Investigation of typhlitis in bone marrow transplant patients in a stem cell transplant unit.

Typhlitis is a special type of enterocolitis that specifically develops in immunosuppressive patients with hematological malignancies. Typhlitis is a common consideration after bone marrow transplantation due to high-dose chemotherapy that is used in conditioning regimens those contain high-dose cytotoxic chemotherapeutic agents. Although there are several studies about typhlitis during chemotherapy or in leukemia patients, there is not enough data evaluating its relationship between stem cell transplant in adults. Therefore, the current study aimed to analyze the possible causes that may lead to the development of typhlitis in hematopoietic stem cell recipient patients. This retrospective study included 210 adult patients who underwent bone marrow transplantation between January 2017 and December 2019. Pediatric patients (patients younger than 18 years of age) were excluded. Patients' data were evaluated to determine their effects on typhlitis and the mortality risk of the patients with typhlitis. The analysis of the variables was performed using the IBM SPSS Statistics for Windows version 26 (IBM Corp., Armonk, NY).Variables were analyzed at a 95% confidence level and a P value <0.05 was considered significant. Typhlitis developed in 23 (10.9%) transplant patients. Male sex, length of hospital stay, presence of febrile neutropenia, antibiotic and antifungal use, need for switching antibiotics, duration of neutropenia, diarrhea and antibiotic use in days were risk factors for development of typhlitis. It was observed that 100-days mortality was higher in typhlitis group reaching to a statistical significance (P < .05). In multiple logistic regression analysis, presence of mucositis and additional source of infection were determined as independent risk factors for the development of typhlitis in bone marrow transplant patients. This study provides valuable information for bone marrow transplant patients through an analysis of risk factors for the development of typhlitis. According to our results, mucositis and additional bacterial infections were found as risk factors for typhlitis therefore it would be beneficial for clinicians to consider these factors in patient follow-up. However, due to the retrospective nature of our study, prospective studies are needed to investigate risk factors and optimum treatment methods for typhlitis.

Quality Assessment of a Novel Camera-Based Measurement System for Roughness Determination of Concrete Surfaces-Accuracy Evaluation and Validation.

The roughness of a surface is a decisive parameter of a material. In rehabilitation of concrete structures, for example, it significantly affects the adhesion between the coating material and the base concrete. However, the standard measurement procedure in construction suffers from considerable disadvantages, which leads to the demand for more sophisticated methods. In a research project, we, therefore, developed a novel camera-based measurement system, which is customized to meet the prevailing requirements for practical use on construction sites. In this article, we provide an overview of the measurement system and present comprehensive examinations to evaluate the accuracy and to provide evidence of validity. First, we examined the accuracy of the system by empirically assessing both trueness and precision of measurements using three concrete specimens. Trueness was determined by comparing the surface measurements to those of a highly accurate microscope system, revealing RMSE values of around 40-50 µm. Precision, on the other hand, was assessed considering the scattering of the roughness measurements under repeat conditions, which led to standard deviations of less than 6 µm. Furthermore, to proof validity, a comparative study was conducted based on sixteen concrete specimens, which includes the sand patch method and laser triangulation as established roughness measurement methods in practice. The empirically determined correlation coefficients between all three methods were greater than 0.99, indicating extraordinarily high linear relationships. Among them, the greatest correlation was between the camera-based system and laser triangulation.

Laparoscopic Transgastric Resection of a Gastrointestinal Stromal Tumor and Concomitant Sleeve Gastrectomy: a Case Report.

BACKGROUND: Incidences of obesity, obesity surgeries, and gastric submucosal tumors (GST) have increased worldwide. This case report aims to demonstrate that concomitant laparoscopic transgastric resection (LTGR) of a gastrointestinal stromal tumor (GIST) near the esophagogastric junction (EGJ) can be performed safely and effectively in a patient with morbid obesity and scheduled sleeve gastrectomy (SG). METHODS: The patient was planned to undergo SG surgery after the diagnosis of morbid obesity (BMI, 40.4 kg/m2). The routine preoperative endoscopic examination revealed a 4-cm diameter GIST-compatible lesion in the stomach near the EGJ. The LTGR with concomitant SG was scheduled for the patient. RESULTS: The ports were placed for laparoscopic SG. Greater curvature and gastric fundus were fully mobilized. Along the greater curvature gastrotomy was performed, and thus the tumor was localized. The tumor was resected with a linear stapler by considering surgical margins. The frozen section examination showed no malignancy. The gastrotomy was closed, and the SG was performed via the orogastric tube (39F). In the postoperative passage X-ray, there was no stenosis or leaking, and the patient was externed on the third postoperative day. In the immunohistochemical examination, it was reported that the tumor was a GIST, and the surgical margins were negative. CONCLUSION: The LTGR may help to protect the stomach or minimize the degree of partial resection in the treatment of especially GSTs near the EGJ.

A Novel Camera-Based Measurement System for Roughness Determination of Concrete Surfaces.

Determining the roughness of technical surfaces is an important task in many engineering disciplines. In civil engineering, for instance, the repair and reinforcement of building component parts (such as concrete structures) requires a certain surface roughness in order to ensure the bond between a coating material and base concrete. The sand patch method is so far the state-of-the-art for the roughness measurement of concrete structures. Although the method is easy to perform, it suffers from considerable drawbacks. Consequently, more sophisticated measurement systems are required. In a research project, we developed a novel camera­based alternative, which comes with several advantages. The measurement system consists of a mechanical cross slide that guides an industrial camera over a surface to be measured. Images taken by the camera are used for 3D reconstruction. Finally, the reconstructed point clouds are used to estimate roughness. In this article, we present our measurement system (including the hardware and the self-developed software for 3D reconstruction). We further provide experiments to camera calibration and evaluation of our system on concrete specimens. The resulting roughness estimates for the concrete specimens show a strong linear correlation to reference values obtained by the sand patch method.

Contralateral Limberg flap reconstruction for pilonidal disease recurrence.

To identify surgical techniques applied in case of recurrence in patients with pilonidal sinus, who have undergone primary treatment with Limberg flap, and to present our cases treated with Limberg flap reconstruction prepared from the contralateral gluteal region. Nine patients with recurrence out of 219 patients who underwent Limberg flap reconstruction between 2009 and 2016 at our clinics, and 6 patients who have been referred to our clinics with total 15 recurrence after primary Limberg flap reconstruction at other institutes were included in the study. Total excision and primary repair was applied in 3 patients while 2 patients underwent excision with lay open procedures. The remaining 10 patients underwent rhomboid excision of the recurrence area and Limberg flap repair from the contralateral gluteal area. All patients who underwent primary repair or excision-lay open procedures recurred again. These two patients also underwent contralateral Limberg flap reconstruction as their second revision surgery. There were no complications or recurrences in the study group. We believe that reconstruction with contralateral Limberg flap is an effective and feasible method in recurrent pilonidal sinus cases who have been initially treated surgically by the Limberg flap.

Isolated Superior Mesenteric Vein Tumor Thrombus in a Patient with Gastric Cancer.

Tumor thrombus in the portal vein can rarely originate from gastric cancer via hematogenous spread, with only few case reports published in the literature. Isolated superior mesenteric vein tumor thrombus in gastric cancer has not been previously reported. A 61-year-old male patient who had undergone distal gastrectomy and gastroenterostomy for gastric ulcer 20 years ago was diagnosed with an obstructive tumor originating from the gastroenterostomy anastomosis site on upper gastrointestinal endoscopy that was performed for complaints of fatigue, oral feeding problems, and anemia. The PET-CT imaging revealed a hypermetabolic mass in the gastroenterostomy region along with hypermetabolic suspected tumor thrombus in the superior mesenteric vein (SMV). A suspected tumor thrombus with contrast enhancement that completely obstructed the SMV was detected on triphasic abdominal computed tomography. Decision for surgery was made due to gastric tumor obstruction. Firstly, lesions suspected with tumor thrombus were extirpated from the SMV and sent to frozen section. Then, it was completely recanalized. A locally advanced tumor originating from the gastroenterostomy anastomosis site that totally obliterated the lumen was observed on surgical exploration. After proving tumor thrombus by frozen, near-total gastrectomy was performed for palliative purposes. Histopathologic examination of the specimen showed gastric invasive adenocarcinoma and tumor thrombi in the SMV (T4N2M1). The patient received adjuvant chemotherapy, and he is at his 22nd-month follow-up with extensive hepatic metastases and intra-abdominal disease. It should be kept in mind that gastric cancer may lead to portal vein tumor thrombus or that it may rarely be associated with an isolated SMV tumor thrombus, both of which are associated with poor prognosis.

Primary splenic angiosarcoma diagnosed after splenectomy for spontaneous rupture.

Primary splenic angiosarcoma is a rare abnormality and has a bad prognosis. It has unknown pathogenesis. This abnormality is usually presented by splenic rupture. Surgery is the most promising treatm Surgery is the most accepted and accurate method for diagnosis and treatment. Surgery before rupture increases the life expectancy. A 65-year-old woman who presented to the emergency room with abdominal pain, abdominal distension, and anemia was found to have a splenic mass and massive ascites. After getting a hemorrhagic sample from the abdomen, the patient was operated with splenic rupture prediagnosis. The spleen material was reported as splenic angiosarcoma. The staging 18F-FDG-Positron Emission Tomography-Computed Tomography did not show any metastasis. Five months later, paclitaxel treatment was initiated upon liver and bone metastasis, and the treatment still continues. Splenic angiosarcoma has a place among splenic parenchymal lesions. The splenectomy material names the diagnosis. Pathologic examination of splenectomy material is revealed certain diagnosis.

Fatty Acid composition of the muscle lipids of five fish species in isikli and karacaören dam lake, Turkey.

Total fatty acid composition of muscle lipids in some fish species (Cyprinus carpio (Isikli Dam Lake), Tinca tinca (Isikli Dam Lake), Scardinius erythrophthalmus (Isikli Dam Lake), Cyprinus carpio (Karacaören Dam Lake), and Carassius carassius (Karacaören Dam Lake)) was determined by gas chromatography. Polyunsaturated fatty acids (PUFAs) of Cyprinus carpio (Isikli Dam Lake) were found higher than PUFA of other species. Palmitic acid was the highest saturated fatty acid (SFA) in Tinca tinca (24.64%). Oleic acid was the highest monounsaturated fatty acid (MUFAs) in Cyprinus carpio (Isikli Dam Lake) (19.25%). The most abundant polyunsaturated fatty acid in Scardinius erythrophthalmus was docosahexaenoic acid (DHA) (17.94%). Total ω3 fatty acid composition was higher than the total ω6 fatty acids of Cyprinus carpio in both dam lakes. ω3/ω6 rates in Cyprinus carpio (Isikli Dam Lake), Tinca tinca, Scardinius erythrophthalmus, Cyprinus carpio (Karacaören), and Carassius carassius were 2.12, 1.19, 2.15, 2.87, and 2.82, respectively.

Retroperitoneoscopic live donor nephrectomy: 7 cases.

Laparoscopic living donor nephrectomy causes less pain, shorter hospital stays and a quicker return to daily activities. Because of potential bowel injuries and risk of intestinal obstruction secondary to adhesions later on, the retroperitoneoscopic donor nephrectomy (RDN) technique has been developed. The first 7 RDN cases carried out at our organ transplantation unit between December 2006 and May 2007 were retrospectively examined. The male/female ratio of the patients was 4/3. Left nephrectomy was performed in all cases. In two patients, the conventional method was performed because of an adhesion in the hilar area in one patient and because of technical difficulty after entering the peritoneum in another patient. Serious complications such as massive hemorrhage and intestinal injury were not observed. None of the patients required blood transfusion. The mean operative time was 161 minutes, with the exception of 2 patients who required conversion to other methods. Mean warm ischemia duration was 125 seconds. Oral feeding began the first postoperative day. The mean inpatient stay was 3.5 days. The mean recipient creatinine levels 24 hours and 1 month post-procedure were 3.78 mg/dl and 1.04 mg/dl, respectively. RDN is technically more difficult and has a steeper learning curve compared to transperitoneal donor nephrectomy. As our RDN cases increase, we will obtain more representative data on complications.