Are trauma victims with obesity lucky in penetrating trauma injuries?

BACKGROUND: We aimed to reveal the protective effect of body mass index (BMI) and subcutaneous adipose tissue thickness (SATT), together with scores covering the abdomen, in patients with penetrating abdominal trauma. METHODS: The data of 234 abdominal penetrating trauma patients over the age of 16 who applied to the emergency general sur-gery unit of Istanbul Medipol Hospital between 2017 and 2021 were analyzed retrospectively. Sex, age, types of penetrating injuries, BMI, need for blood transfusion and intensive care unit (ICU), mortality, Injury Severity Score (ISS), Penetrating Abdominal Trauma Index (PATI), and Flint Colon Injury Score (FCIS) were recorded. RESULTS: The patients were divided into two groups: Gunshot Wound (GW) and Stab Wound (SW).While there was no significant difference in all parameters examined in all patients and GW patients in terms of BMI, a statistically significant difference was found in terms of blood transfusion need in SW patients (p=0.035). As a result of the Receiver Operating Characteristic curve analysis for the SATT variable, the cutoff value between mortality (p=0.866) and SATT (mm) values in all patients was 11 mm for all patients and 12 mm for GW patients. A significant difference was found in all patients and separately in GW and SW groups in terms of ICU and blood transfusion need, length of stay, ISS, PATI, and FCIS scores in non-operated patients (p<0.05). When all patients were examined, a statistically significant difference was found in terms of mortality (p=0.002). CONCLUSION: It is the first study to evaluate penetrating abdominal injuries with both BMI and SATT comprehensively and with all abdominal scores. A cutoff value to be determined for SATT with larger and multicenter studies can take its place as a parameter in the penetrating trauma algorithm.

Effect of glutamine use on the formation of intestinal neomucosa on peritoneal surface in rats.

BACKGROUND: Short bowel syndrome (SBS) is a clinical condition with high mortality and morbidity, which leads to the lack of absorption of fluids or nutrients necessary for the body due to the decrease in the length of the small bowel (SB). Glutamine is an amino acid essential for the nutrition and proliferation of intestinal mucosa cells. The main aim of the present study was to investigate the effect of glutamine on intestinal neomucosa formation in rats which developed SBS. METHODS: Sixteen Wistar Hannover rats were randomly divided into two groups of eight rats. Saline was applied to the rats in Group 1 (control) following the enteroperitoneal anastomosis between mucosal surface of the ileum and the parietal peritoneum surface (adherent to abdominal wall) while glutamine was applied to the rats in Group 2 following the same anastomosis. Fourteen days later, the rats were euthanatized and blood samples were taken. Simultaneously, en bloc resection of the anastomosis part was performed and histopathological examination was carried out to observe neomucosa formation. The effects of glutamine on anastomosis were determined by microscopic and biochemical evaluations. RESULTS: Biochemical analyses were performed by measuring serum oxidant (malondialdehyde [MDA] and 8-hydroxy-2'-deoxyguanosine [8-OHdG]) and antioxidant (superoxide dismutase [SOD] and glutathione peroxidase [GPx]) parameters. Based on the biochemical evaluation results of the antioxidant values of the control and glutamine groups, it was found that while the serum antioxidant level (SOD and GPx activity) was significantly higher (p<0.05) in the glutamine-administered rats compared to the control group, the oxidative damage (MDA and 8-OHdG) was lower (p<0.05). In terms of the histological evaluations made for the neomucosa formation, the number of neomucosa formation was higher in the glutamine group, but the difference was not significant (p=0.315). CONCLUSION: The use of glutamine in patients with SBS may increase surface absorption by increasing neomucosa formation. However, additional studies of large statistical power are needed.

Curcumin Enhanced the Neomucosa Formation by Mediating the Antioxidation Mechanism in Rats.

Objectives: The purpose of the study was to examine the possible effects of curcumin on the formation of neomucosa in parietal peritoneum which was applied as a patch for terminal ileal defect in rats. Methods: Sixteen male Wistar Hannover rats were split into two groups. The control group was injected with saline and curcumin (2 mL/kg/day, by gavage) was given to the experimental group. In both groups, amounts of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA), the activities of glutathione peroxidase and superoxide dismutase were determined in serum. The development of neomucosa formation was examined morphologically. Results: Serum antioxidant levels and glutathione peroxidase activity in rats given curcumin were significantly higher than those of the control group (p<0.05). The levels of oxidative markers (MDA and 8-OHdG) in rats given curcumin were significantly lower than those of the control group (p<0.05). In the histopathological examination, 62.5% of rats in the curcumin group showed formation of neomucosa while 37.5% of control rats showed neomucosa. Conclusion: The use of curcumin in rats with terminal ileal defect enhanced the formation of neomucosa by decreasing the oxidation level and increasing the antioxidation level. Curcumin may be used in the patients with short bowel syndrome to increase the absorption surface area.

Cordycepin prevents the esophageal stricture formation in the alkali-burn rat model by exerting anti-inflammatory and antifibrotic effects.

PURPOSE: To investigate the efficacy of cordycepin, an adenosine analogue, on prevention of esophageal damage and stricture formation due to esophageal caustic burns in rat model comparing with prednisolone. METHODS: Caustic esophageal burn was introduced by 37.5% of NaOH to distal esophagus. Thirty-two Wistar albino rats were divided in four groups: sham rats undergone laparotomy, treated with 0.9% NaCl; control rats injured with NaOH without cordycepin treatment; cordycepin group injured with NaOH, treated with 20 mg/kg cordycepin; prednisolone group injured with NaOH, treated with 1 mg/kg prednisolone for 28 days. Efficacy was assessed by histopathological and immunohistochemical analysis of esophageal tissues. RESULTS: Cordycepin treatment significantly decreased inflammation, granulation tissue and fibrous tissue formation and prevented formation of esophageal strictures shown by histopathological damage score and stenosis indexes compared to control group (p < 0.01). These effects are relatively more substantial than prednisolone, probably based on attenuation of elevation of proinflammatory cytokines hypoxia-inducible factor 1-alpha (HIF-1?), tumor necrosis factor alpha (TNF-?), proliferative and fibrotic factor fibroblast growth factor 2 (FGF2) and angiogenic factor vascular endothelial growth factor A (VEGFA) (p < 0.05). CONCLUSIONS: The findings suggest that cordycepin has a complex multifactorial healing process in alkali-burned tissue, more successful than prednisolone in preventing the formation of esophageal strictures and may be used as a therapeutic agent in the acute phase of esophageal alkali-burn.

COVID-19 and acute biliary pancreatitis: comparative analysis between the normal period and COVID-19 pandemic.

BACKGROUND: The development of acute pancreatitis is multifactorial requiring predisposition and relevant injury.Viral acute pancreatitis has been described in other viral infections.However, pancreatic involvement in SARS-CoV-2 infection is still poorly defined.The present comparative study reports the patients with acute pancreatitis during the COVID-19 pandemic and last year covering the same period to appraise the link between COVID-19 and acute biliary pancreatitis. METHODS: The retrospective observational study was conducted in acute biliary pancreatitis patients from 13.03.19to13.09.19 and from 13.03.20to13.09.20 respectively. RESULTS: The study included 181patients(105patients in 2019;76 patients in 2020(during COVID-19 pandemic)).The patients were named as Group A(Normal period)and GroupB(Pandemic period),respectively.The groups were found to be comparable as there was no significant difference between the mean age, sex, comorbidities, cholecystectomized, and recurrency. There is no significant difference in the laboratory and radiological findings of GroupA and GroupB. However, there is a significant difference between the COVID-19 positive and negative patients in GroupB in terms of Glucose levels(p=0,025)and the presence of edema or necrosis in radiological images(p=0,046).There is a significant difference between the patients' number with abdominal pain of acute biliary pancreatitis in 2019and2020.(p=0)The length of stay was statistically significant in COVID-19 positive patients.(p= 0,013) CONCLUSIONS: Clinicians involved in the management of acute pancreatitis should be aware of its existence in the context of COVID-19.Understanding of the disease process and clinical manifestations of COVID-19 is still developing.Awareness of these issues and addressing them adequately will be crucial for the management. KEY WORDS: Acute Biliary Pancreatitis, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Reverse Trendelenburg position applied prior to pneumoperitoneum prevents excessive increase in optic nerve sheath diameter in laparoscopic cholecystectomy: randomized controlled trial.

The aim of this randomized controlled trial was to determine whether applying the reverse Trendelenburg position before pneumoperitoneum has a preventive effect on increased intracranial pressure using optic nerve sheath diameter (ONSD) measurement as a noninvasive parameter. Seventy-nine patients were allocated to two groups according to whether pneumoperitoneum was applied in the supine position (group S, n = 40) or in the reverse Trendelenburg position (group RT, n = 39). The ONSD was measured at the following time points: T0: before anesthesia; T1: after endotracheal intubation; T2: after pneumoperitoneum in group S and after positioning in group RT; T3: after positioning in group S and after pneumoperitoneum in group RT; T4: 30 min after endotracheal intubation, and T5: after desufflation. The end-tidal carbon dioxide (EtCO2), regional cerebral oxygen saturation (rSO2), peripheral oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR), peak inspiratory pressure (Ppeak), and dynamic compliance (Cdyn) were recorded. Background and perioperative characteristics were similar in both groups. In group S, the ONSD was higher at T2, T3, T4, and T5 than that in group RT (p < 0.001, p = 0.002, p = 0.001, and p = 0.012, respectively). In the same group, the number of patients with an ONSD above 5.8 mm was higher at T2, T3, and T4 (p < 0.001, p = 0.042, p = 0.036, respectively). The rSO2 and SpO2 were not different between the groups. The mean arterial pressure was lower in group RT at T2, and the HR was not different between the groups (p < 0.001). In group S, Ppeak was higher and Cdyn was lower at T2 (p < 0.001). The number of patients with nausea was higher in group S (p = 0.027). The present study demonstrates that applying the reverse Trendelenburg position before pneumoperitoneum prevented an increase in the ONSD in patients undergoing laparoscopic cholecystectomy.Trial registration The trial was registered prior to patient enrollment at https://register.clinicaltrials.gov (NCT04224532, Date of the registration: January 8, 2020).

Cordycepin prevents the esophageal stricture formation in the alkali-burn rat model by exerting anti-inflammatory and antifibrotic effects

ABSTRACT Purpose To investigate the efficacy of cordycepin, an adenosine analogue, on prevention of esophageal damage and stricture formation due to esophageal caustic burns in rat model comparing with prednisolone. Methods Caustic esophageal burn was introduced by 37.5% of NaOH to distal esophagus. Thirty-two Wistar albino rats were divided in four groups: sham rats undergone laparotomy, treated with 0.9% NaCl; control rats injured with NaOH without cordycepin treatment; cordycepin group injured with NaOH, treated with 20 mg/kg cordycepin; prednisolone group injured with NaOH, treated with 1 mg/kg prednisolone for 28 days. Efficacy was assessed by histopathological and immunohistochemical analysis of esophageal tissues. Results Cordycepin treatment significantly decreased inflammation, granulation tissue and fibrous tissue formation and prevented formation of esophageal strictures shown by histopathological damage score and stenosis indexes compared to control group (p < 0.01). These effects are relatively more substantial than prednisolone, probably based on attenuation of elevation of proinflammatory cytokines hypoxia-inducible factor 1-alpha (HIF-1?), tumor necrosis factor alpha (TNF-?), proliferative and fibrotic factor fibroblast growth factor 2 (FGF2) and angiogenic factor vascular endothelial growth factor A (VEGFA) (p < 0.05). Conclusions The findings suggest that cordycepin has a complex multifactorial healing process in alkali-burned tissue, more successful than prednisolone in preventing the formation of esophageal strictures and may be used as a therapeutic agent in the acute phase of esophageal alkali-burn.

The efficacy of curcumin on PDGF expression and NF-kappa B pathway: TNBS-induced colitis.

BACKGROUND: Curcumin is an antioxidant and anti-inflammatory molecule known to be a potent inhibitor of nuclear factor kappa B (NF-kappa B). In this study, we aimed to investigate the therapeutic effects of curcumin on colitis induced by a 2,4,6-trinitrobenzene sulfonic acid (TNBS). METHODS: After the induction of colitis under anesthesia, 42 rats were divided into six groups as follows; the curcumin oral group, curcumin (20 mg/kg); the corn oil oral group, corn oil (20 mg/kg) using gastric gavage, the curcumin rectal group, curcumin; the corn oil rectal group, corn oil; the control group, 1 mL saline solution (0.9% NaCl) were administered using the rectal route. In the sham group, only rectal catheterization was performed. At the end of the seven day, the blood and intestinal tissue samples were obtained for histopathological examination and for MPO, MDA, NO, PDGF, IL-6, TNF-alpha, NF-kappaB. RESULTS: The macroscopic damage score was significantly higher in curcumin oral, corn oil oral and saline groups when compared to the sham group (p<0.05). The significant differences between groups were evaluated using the biochemical analysis of intestinal tissue for IL-6, NO, NF-κB, PDGF, TNF-α, MDA, MPO (p<0.05). NF-κB levels of blood in curcumin oral, curcumin rectal, sham, corn oil oral, corn oil rectal groups were significantly increased when compared to saline rectal group (p≤0.001). NF-κB serum levels of corn oil rectal and control group (p≤0.001) were lower than the sham group (p=0.012). CONCLUSION: The effects of curcumin improved possibly by modulating the NF-κB signaling pathway should be considered against colitis alone or in combination with the conventional anti-colitic therapies in future studies.

A comparison of the quantitative evaluation of in situ parathyroid gland perfusion by indocyanine green fluorescence angiography and by visual examination in thyroid surgery

ABSTRACT Objective The most vital complications of thyroidectomy are recurrent nerve damage and hypocalcaemia. We aimed to compare the tissue perfusion scores (PS) of IG fluorescence angiography (IGFA) and visual examination by the surgeon after total thyroidectomy. Subjects and methods Forty-three patients were accepted into the study. Localisation of the parathyroid gland (PG) was determined by the naked eye and scored in terms of tissue perfusion. The averages of fluorescent light intensities for each IGFA were calculated, the perfusions were scored and compared with the PS given by the surgeon. Biochemical parameters were noted. Results 37.2% of patients had autotransplanted PGs, according to their visual scores. The means of IGFA-PS for PGs scored as 0, 1 or 2 on visual inspection were 48.58 ± 4.49 [30-70], 89.65 ± 8.93 [36-144] and 158.76 ± 8.93 [70-253], respectively, which correlated with the visual PSs in a statistically significant manner (P < 0.0001). The predictive cut-off value for IGFA-PS was determined to be 70, given a visual PS of 0 (95% CI [0.72-0.85]), and this was interpreted to be a candidate cut-off point for the autotransplantation of PGs. Conclusion IGFA scoring may be considered as an operative predictor, providing objective criteria to evaluate the tissue and blood perfusion of PGs after thyroidectomy. IGFA scoring may be considered to have value in minimising postoperative permanent hypoparathyroidism in patients.

A comparison of the quantitative evaluation of in situ parathyroid gland perfusion by indocyanine green fluorescence angiography and by visual examination in thyroid surgery.

Objective The most vital complications of thyroidectomy are recurrent nerve damage and hypocalcaemia. We aimed to compare the tissue perfusion scores (PS) of IG fluorescence angiography (IGFA) and visual examination by the surgeon after total thyroidectomy. Subjects and methods Forty-three patients were accepted into the study. Localisation of the parathyroid gland (PG) was determined by the naked eye and scored in terms of tissue perfusion. The averages of fluorescent light intensities for each IGFA were calculated, the perfusions were scored and compared with the PS given by the surgeon. Biochemical parameters were noted. Results 37.2% of patients had autotransplanted PGs, according to their visual scores. The means of IGFA-PS for PGs scored as 0, 1 or 2 on visual inspection were 48.58 ± 4.49 [30-70], 89.65 ± 8.93 [36-144] and 158.76 ± 8.93 [70-253], respectively, which correlated with the visual PSs in a statistically significant manner (P < 0.0001). The predictive cut-off value for IGFA-PS was determined to be 70, given a visual PS of 0 (95% CI [0.72-0.85]), and this was interpreted to be a candidate cut-off point for the autotransplantation of PGs. Conclusion IGFA scoring may be considered as an operative predictor, providing objective criteria to evaluate the tissue and blood perfusion of PGs after thyroidectomy. IGFA scoring may be considered to have value in minimising postoperative permanent hypoparathyroidism in patients.

Diverting Ileostomy Duration Is the Main Determinant of Ileostomy-Related Complications after Surgical Treatment of Rectum Cancer.

BACKGROUND: This study aimed to investigate factors associated with the development of ileostomy complications in rectal cancer patients, including those who received neoadjuvant treatment. METHODS: This retrospective trial included 133 consecutive patients who underwent surgery for rectal cancer with temporary diverting ileostomy. Patients' demographic characteristics as well as the pre- and postclosure outcomes and complications were analyzed. RESULTS: In logistic regression analysis, longer duration of ileostomy emerged as a significant independent predictor of any complication during ileostomy. The respective odds ratios for 3-6 months and >6 months vs. <3 months of ileostomy duration were as follows: OR, 4.5 (95% CI, 1.2-16.7), p=0.023; and OR, 15.2 (95% CI, 3.1-75.2), p=0.001. An additional stepwise model also identified hypertension as a significant predictor. In stepwise logistic regression model, adjuvant chemoradiotherapy emerged as significant independent predictor of "any ileostomy-related complication after ileostomy closure": OR, 4.5 (2.0-10.2), p < 0.001. CONCLUSION: Duration of ileostomy appears to be the main determinant of ileostomy-related complications. Patients who had received neoadjuvant or adjuvant therapy had longer ileostomy duration, which may be attributed to the concerns of the surgeon or to the complications themselves.

Our experience with dermal substitute Nevelia® in the treatment of severely burned patients.

BACKGROUND: This research aims to retrospectively evaluate the effectiveness and safety of dermal substitute (DS), Nevelia®, for the treatment of severely burned patients. METHODS: Twenty severely burned patients were enrolled in this study between May 2017 and May 2018. After escharotomy of the wound, the treatment protocol was applied following a two-step procedure -DS implantation followed by split-thickness skin graft (STSG) application. Need for surgery, complications, hospitalisation duration and overall survival were analysed. RESULTS: Mean age was 40.1±4 (18-86) years old; female/male: 5/15. Mean burn surface area was 50.1%±2 (25-96). Two patients died under hospital treatment due to the severity of their burn trauma and comorbidities. For the rest of the cases, STSG was performed after Nevelia® at mean 21.2 days. No complications due to Nevelia® were detected. The patients were discharged with a mean total recovery of 55.2±4 days. CONCLUSION: This study showed that Nevelia® can be used safely and effectively in severely burned patients with low complication rates and short hospital stay.

Psychological well-being and marital satisfaction in response to weight loss after bariatric surgery.

PURPOSE: To compare the marital satisfaction (MS) and psychological well-being (PWB) of men and women before and after bariatric surgery for obesity. METHODS: The subjects of this prospective observational study were obese patients who underwent bariatric surgery. MS and PWB were assessed before, and 6 months after the surgery, using specific scales for MS and PWB. RESULTS: The correlation matrix showed that age was not correlated with any of the scores from the PWB scales, and only with the total MS scores of men (P < 0.05). The pre-surgical BMI-post-surgical BMI (ΔBMI) was correlated negatively and significantly with the post-surgical total MS, especially for women, but it was not correlated with the sexual satisfaction of either gender. The score of positive interpersonal relationships was negatively correlated with the ΔBMI, especially for women (P < 0.05), whereas personal improvement was positively correlated for men (P < 0.05). There was also a significant correlation between ΔBMI and purpose in life for both genders. Post-surgical ΔBMIs were not associated with the other two indicators of PWB, namely, autonomy and environmental mastery for both genders. CONCLUSIONS: For women, weight loss after bariatric surgery seemed to improve PWB and MS when assessed 6 months post-operatively; however, the psychiatric assessment of patients before and after the surgery is crucial.

Evaluation of prophylactic and therapeutic effects of sildenafil on acute radiation proctitis in rats.

PURPOSE: To investigate the prophylactic and therapeutical effects of sildenafil in a model of acute radiation proctitis (ARP). METHODS: All experimental procedures of this study was examined by histopathological, immunohistochemical and transmission electron microscopic analysis. RESULTS: Our histopathological evaluations indicated significant increases in lesion severity, cryptic apsis, cryptitis, cryptic distortion, reactive atypia and infiltration depth of the control (proctitis) group. While the prophylaxis group and the treatment group had significantly lower scores. High-dose group showed similar results as prophylaxis group. Histopathological findings of the prophylaxis group was more significant than the treatment group. Immunoreactivities of IL-1ß, FGF-2, TNF- α and HIF-1α increased in the control group especially in the epithelial and cryptic regions. On the contrary, sildenafil application caused significant decreases of inflammatory markers in all treatment groups, specifically better results in the prophylaxis group. CONCLUSION: The sildenafil has anti-inflammatory effects on ARP, as well as protective effects against ARP and the protective effect of sildenafil surpasses its therapeutic effect histopathologically.

Evaluation of prophylactic and therapeutic effects of ruscogenin on acute radiation proctitis: an experimental rat model.

PURPOSE: Radiation proctitis (RP) is inflammation and damage to the rectum, manifested secondary to ionizing radiation utilized for treatment. In this study, we evaluated the anti-inflammatory therapeutical and protective effects of ruscogenin in a model of acute RP. METHODS: Thirty-two Sprague-Dawley rats were divided into 4 groups (n = 8) as sham, control, treatment, and prophylaxis groups. Prophylaxis group and treatment group were dosed ruscogenin by oral gavage for 14 days pre- and postradiation. At the end of the 28th day, all subjects were sacrificed. RESULTS: Histopathological analysis showed a significant increase in cryptitis abscess, cryptitis and reactive atypia, and depth of lymphocytic infiltration of the control group, compared to the other groups (P < 0.05), while treatment and prophylaxis groups showed significant decreases (P < 0.05). Immunohistochemical analysis indicated that immunoreactivity were significantly higher in control group (P < 0.05, P < 0.001, and P < 0.01, respectively), but vice versa for treatment and prophylaxis groups. There was not any significant difference for fibroblast growth factor 2 immunoreactivity. The epithelium of control rectums indicated an increase in TNF-α immunoreactivity while other groups had significant decrease (P < 0.01). Electron microscopical findings were parallel to light microscopy. CONCLUSION: In this study, ruscogenin was observed to be effective on prophylaxis or treatment of acute RP. Although there are various reports on the treatment of the rectum damaged by acute RP in the literature, this could be the first study since there is no research indicating the ultrastructural effect of ruscogenin.

Evaluation of prophylactic and therapeutic effects of sildenafil on acute radiation proctitis in rats

Abstract Purpose: To investigate the prophylactic and therapeutical effects of sildenafil in a model of acute radiation proctitis (ARP). Methods: All experimental procedures of this study was examined by histopathological, immunohistochemical and transmission electron microscopic analysis. Results: Our histopathological evaluations indicated significant increases in lesion severity, cryptic apsis, cryptitis, cryptic distortion, reactive atypia and infiltration depth of the control (proctitis) group. While the prophylaxis group and the treatment group had significantly lower scores. High-dose group showed similar results as prophylaxis group. Histopathological findings of the prophylaxis group was more significant than the treatment group. Immunoreactivities of IL-1β, FGF-2, TNF- α and HIF-1α increased in the control group especially in the epithelial and cryptic regions. On the contrary, sildenafil application caused significant decreases of inflammatory markers in all treatment groups, specifically better results in the prophylaxis group. Conclusion: The sildenafil has anti-inflammatory effects on ARP, as well as protective effects against ARP and the protective effect of sildenafil surpasses its therapeutic effect histopathologically.

Role of diclofenac sodium and paracetamol on colonic anastomosis: An experimental rodent model.

BACKGROUND: Despite many advances in surgery and technology, colonic anastomosis remains a challenge after colonic resection. The purpose of this study is to compare the safety of using diclofenac sodium and paracetamol for analgesia in colonic anastomosis on rats. METHODS: Wistar-Hannover rats were randomly allocated to four groups: Group 1, sham-operated group; Group 2, control group; Group 3, diclofenac sodium group; Group 4, paracetamol group. After laparotomy, the left colon was transected and a single-layer anastomosis was made with 5/0 vicryl in Groups 2, 3, and 4. Only laparotomy was performed in Group 1. After anastomosis, we administered saline to Group 2, diclofenac sodium to Group 3, and paracetamol to Group 4 for 7 days. Then, all animals were decapitated. The anastomotic region was resected, and bursting pressure was measured. Then, the specimen was sent to the laboratory for histological examination and hydroxyproline analysis. RESULTS: Bursting pressure and hydroxyproline level were significantly higher in the paracetamol group (p<0.05). When we looked at the fibrosis levels of these groups, it was also higher in paracetamol group. CONCLUSION: Bursting pressure, hydroxyproline levels, and fibrosis levels indicate that the perioperative use of paracetamol for analgesia when undergoing colonic anastomosis is safer than diclofenac sodium.

Isolated thyroid metastasis from renal cell carcinoma.

Metastatic neoplasms of the thyroid are uncommon when compared to primary tumors of the gland. Renal cell carcinoma (RCC) is a highly aggressive tumor of the urinary system. It can spread all over the body. Isolated solitary metastases of RCC to the thyroid are very rarely observed. A 64-year-old woman with a history of left radical nephrectomy for RCC, was referred to our clinic with palpable thyroid nodule. Ultrasound confirmed the nodule on the left lobe. Histopathological examination of the thyroidectomy specimen revealed that there were two solitary metastasis of RCC. No other distant metastasis were detected. Metastatic tumors of the thyroid gland are very rare. When patients with thyroid nodule are referred to our clinic with the history of other malignancies, we must consider metastasis. Thyroidectomy is recommended in the case of isolated thyroid metastasis of RCC.

Comparison of the Effects of Glutamine, Curcumin, and Nesfatin-1 on the Gastric Serosal Surface Neomucosa Formation: An Experimental Rodent Model.

Introduction. Short bowel syndrome can crop up if more than 50% of small intestine is resected or when less than 100 cm of small bowel is left. Glutamine is the main food source of enterocytes. Curcumin has protective effects on intestinal ischemia-reperfusion damage. Nesfatin-1 is a satiety molecule. It has protective effects on gastric mucosa. The primary purpose of this study is to compare effects of glutamine, curcumin, and nesfatin-1 on the gastric serosal surface neomucosa formation on rats. Materials and Methods. 24 Wistar-Hannover rats were randomly divided into 4 groups and treated with saline, glutamine, curcumin, and nesfatin-1 after ileogastric anastomosis. After 14 days all rats were euthanized, and blood was collected. En bloc resection of anastomotic part was performed for histopathological examination. Results. PDGF, TGF-ß, and VEGF levels and neomucosa formation were higher in glutamine group (p = 0.003, p = 0.003, and p = 0.025). Glutamine promotes the intestinal neomucosa formation on the gastric serosal surface and augments growth factors essential for neomucosa formation on rats. Conclusion. Glutamine may be used in short bowel syndrome for increasing the absorption surface area. But that needs to be determined by adequately powered clinical trials.

Primary squamous cell carcinoma of the stomach.

Primary squamous cell carcinoma of the stomach accounts for less than 1% of all gastric malignancies. Less than 100 cases were reported in the literature. Therefore, knowledge about management and prognosis of the disease is limited. Surgical approach is the basic form of treatment. In this study we confirmed a case of primary gastric squamous cell carcinoma with the aim of contribution to the literature, which is seen rare, and the diagnosis was confirmed pathologically.