Barış Sevinç

Is Early Detection of Colon Cancer Possible with Red Blood Cell Distribution Width

BACKGROUND Red cell distribution width (RDW) is one of the standard parameters with blood cell counts. Much previous research has indicated that it increases in cases of systemic inflammation or cardiametabolic incident. However, information on the relation of RDW with solid tumors causing systemic inflammation is limited. In the present research, we examined the relation of RDW with malignant and benign lesions of the colon. MATERIALS AND METHODS 115 patients with colon polyps (group 1), and 30 with colon cancer (group 2) who were diagnosed histopathologically in our clinic between January 2010-January 2013 were scanned retrospectively. Patients with anemia, hematologic diseases and active inflammation were excluded. RDW, mean corpuscular volume (MCV), hemoglobin (Hgb) and platelet (Plt) measurements were recorded and their relations with the malignant and benign lesions of the colon were examined. RESULTS Both groups were similar in age and gender distribution. RDW values of patients with colon cancer were significantly higher than the patients with colon polyp (p=0,01). No significant differences were detected between the two groups in terms of MCV and Plt values (p>0,05). CONCLUSIONS RDW can be used as an early warning biomarker for solid colon tumors. Further prospective research is required on the relations of cheap and easily measured RDW parameters with colon malignancies.

Paratiroid cerrahisinin gelişimini etkileyen faktörler

GIRIŞ Primer hiperparatiroidi (pHPT) tanisi serum kalsiyum yuksekligi ile beraber uygunsuz parathormon (PTH) yuksekligi ile konur. pHPT olgulari semptomatik ve asemptomatik olabilir. Semptomatik pHPT’nin ve medikal tedaviye cevap vermeyen sekonder hiperparatiroidizmin tedavisi cerrahidir. Asemptomatik pHPT’nin ameliyat endikasyonlari 2002 Konsensus Toplantisi’nda yeniden duzenlenmistir (1).

Conservative management of abdominal injuries.

OBJECTIVE Non-operative management of abdominal injuries has recently become more common. Especially non-operative treatment of blunt abdominal trauma is gaining wide acceptance. In this study, the efficacy of non-operative treatment in abdominal trauma (blunt penetrating) is discussed. MATERIAL AND METHODS All patients who received treatment due to abdominal trauma from November 2008 to January 2013 were retrospectively analyzed. The demographic characteristics, type of injury, injured organ, type of treatment (operative vs. nonoperative) and mortality data were evaluated. RESULTS The study includes 115 patients treated for abdominal trauma in our department. The mechanism of trauma was stab wounds in 60%, blunt abdominal trauma in 23.5% and gunshot wounds in 16.5%. Forty-two patients (36.5%) were operated for hemodynamic instability and/or peritonitis on admission. The remaining 63.5% of patients (n=73) were treated nonoperatively, 10 of whom required laparotomy during follow-up. The remaining 63 patients were treated with non-operative management. The success rate for non-operative treatment was 86.3% and there was no difference in terms of the types of injuries. The mortality rate was 4.3% (n= 5) in the whole series, but there were no deaths among the patients who had received non-operative treatment. In the whole patient group 54.2% (n=63) were treated nonoperatively. CONCLUSION Nonoperative treatment in abdominal trauma is safe and effective. Patients with clinical stability and normal physical examination findings can be treated nonoperatively with close monitoring.

Relation between serology and grow-up time in atypically localized hydatic cysts.

OBJECTIVE Hydatic cyst is a parasitic disease caused by the larvae of Echinococcus granulosus. In the study, the aim is to evaluate the relation between serology and grow-up time in atypically localized cysts. METHODS Retrospectively, all the patients with hydatic disease between December 2004 and May 2012 were screened from the hospital database. Hydatic cyst localization other than the liver and lungs were accepted as atypical localization. RESULTS There were 325 patients with a diagnosis of hydatic disease. Most common localizations of the cysts were the liver (72.8%) and lungs (21%). Atypically localized cyst rate was 6.4% (n: 21). The most common atypical localization was the spleen (2.4%). 80.9% of atypically localized cysts were primary cases. In 3 cases with primary intramuscular hydatic cyst and 2 cases with primary subcutaneous hydatic cysts, serology was negative. CONCLUSION The relation between the hydatid cyst and the host is the main factor in serological tests and grow-up time. In tissues with a weaker cellular immunity like muscle and subcutaneous tissue, serology tends to be negative and grow-up time to be faster. In atypically localized cysts,hematogenous dissemination cannot explain the pathogenesis fully. Therefore, lymphatic dissemination should be kept in mind.

Comparison of topical zinc oxide and silver sulfadiazine in burn wounds: an experimental study

BACKGROUND We aimed to compare the effects of topical zinc oxide and topical silver sulfadiazine in the treatment of partial-thickness burn wounds. METHODS The study was conducted with 20 New Zealand rabbits, and burn wounds were created by a brass probe. The animals were randomly divided into two groups. The burns were treated with zinc oxide (Group O) or silver sulfadiazine (Group S) with daily application. The wound healing process was followed both clinically and histopathologically. We determined the days at which 50% and 80% re-epithelization was observed. RESULTS The mean time for 50% and 80% re-epithelization was 21.4 and 25.4 days in Group O and 25.8 and 30.2 days in Group S, respectively (p<0.001). The mean score for wound colonization was lower in Group O. The difference was statistically significant at weeks 2, 3, 4, and 6 (p<0.001). In the histopathological examination, the thicknesses of the epidermis, dermis and scar tissue were 0.12 mm, 3.80 mm and 244 mm in Group O, and 0.16 mm, 4.76 mm and 3.16 mm in Group S, respectively (p<0.001). CONCLUSION In this experimental burn study, zinc oxide was more effective than silver sulfadiazine in terms of epithelization, dermis maturation and scar formation.

Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia

Objective Incisional hernia is a significant problem after laparotomy, and there is still no consensus on an ideal treatment method. The aim of this study was to compare the results of onlay and sublay mesh repair techniques. Material and Methods In this randomized prospective trial, 100 patients were divided into two groups: onlay and sublay groups. Recurrences were evaluated by performing a physical examination. Results The median follow-up was 37.1 (26.6 to 46.5) months. In the onlay group, the mean operation time was significantly shorter. However, in terms of postoperative pain and wound complications, the sublay group had significantly better results. The recurrence rates were found to be similar in both groups (6% in the onlay group and 2% in the sublay group). Conclusion In the treatment of incisional hernia, sublay mesh repair is superior to onlay mesh repair in terms of postoperative pain and wound complications. Both techniques have similar recurrence rates.

Pilonidal sinüs ameliyatlarındaki artış normal mi

GIRIŞ Pilonidal sinus, gobek basta olmak uzere degisik yerlesimlerde gorulmekle birlikte en sik yerlesim yeri sakrokoksigiyal bolgedir. Daha cok 15–30 yas arasindaki aktif genclerde ve erkeklerde gorulur. Hastaligin etyopatogenezi ve tedavisi en cok tartisilan konulardir. Gunumuzde pilonidal sinusun edinsel hastalik oldugu genel kabul gormektedir. Akdeniz ulkelerinde yuksek siklik gosterir (2). Turk askerleri arasinda %8,8 oraninda pilonidal sinus bulunmustur (3). Insan sagligi ve ulkemizde cok uzerinde durulmayan ekonomik yuk ve isgucu kaybi bakimindan %8,8 onemli bir orandir.

Toksik tiroit nodülü için radyoaktif iyot tedavisinden sonra gelişen tiroit papiller karsinomu: Olgu sunumu

Amerikan Tiroit Dernegi (ATA) toksik tiroit nodullerinde ince igne aspirasyon biyopsisi (IIAB) yapilmaksizin radyoaktif iyot (RAI) tedavisi onermektedir. Elli bes yasinda kadin hasta 2005 yilinda tespit edilen tiroit sag lobunda yerlesimli toksik nodul nedeniyle RAI tedavisi almis. Hastanin RAI oncesi yapilan IIAB sonucu benign tiroit nodulu olarak rapor edilmis. Hastanin 8 yil sonra yapilan kontrol ultrasonografisinde tiroit sag lobda yerlesimli 15 mm capli solid nodul saptandi. Hastaya yapilan IIAB sonucu papiller karsinom acisindan supheli olarak rapor edildi. Hastaya bilateral total tiroidektomi yapildi. Histopatolojik incelemede nodulde papiller tiroit karsinomu tespit edildi. Bu vaka RAI sonrasi karsilastigimiz ikinci papiller karsinom vakasidir. Bu yazida sundugumuz olgu, RAI oncesi hastanin karsinomunun olmadigi ve kanser gelisiminin RAI tedavisi sonrasi oldugu IIAB ile gosterilmistir. Sonuc olarak, RAI tedavisi alan hastalar uzun donemde karsinom gelisimi acisindan yakin takip edilmelidir.

The Role Safety Steps in Success and Complication Rate of Endoscopic Retrograde Cholangiopancreatography

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is widely used for treatment of biliary disorders. There are several studies to increase the success rate and decrease the complication rate of ERCP. In this study we aimed to evaluate the affect of safety steps in success and complication rate of ERCP. Materials and Methods: In this cohort study patients were evaluated under 2 groups divided as before the introduction of safety steps and after. Successful cannulation rate, difficult cannulations, and complications of the procedure were recorded. Result: Failed ampullary cannulation rates were 8.2% in group 1 and 4% in group 2. In terms of postprocedural complications; in group 2 complication rates significantly decreased from 10.7% to 4.3%. Moreover, post-ERCP pancreatitis rate decreased from 9.1% in group 1 to 4% in group 2. Conclusions: Introduction of safety steps, significantly increase the cannulation rate and decrease both overall complication rate and pancreatitis risk.

Effect of medical treatment on histological findings in rabbits with acute appendicitis

BACKGROUND Acute appendicitis (AA) is the most common reason for abdominal surgery in the world. The aim of this study was to evaluate the effect of medical treatment on histological findings in rabbits with AA. METHODS Twenty-one male New Zealand rabbits were divided into 3 groups: appendix ligation and medical treatment, appendix ligation and no treatment, and control group, which underwent only laparotomy. RESULTS In appendix ligation without treatment group, AA findings were much more severe. CONCLUSION Medical treatment reduced inflammation of AA.