Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent e...Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum. According to our knowledge, this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.展开更多
The mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperati...The mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperative suspicion and diagnosis of appendiceal mucocele are important. Ultrasonography and computed tomography are useful tools for the diagnosis of appendiceal mucocele. It may be also recognised by colonoscopy as a smooth submucosal lesion of the cecum. Optima management of the mucocele could be achieved through accurate preoperative diagnosis. Preoperative diagnosis is a major component for minimizing intra-operative and post-operative complications. We herein report five cases and discuss the diagnostic methods and surgical treatment.展开更多
There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the mo...There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the more appropriate methods to diagnose pancreatic hyperechogenicity when compared with transcutaneous or endoscopic ultrasound examination. More importantly, pancreatic hyperechogenicity may not be a certain indicator of pancreatic fat infiltration. Even if it is true, we do not know the clinical significances of pancreatic fat accumulation. Some suggested that excess fat in the pancreas is associated with chronic pancreatitis. However, several histological studies on human alcoholic chronic pancreatitis did not prove the presence of fatty pancreas in such cases. Thus, except for aging, it is very rare to have truly steatotic pancreas in the absence of certain human diseases.展开更多
AIM: To examine the effects of adenosine and A1 re- ceptor activation on reperfusion-induced small intestinal injury. METHODS: Rats were randomized into groups with sham operation, ischemia and reperfusion, and system...AIM: To examine the effects of adenosine and A1 re- ceptor activation on reperfusion-induced small intestinal injury. METHODS: Rats were randomized into groups with sham operation, ischemia and reperfusion, and systemic treatments with either adenosine or 2-chloro-N6-cyclo- pentyladenosine, A1 receptor agonist or 8-cyclopentyl- 1,3-dipropylxanthine, A1 receptor antagonist, plus ade- nosine before ischemia. Following reperfusion, contra- ctions of ileum segments in response to KCl, carbachol and substance P were recorded. Tissue myeloperoxidase, malondialdehyde, and reduced glutathione levels were measured. RESULTS: Ischemia significantly decreased both contra- ction and reduced glutathione level which were ameliora- ted by adenosine and agonist administration. Treatment also decreased neutrophil infiltration and membrane lipid peroxidation. Beneficial effects of adenosine were abolis- hed by pretreatment with A1 receptor antagonist. CONCLUSION: The data suggest that adenosine and A1 receptor stimulation attenuate ischemic intestinal in- jury via decreasing oxidative stress, lowering neutrophil infiltration, and increasing reduced glutathione content.展开更多
Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious ...Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious morbidity and mortality generally. We present herein a case with a spontaneous rupture of a hepatic hidatid disease into the peritoneum without any serious symptoms. A 15-year-old boy was admitted to the emergency room with a mild abdominal pain lasting for a day. Physical examination revealed only mild abdominal tenderness. There was no history of trauma or complaints related to hydatid diseases. Ultrasonography showed a large amount of free fluid and a cystic lesion with irregular borders in the liver. He was operated on. Postoperative albendazol therapy was given for 2 mo. No recurrence or secondary hydatidosis was seen on CT investigation in the 3rd, 6th and 12th mo following surgery.展开更多
The airborne ragweed pollen spectrum was investigated in the air of Ankara, Turkey for aperiod of ten years (1990-1999) using a Burkard seven-day volumetric recording trap. In our study period,long distance transporte...The airborne ragweed pollen spectrum was investigated in the air of Ankara, Turkey for aperiod of ten years (1990-1999) using a Burkard seven-day volumetric recording trap. In our study period,long distance transported Ambrosia pollen has been registered. Daily pollen levels varied from low to highin Burge抯 system. In last three years, the pollen concentration of Ambrosia showed a clear increasingtendency. Our results prove that ragweed pollen may be an important threat for ragweed sensitive patientsin Ankara city in near future.展开更多
Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice...Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with corticosteroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow- up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure.展开更多
This study presents earthquake performance analysis of the Torul Concrete-Faced Rockfill (CFR) Dam with two-dimensional dam-soil and dam-soil-reservoir finite element models. The Lagrangian approach was used with flui...This study presents earthquake performance analysis of the Torul Concrete-Faced Rockfill (CFR) Dam with two-dimensional dam-soil and dam-soil-reservoir finite element models. The Lagrangian approach was used with fluid elements to model impounded water. The interface elements were used to simulate the slippage between the concrete face slab and the rockfill. The horizontal component of the 1992 Erzincan earthquake, with a peak ground acceleration of 0.515g, was considered in time-history analysis. The Drucker-Prager model was preferred in nonlinear analysis of the concrete slab, rockfill and foundation soil. The maximum principal stresses and the maximum displacements in two opposite directions were compared by the height of the concrete slab according to linear time-history analysis to reveal the effect of reservoir water. The changes of critical displacements and principal stresses with time are also shown in this paper. According to linear and nonlinear time-history analysis, the effect of the reservoir water on the earthquake performance of the Torul CFR Dam was investigated and the possible damage situation was examined. The results show that the hydrodynamic pressure of reservoir water leads to an increase in the maximum displacements and principal stresses of the dam and reduces the earthquake performance of the dam. Although the linear time-history analysis demonstrates that the earthquake causes a momentous damage to the concrete slab of the Torul CFR Dam, the nonlinear time-history analysis shows that no evident damage occurs in either reservoir case.展开更多
AIM: To investigate the gastroprotective effect of vardenafil against indomethacin-induced gastric damage. METHODS: Forty-eight female Wistar albino rats were randomly divided into 6 groups. Group 1 received saline on...AIM: To investigate the gastroprotective effect of vardenafil against indomethacin-induced gastric damage. METHODS: Forty-eight female Wistar albino rats were randomly divided into 6 groups. Group 1 received saline only. Group 2 (indomethacin) received indomethacin. Rats in group 3 and 4 were pretreated with different doses of famotidine. Group 5 and 6 were pretreated with different doses of vardenafil. Rats in groups 3 to 6 received 25 mg/kg indomethacin 30 min after pretreatment. The animals were sacrificed 6 h later and their stomachs were opened. Gastric lesions were counted and measured. The stomach of each animal was divided in two parts for histopathological examinations and nitric oxide (NO) and malondialdehyde (MDA) assays, respectively. RESULTS: There were no gastric mucosal lesion in the saline group but all rats in the indomethacin group had gastric mucosal ulcerations (ulcer count; 6.25 ± 3.49, and mean ulcer area; 21.00 ± 12.35). Ulcer counts werediminished with famotidine 5 mg/kg (4.12 ± 2.47, P > 0.05), 20 mg/kg (2.37 ± 4.43, P < 0.05), vardenaf il 2 mg/kg (4.37 ± 3.06), and vardenafil 10 mg/kg (1.25 ± 1.38, P < 0.05) compared to the indomethacin group. Gastric mucosal lesion areas were diminished with famotidine 5 mg/kg (8.62 ± 2.97, P < 0.001), famotidine 20 mg/kg (0.94 ± 2.06, P < 0.001), vardenafil 2 mg/kg (6.62 ± 5.87, P < 0.001), and vardenafil 10 mg/kg (0.75 ± 0.88, P < 0.001) compared to the indomethacin group. MDA levels were signif icantly higher in indometh-acin group (28.48 ± 14.51), compared to the famotidine 5 mg/kg (6,21 ± 1.88, P < 0.05), famotidine 20 mg/kg (5.88 ± 1.60. P < 0.05), vardenaf il 2 mg/kg (15.87 ± 3.93, P < 0.05), and vardenafil 10 mg/kg (10.97 ± 4.50, P < 0.05). NO concentration in gastric tissues of the fa-motidine groups were significantly increased (P < 0.05), but the NO increases in the vardenafil groups were not statistically significant. Histopathology revealed dimin-ished gastric damage for pretreatment groups compared to the indomethacin group (P < 0.05). CONCLUSION: Vardenafil affords a significant dose-dependent protection against indomethacin induced gastric mucosal lesions in rats.展开更多
AIM: To evaluate the frequency of neural cell adhesion molecule (NCAM)-180 expression in fresh tumor tissue samples and to discuss the prognostic value of NCAM-180 in routine clinical practice. METHODS: Twenty-six pat...AIM: To evaluate the frequency of neural cell adhesion molecule (NCAM)-180 expression in fresh tumor tissue samples and to discuss the prognostic value of NCAM-180 in routine clinical practice. METHODS: Twenty-six patients (16 men,10 women) with colorectal cancer were included in the study. Fresh tumor tissue samples and macroscopically healthy proximal margins of each specimen were subjected to flow-cytometric analysis for NCAM-180 expression. RESULTS: Flow-cytometric analysis determined NCAM-180 expression in whole tissue samples of macroscopically healthy colorectal tissues. However,NCAM-180 expression was positive in only one case (3.84%) with well-differentiated Stage Ⅱ?disease who experienced no active disease at 30 mon follow-up. CONCLUSION: As a consequence of the limited number of cases in our series,it might not be possible to make a generalisation,nevertheless the routine use of NCAM-180 expression as a prognostic marker for colorectal carcinoma seems to be unfeasible and not cost-effective in clinical practice due to its very low incidence.展开更多
PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetricmodified Limberg flap were compared with respect to complications and patient comfort in the postoperativ...PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetricmodified Limberg flap were compared with respect to complications and patient comfort in the postoperative period. METHODS: In this prospective, randomized study, 68 of 70 patients were followed for a mean of 29.22 (range, 6- 44) months after wide excision plus classic Limberg flap (Group 1, n = 35) and after asymmetric modified Limberg flap closure (Group 2, n = 33). RESULTS: There were significantly more macerations in Group 1 (P < 0.001). All macerations were detected on the lower part of the incision left on the intergluteal sulcus, and infections occurred subsequent to maceration. The infection rate was statistically higher in Group 1 than in Group 2 (P = 0.028). We noted that as a result of these complications, time to suture removal (P = 0.001), discharge from hospital (P = 0.001), and time off from work (P = 0.001) were significantly longer for Group 1 than for Group 2. There were two recurrences in the inferior part of the suture line in Group 1 and none in Group 2, which showed no statistical difference (P = 0.493). CONCLUSIONS: The deep intergluteal sulcus and midline gap were slightly flattened over the anococcygeal region. The vacuum effect was decreased, and there were less macerations and fewer infections. Time off from work and discharge time from hospital were shortened by eliminating the moisture effect and reducing complications by lateralizing the lower part of the suture line.展开更多
文摘Lipoma within an inverted Meckel's diverticulum presen- ting with hemorrhage and partial intestinal obstruction is an exceptional clinical entity. We report a case of 47-year-old male with a history of recurrent episodes of partial intestinal obstruction and melena due to a subserosal lipoma located in the base of an inverted Meckel's diverticulum. According to our knowledge, this is the first case of a lipoma within a Meckel's diverticulum giving rise to this clinical scenario without the existence of heterotrophic gastric or pancreatic tissues.
文摘The mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperative suspicion and diagnosis of appendiceal mucocele are important. Ultrasonography and computed tomography are useful tools for the diagnosis of appendiceal mucocele. It may be also recognised by colonoscopy as a smooth submucosal lesion of the cecum. Optima management of the mucocele could be achieved through accurate preoperative diagnosis. Preoperative diagnosis is a major component for minimizing intra-operative and post-operative complications. We herein report five cases and discuss the diagnostic methods and surgical treatment.
文摘There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the more appropriate methods to diagnose pancreatic hyperechogenicity when compared with transcutaneous or endoscopic ultrasound examination. More importantly, pancreatic hyperechogenicity may not be a certain indicator of pancreatic fat infiltration. Even if it is true, we do not know the clinical significances of pancreatic fat accumulation. Some suggested that excess fat in the pancreas is associated with chronic pancreatitis. However, several histological studies on human alcoholic chronic pancreatitis did not prove the presence of fatty pancreas in such cases. Thus, except for aging, it is very rare to have truly steatotic pancreas in the absence of certain human diseases.
基金Zonguldak Karaelmas University Research Proje-cts Fund, No. 2003-01-09
文摘AIM: To examine the effects of adenosine and A1 re- ceptor activation on reperfusion-induced small intestinal injury. METHODS: Rats were randomized into groups with sham operation, ischemia and reperfusion, and systemic treatments with either adenosine or 2-chloro-N6-cyclo- pentyladenosine, A1 receptor agonist or 8-cyclopentyl- 1,3-dipropylxanthine, A1 receptor antagonist, plus ade- nosine before ischemia. Following reperfusion, contra- ctions of ileum segments in response to KCl, carbachol and substance P were recorded. Tissue myeloperoxidase, malondialdehyde, and reduced glutathione levels were measured. RESULTS: Ischemia significantly decreased both contra- ction and reduced glutathione level which were ameliora- ted by adenosine and agonist administration. Treatment also decreased neutrophil infiltration and membrane lipid peroxidation. Beneficial effects of adenosine were abolis- hed by pretreatment with A1 receptor antagonist. CONCLUSION: The data suggest that adenosine and A1 receptor stimulation attenuate ischemic intestinal in- jury via decreasing oxidative stress, lowering neutrophil infiltration, and increasing reduced glutathione content.
文摘Hydatid disease is an endemic disease in certain areas of the world. It is located mostly in the liver. Spontaneous rupture of the hydatid cyst into the peritoneum is a rare condition, which is accompanied by serious morbidity and mortality generally. We present herein a case with a spontaneous rupture of a hepatic hidatid disease into the peritoneum without any serious symptoms. A 15-year-old boy was admitted to the emergency room with a mild abdominal pain lasting for a day. Physical examination revealed only mild abdominal tenderness. There was no history of trauma or complaints related to hydatid diseases. Ultrasonography showed a large amount of free fluid and a cystic lesion with irregular borders in the liver. He was operated on. Postoperative albendazol therapy was given for 2 mo. No recurrence or secondary hydatidosis was seen on CT investigation in the 3rd, 6th and 12th mo following surgery.
基金Supported by the Research Foundation of Ankara University.
文摘The airborne ragweed pollen spectrum was investigated in the air of Ankara, Turkey for aperiod of ten years (1990-1999) using a Burkard seven-day volumetric recording trap. In our study period,long distance transported Ambrosia pollen has been registered. Daily pollen levels varied from low to highin Burge抯 system. In last three years, the pollen concentration of Ambrosia showed a clear increasingtendency. Our results prove that ragweed pollen may be an important threat for ragweed sensitive patientsin Ankara city in near future.
文摘Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with corticosteroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow- up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure.
文摘This study presents earthquake performance analysis of the Torul Concrete-Faced Rockfill (CFR) Dam with two-dimensional dam-soil and dam-soil-reservoir finite element models. The Lagrangian approach was used with fluid elements to model impounded water. The interface elements were used to simulate the slippage between the concrete face slab and the rockfill. The horizontal component of the 1992 Erzincan earthquake, with a peak ground acceleration of 0.515g, was considered in time-history analysis. The Drucker-Prager model was preferred in nonlinear analysis of the concrete slab, rockfill and foundation soil. The maximum principal stresses and the maximum displacements in two opposite directions were compared by the height of the concrete slab according to linear time-history analysis to reveal the effect of reservoir water. The changes of critical displacements and principal stresses with time are also shown in this paper. According to linear and nonlinear time-history analysis, the effect of the reservoir water on the earthquake performance of the Torul CFR Dam was investigated and the possible damage situation was examined. The results show that the hydrodynamic pressure of reservoir water leads to an increase in the maximum displacements and principal stresses of the dam and reduces the earthquake performance of the dam. Although the linear time-history analysis demonstrates that the earthquake causes a momentous damage to the concrete slab of the Torul CFR Dam, the nonlinear time-history analysis shows that no evident damage occurs in either reservoir case.
文摘AIM: To investigate the gastroprotective effect of vardenafil against indomethacin-induced gastric damage. METHODS: Forty-eight female Wistar albino rats were randomly divided into 6 groups. Group 1 received saline only. Group 2 (indomethacin) received indomethacin. Rats in group 3 and 4 were pretreated with different doses of famotidine. Group 5 and 6 were pretreated with different doses of vardenafil. Rats in groups 3 to 6 received 25 mg/kg indomethacin 30 min after pretreatment. The animals were sacrificed 6 h later and their stomachs were opened. Gastric lesions were counted and measured. The stomach of each animal was divided in two parts for histopathological examinations and nitric oxide (NO) and malondialdehyde (MDA) assays, respectively. RESULTS: There were no gastric mucosal lesion in the saline group but all rats in the indomethacin group had gastric mucosal ulcerations (ulcer count; 6.25 ± 3.49, and mean ulcer area; 21.00 ± 12.35). Ulcer counts werediminished with famotidine 5 mg/kg (4.12 ± 2.47, P > 0.05), 20 mg/kg (2.37 ± 4.43, P < 0.05), vardenaf il 2 mg/kg (4.37 ± 3.06), and vardenafil 10 mg/kg (1.25 ± 1.38, P < 0.05) compared to the indomethacin group. Gastric mucosal lesion areas were diminished with famotidine 5 mg/kg (8.62 ± 2.97, P < 0.001), famotidine 20 mg/kg (0.94 ± 2.06, P < 0.001), vardenafil 2 mg/kg (6.62 ± 5.87, P < 0.001), and vardenafil 10 mg/kg (0.75 ± 0.88, P < 0.001) compared to the indomethacin group. MDA levels were signif icantly higher in indometh-acin group (28.48 ± 14.51), compared to the famotidine 5 mg/kg (6,21 ± 1.88, P < 0.05), famotidine 20 mg/kg (5.88 ± 1.60. P < 0.05), vardenaf il 2 mg/kg (15.87 ± 3.93, P < 0.05), and vardenafil 10 mg/kg (10.97 ± 4.50, P < 0.05). NO concentration in gastric tissues of the fa-motidine groups were significantly increased (P < 0.05), but the NO increases in the vardenafil groups were not statistically significant. Histopathology revealed dimin-ished gastric damage for pretreatment groups compared to the indomethacin group (P < 0.05). CONCLUSION: Vardenafil affords a significant dose-dependent protection against indomethacin induced gastric mucosal lesions in rats.
文摘AIM: To evaluate the frequency of neural cell adhesion molecule (NCAM)-180 expression in fresh tumor tissue samples and to discuss the prognostic value of NCAM-180 in routine clinical practice. METHODS: Twenty-six patients (16 men,10 women) with colorectal cancer were included in the study. Fresh tumor tissue samples and macroscopically healthy proximal margins of each specimen were subjected to flow-cytometric analysis for NCAM-180 expression. RESULTS: Flow-cytometric analysis determined NCAM-180 expression in whole tissue samples of macroscopically healthy colorectal tissues. However,NCAM-180 expression was positive in only one case (3.84%) with well-differentiated Stage Ⅱ?disease who experienced no active disease at 30 mon follow-up. CONCLUSION: As a consequence of the limited number of cases in our series,it might not be possible to make a generalisation,nevertheless the routine use of NCAM-180 expression as a prognostic marker for colorectal carcinoma seems to be unfeasible and not cost-effective in clinical practice due to its very low incidence.
文摘PURPOSE: Cases treated surgically using wide excision plus classic Limberg flap or wide excision plus asymmetricmodified Limberg flap were compared with respect to complications and patient comfort in the postoperative period. METHODS: In this prospective, randomized study, 68 of 70 patients were followed for a mean of 29.22 (range, 6- 44) months after wide excision plus classic Limberg flap (Group 1, n = 35) and after asymmetric modified Limberg flap closure (Group 2, n = 33). RESULTS: There were significantly more macerations in Group 1 (P < 0.001). All macerations were detected on the lower part of the incision left on the intergluteal sulcus, and infections occurred subsequent to maceration. The infection rate was statistically higher in Group 1 than in Group 2 (P = 0.028). We noted that as a result of these complications, time to suture removal (P = 0.001), discharge from hospital (P = 0.001), and time off from work (P = 0.001) were significantly longer for Group 1 than for Group 2. There were two recurrences in the inferior part of the suture line in Group 1 and none in Group 2, which showed no statistical difference (P = 0.493). CONCLUSIONS: The deep intergluteal sulcus and midline gap were slightly flattened over the anococcygeal region. The vacuum effect was decreased, and there were less macerations and fewer infections. Time off from work and discharge time from hospital were shortened by eliminating the moisture effect and reducing complications by lateralizing the lower part of the suture line.
