BackgroundThe purpose of this study was to investigate plasma levels of thrombin activatable fibrinolysis inhibitor (TAFI) and TAFI’s relationship with coagulation markers (prothrombin fragment 1 + 2) in gastric cancer patients.MethodsThirty-three patients with gastric adenocarcinoma and 29 healthy control subjects were prospectively enrolled in the study. Patients who had a history of secondary malignancy, thrombosis related disease, oral contraceptive use, diabetes mellitus, chronic renal failure or similar chronic metabolic disease were excluded from the study. A fasting blood sample was drawn from patients to determine the plasma levels of TAFI and Prothrombin Fragment 1 + 2 (F 1 + 2). In addition, data on patient age, sex, body mass index (BMI) and stage of disease were recorded. The same parameters, except stage of disease, were also recorded for the control group. Subsequently, we assessed the difference in the levels of TAFI and F 1 + 2 between the patient and control groups. Moreover, we investigated the relation of TAFI and F 1 + 2 levels with age, sex, BMI and stage of disease in the gastric cancer group.ResultsThere were no statistical differences in any demographic variables (age, gender and BMI) between the groups (Table 1). The mean plasma TAFI levels of the gastric cancer group (69.4 ± 33.1) and control group (73.3 ± 27.5) were statistically similar (P = 0.62). The mean plasma F 1 + 2 level in the gastric cancer group was significantly higher than for those in the control group (549.7 ± 325.3 vs 151.9 ± 67.1, respectively; P < 0.001). In the gastric cancer group, none of the demographic variables (age, gender and BMI) were correlated with either TAFI or F 1 + 2 levels. Also, no significant associations were found between the stage of the cancer and either TAFI or F 1 + 2 levels.ConclusionIn our study, TAFI levels of gastric cancer patients were similar to healthy subjects. The results of our study suggest that TAFI does not play a role in pathogenesis of the hypercoagulable state in gastric cancer patients.
BackgroundMetastasis in the axillary lymph nodes is the most important known prognostic factor for breast cancer. We aimed to investigate the contribution of the radioisotope tracer method to the dye-only method by performing sentinel lymph node biopsy on the same patient group during a single surgical session.MethodsForty-two patients who underwent operations in our clinic from February 2010 to October 2011 and with masses of <5 cm and clinically and radiologicallly negative axilla (T1-2 N0) were prospectively included in this study. After paraffin examination results were obtained, the numbers and metastatic states of the lymph nodes that were unidentifiable during surgery (although they were stained) but were detected by a gamma probe, lymph nodes that were only stained, lymph nodes that were only radioactive (hot), and lymph nodes that were both stained and radioactive (stained-hot) were determined in all patients. In patients who underwent axillary lymph node dissection, the total numbers of lymph nodes removed and their metastatic states were determined separately.ResultsAt least one blue-stained sentinel lymph node was identified in all patients during the blue-stained lymph node detection stage. The average number of sentinel nodes removed at this stage was 2.1 ± 1.1. In the second surgical stage (the stage in which nodes with axillary counts were investigated with the gamma probe) in these 41 patients, at least one additional hot node was removed, or at least one of the nodes that was removed because it was blue was also hot. In addition to the lymph nodes removed in the dye stage, 34 hot lymph nodes were excised from 21 patients. Overall, the average number of hot lymph nodes removed was 2.9 ± 1.5. In all patients, subsequent frozen sections and histopathological examinations were 100% concordant with the sentinel lymph nodes that were removed; the stained sentinel lymph nodes that were removed first did not affect the decision to perform axillary dissection.ConclusionThe results of our study indicate that performing sentinel lymph node biopsy with dye only is sufficient and as effective as the combined method.
BACKGROUND:In this study, we aimed to evaluate the clinical efficacy and safety of negative-pressure wound therapy (NPWT) in the treatment of the patients with electrical burns. METHODS:This study was retrospectively performed using a database placed prospectively in the burn center of our hospital. All consecutive patients with electrical burns treated using NPWT at our center between August 2008 and December 2012 were included. The treatment results in our study were grouped as successful or unsuccessful considering the treatment objectives in accordance with therapy indications. RESULTS:In total, 39 patients were included in our study; of them, 36 (92.3%) were men. The average age was 34.9±9.8 years (range, 17-63 years). The majority of the patients in our study (92.3%) had been exposed to high voltage electricity. The mean total burned body surface area (TBSA) was 19.3±9.8 (range, 4-44). Six patients (15.4%) had TBSAs ≥30%, 31 (79.5%) had third degree burns, and 8 (20.5%) had fourth degree burns. In our study, indications of NPWT included bone and/or tendon exposed deep wounds that are not suitable for early grafting or flap applications owing to the lack of supporting tissue in 27 (69.2%) patients, graft fixation in 8 (20.5%) patients, and secondary grafting following graft loss in 4 (10.3%) patients. The general success rate of NPWT was 90.7% according to indications and treatment objectives in our study. CONCLUSION:In the light of our results, NPWT may contribute to the present conventional treatments used in severe electrical burns.
Objective: Postoperative intraabdominal adhesions still cause significant morbidity in surgical patients. This study aims to evaluate the effects of an immunosuppressor known as Sirolimus and an antiadhesive membrane which is formed with sodium hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm™) to the intraabdominal adhesion formation in a rat model. Materials and Methods: This experimental study was performed at an experimental research center, Yeditepe University Faculty of Medicine, Istanbul. Spraque-Dawley Rats, at a weight of about 250±20 gr, were used. Group 1 (n=8): Abdomen was closed after applying cecal abrasion (control group), group 2 (n=8): 10 x 30 mm Seprafilm™ was applied under the abdominal wall after cecal abrasion ( Seprafilm™ group ). Group 3 (n =8): Sirolimus (0,5 mg/kg) was applied (Sirolimus group). Adhesions quantitatively evaluated by a blinded assessor according to the classification of Nair and his colleagues. Results: Statistically significant difference in terms of adhesion severity scores according to the Nair classification was found between the Sirolimus and the control group (p=0,03). Whereas, no statistically significant difference was found between the Seprafilm™ and the control group (p=0,17). Similarly, no statistically significant difference was found between Seprafilm™ and sirolimus group (p=0,64). Conclusion: Although there was no statistically significant difference between intraperitoneal application of Sirolimus and Seprafilm™ group (p = 0.57), a statistically significant difference was found when each group compared with the control group (p=0,03). Combined anti-adhesive effect of Sirolimus and Seprafilm™ can be evaluated in future studies.
GirişAkut apandisit akut karının en sık sebeplerinden biridir. Apendiks lümeninin fekalom, lenfoid hiperplazi, parazit, yabancı cisim ve tümör tarafından tıkanmasıy-la apandisit geliştiği bilinmektedir.[1] Akut apandisit ve kolon kanseri arasındaki ilişki ile ilgili ilk çalışmalar genellikle retrospektif ve appendektomi sonrası kanser gelişiminin değerlendirilmesiyle ilgilidir. Apandisitle kolon kanseri arasındaki ilişki ilk kez Shears [2] tarafın-dan bildirilmiş, daha sonra diğer araştırmacılar tarafın-dan yapılan çalışmalar yayınlanmıştır. [3][4][5] Hastanın başvurusu sırasında kolon kanseri olmasına rağmen akut apandisit tanısıyla apendektomi ameliyatı yapılan, ancak ilerleyen dönemlerde kolon kanseri tanısı konan olgular nadir görülmekte [6][7][8] ve genellikle olgu sunumu şeklinde olmaktadır. [8][9][10] Literatürde sunulan olguların çoğunluğu 40 yaş ve üzeri hastaları içermektedir. [5][6][7]11] Genç Hastalarda Kolon Kanserinin İlk Bulgusu Olarak Akut Apandisit Acute Appendicitis as First Sign of Colon Cancer in Young PatientsNecmi KURT, Hasan Ediz SIKAR, Cemile KURT, Mehmet ESER, Hüseyin UZUN, Salim BALİN, Selçuk GÖKTAŞ, Mehmet GÖKÇEİMAM ÖzetAkut apandisit, apendiks lümeninin fekalom, lenfoid hiperplazi, parazit, yabancı cisim ve tümör tarafından tıkan-masıyla oluşur. Son yıllarda tıkanma yapan kolon tümörleri-nin de apandisit bulguları oluşturduğu ve bu nedenle apendektomi ameliyatı yapıldığı bildirilmektedir. Özellikle 40 yaşın üzerinde apendektomi ameliyatı uygulanan hastalarda böyle bir olasılığın olduğunu bilerek ameliyat öncesi, ameliyatta ve ameliyat sonrası dönemde tanıya yönelik gerekli incelemeleri yapmak gerekir. Biz başvuru esnasında kolon kanseri olmasına rağmen akut apandisit tanısıyla apendektomi ameliyatı yapılan, ancak ilerleyen dönemde kolon kanseri tanısı konulan 40 yaşın altında 2 olguyu sunarak, genç-lerde de akut apandisit ve kolon kanseri arasındaki ilişkiyi vurgulamak istedik.
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