Between 1980 and 1985, a total of 260 patients with hydatid cysts of the liver have been treated surgically at the Department of Surgery of University Hospital of Ankara. All patients with organ cysts of other than the liver are excluded. In this retrospective study, the results of different surgical techniques were compared with respect to postoperative complications, morbidity, mortality, and recurrence of disease. Patients were divided into 2 groups retrospectively. The first group (I) involved patients treated without drainage (n = 87), and the second group (II) involved patients treated with external drainage (n = 173). Postoperative complication rates were 10.8% in group I, and 65.8% in group II. Mean postoperative hospital stay was 9.9 +/- 0.8 days in group I, and 20.6 +/- 1.1 days in group II. Most of the patients in group II had purulent or biliary discharge from the drainage site (average, 199 +/- 47 days). During the follow-up period, which varied from 1 to 6 years, recurrence rates were not significantly different in the 2 groups. The results strongly suggest that in the management of uncomplicated hydatid cysts of the liver, the surgical techniques which do not employ drainage of the cystic cavity are superior to those which use drainage.

Two aspects of religious worship (praying and fasting) were significantly impaired in the Muslim patients who had a stoma as a result of sphincter-sacrificing surgery. To improve quality of life in these patients, religious issues as they relate to the presence of a stoma should be discussed during preoperative counseling, the informed consent process, and counseling with local religious authorities.

Substaging of T1 tumors did not affect response to BCG in regard to recurrence or progression. Therefore, intravesical BCG is effective for stages T1a and T1b disease.

In order to characterize human colorectal cancer, much attention has been paid to enzyme studies. However, little is known about the correlation between the levels of key enzymes of purine nucleotide pathway and some clinical and biological indicators of tumor invasiveness and aggressiveness. Adenosine deaminase (ADA) and 5'-nucleotidase (5'-NT) were measured in cancerous and cancer-free adjacent large bowel tissues from 38 patients with colorectal carcinoma. We have analyzed the relationship between the enzyme levels and some clinical and pathological parameters. The enzymes' activities were markedly higher in primary tumors than in corresponding normal mucosae. The ADA level in tumor tissue was significantly correlated with lymph node metastasis, histologic type, tumor location, and patient's age, whereas the 5'-NT level showed a significant correlation with tumor grade and tumor location. ADA activity in tumor tissues was significantly higher in patients whose clinical course remained stable than in those with recurrent diseases. The purine metabolism and salvage pathway activity of purine nucleotides are accelerated in the cancerous human colorectal tissue. Although our findings suggest that these enzymes' activities are most likely related to the same histomorphological architecture of the tumor, the authors believe that long-term follow-up studies are needed to evaluate the prognostic value of purine enzymes for colorectal cancer.

We measured activities of some DNA turnover enzymes in 9 breast tissues with stage II cancer, 6 breast tissues with stage IIIa cancer, and 9 non-cancerous adjacent breast tissues from the same patients with stage II cancer. We found higher Adenosine Deaminase (ADA) and 5'-Nucleotidase (5'NT) and lower Guanase (GUA) activities in the cancerous tissues compared with the non-cancerous ones. No meaningful differences were however found between Cytidine Deaminase (CD) activities. Regarding the correlation analysis, positive correlations were established between ADA and 5'NT activities of the cancerous tissues (r = 0.45 for the tissues with stage II and r = 0.60 for the tissues with stage IIIa cancer). No meaningful correlations were however found between other enzyme activities. Relating to activity ratios, no meaningful differences were found between ADA/5'NT values in the tissues. GUA/CD ratios were however lower and the other ratios higher in the cancerous tissues. Results indicated that ADA and 5'NT activities increased and GUA activity decreased in the cancerous breast tissues but CD activities did not change in the tissues affected. It has been suggested that increased ADA and 5'NT together with decreased GUA activities might be a physiologic attempt of the cancer cells to provide more substrates needed by cancer cells to accelerate the salvage pathway activity. Furthermore, high ADA activity might also play part in the detoxication process of high amounts of toxic adenosine and deoxyadenosine substrates produced from accelerated purine metabolism in the cancerous tissues.

Background and Aims: When excisional biopsy or lumpectomy is performed without margin assessment in early breast cancer,further surgery are required if positive margins exist. We evaluated the role of the intraoperative frozen section in breast conserving surgery (BCS). Clinicopathologic factors associated with re-excision were searched.Material and Methods: 190 tumors in 186 patients with early invasive breast cancer treated by BCS. Breast tumor was excised with 2c mm acroscopic margin, and microscopic margins examined by intraoperative frozen section.Results: After frozen section, 160 cases had negative margins (no re-excision), but 30 patients (16%) underwent re-excision because of close/positive margins. Negative margins were obtained in 24 patients but six patients underwent mastectomy due to persistent involved margins. Local recurrence was 2.1% and systemic recurrence was 2.6% with mean 62 months follow-up. Tu mor type, tumor size, extranodal extension and extensive intraductal component were significant predictors of re-excision by multivariate analysis. Re-excision procedures haven'tanimpact on local recurrence.Conclusions: Intraoperative frozen section is an effective procedure in reducing the need of second operation. We have observed lower recurrence rates than other studies because of our 2cmmacroscopic margin width and >2mmmicroscopic negative margin which obtained by intraoperative frozen section.

Our results show that chromogranin A is the most sensitive and specific neuroendocrine marker. Chromogranin A positivity appears to bear a poor prognosis in patients with colorectal cancers.

SummaryThe importance of tumour angiogenesis in the process of tumour growth and progression in solid tumours has been widely accepted. Among many angiogenic factors, vascular endothelial growth factor (VEGF) has been shown to play a major role in the development and dissemination of the malignant tumours. Nitric oxide (NO) production was also observed in solid tumour tissues. NO has been reported to play an important role for the mitogenic effect of VEGF in the angiogenic process. However, little is known about the correlation between VEGF and NO in circulating levels. Therefore, we investigated serum VEGF and NO concentrations in human gastric cancers as well as healthy individuals, and examined the influence of tumour stage on circulating level of VEGF. The study consisted of 11 healthy individuals and 37 patients with primary gastric cancer who did not receive any prior therapy. Patients were categorized into four groups according to TNM classification. The level of VEGF 165 in preoperative sera of gastric cancer patients and healthy donors was assayed using the quantitative sandwich enzyme immunoassay technique. NO concentration was estimated indirectly from serum nitrite. The ANOVA test showed a significant difference in serum VEGF 165 concentrations between tumour stages (P < 0.001). A striking relationship was found between serum NO levels and tumour stage (P < 0.001). A significant difference was also seen between healthy individuals and patients with stage 1 disease. The present study suggested that large tumour burden was associated with significantly increased levels of VEGF 165 and NO.