan syndrome and an aneurysm of the ventricular septum. Apart from a borderline dilatation of the ascending aorta, there were no cardiovascular manifestations of Marfan syndrome. A transesophageal echocardiographic examination showed a large aneurysm of the ventricular septum. To prevent the imminent rupture and the acute occurrence of a significant left-to-right-shunt on the ventricular level, as well as increasing irritation of tricuspid valve, an elective operation was performed. Besides the routine cardiological diagnostics, the search for intracardial defects is also necessary in patients with Marfan syndrome.