Hayri Erkol

A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia

Introduction There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. Material and methods A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Results Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001). Conclusion In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.Introduction There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. Material and methods A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Results Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p=0.011 and p=0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p=0.001). Conclusion In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.

Collision tumour of trichofolliculoma and basal cell carcinoma

A 52‐year‐old woman presented with a 2‐year history of a reddish nodule on the right nasolabial sulcus. Histopathological examination revealed that the nodule was composed of trichofolliculoma and basal cell carcinoma. There was no transitional zone between the two neoplasms. The diagnosis was made as a collision tumour of trichofolliculoma and basal cell carcinoma.

Analysis of tractor-related deaths

ABSTRACT The aim of the study was to evaluate the properties of tractor-related death cases and discuss the precautions in order to prevent such events. For this aim, reports made between 2006 and 2009 by the First Specialty Board of Council of Forensic Medicine (FSBCFM), Turkey, were evaluated retrospectively. Forty-one tractor-related death cases were included in this study. Thirty-five (85.4%) of the cases were male. The mean age was 42.52 ± 25.1 (with a range between 1 and 84 years old). The average time interval between the incident and death was 13.76 ± 33.53 days (range: 0–176 days) and 20 (48.8%) cases died on the incident spot or during transportation to the hospital. Among the cases, 34.1% (n = 14) were drivers, whereas 39.0% (n = 16) were passengers and the remaining were pedestrians (26.9%, n = 11). The accident was caused by the tractor rolling over in 34.1%, the victim being run over in 22.0%, and the victim falling from the tractor or trailer in 22.0% of the cases. Most of the events (56.1%) occurred on the road. In conclusion, tractors must not be used as a transportation vehicle for passengers. Periodic training of drivers can be useful for reducing tractor-related accidents.

Gender differences in trauma mechanisms, and outcomes in a rural hospital which is not designed as trauma centre

Objectives This study aimed to investigate how trauma characteristics and outcomes differ between genders in a rural hospital. Methods Records of trauma patients admitted to a state emergency department (ED) in eastern Turkey, between January 2006 and December 2007 were reviewed and data were analysed based on gender. Results In total, 5379 (87.0%) men and 806 (13.0%) women, totalling 6185 patients, were assessed. Mean age was 26.5 (1 month – 80 years) years for men and 24.7 (2 month – 81 years) years for women. Men comprised 90.2%, 81.3% and 77.3% of the patients injured by assault, motor vehicle incidents and falls, respectively. Women comprised a significantly larger share of suicide attempts (70.8%) than men. Of the men injured, 90.6% were discharged after treatment in the ED. The per cent of hospitalised women (5.8%) was increased compared with the per cent of hospitalised men (p=0.011). There was a higher frequency of transfer among women (8.6%) when compared with men (p<0.001). Women had a mortality frequency of 1.2%, which was similar to the mortality per cent calculated for men. Conclusions Men were at an increased risk for trauma, especially assault. The percentage of women injured and admitted to the ED due to assault was low compared with statistics reported in the literature. However, assault is the most common cause of trauma among women. The high per cent of hospitalisation and transfer among women may indicate that women are exposed to more severe trauma, and therefore experience increased morbidity compared with men.

Effects of beta-glucan on hepatic damage caused by obstructive jaundice

BACKGROUND Beta-glucans are known as macrophage stimulators and antioxidants. This study aimed to investigate the effects of beta-glucans on oxidative damage to the liver during obstructive jaundice. METHODS Sham, control and treatment groups (7 Wistar Albino rats in each) were designed. In the treatment group, beta-glucan was given through gavages for 10 days after bile duct ligation. All groups were sacrificed on the 11th day. Liver function tests, superoxide dismutase (SOD), myeloperoxidase (MPO), malondialdehyde (MDA), lipid peroxide (LPO), glutathione (GSH), and histopathological examination of the liver were investigated. RESULTS In the treatment group, the levels of alanine and aspartate aminotransferases (AST, ALT), gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), total and direct bilirubin, MPO in the serum, and the levels of MDA and LPO in the liver tissue were significantly lower when compared with the control group. Moreover, SOD and GSH levels were relevantly high in the treatment group. Histopathological examination of the liver revealed less damage in the treatment group. CONCLUSION These results show that beta-glucan induced the phagocytic and anti-oxidative effects and also reduced the liver damage and oxidative stress in obstructive jaundice. Advanced studies are required for the clinical use of beta-glucan in obstructive jaundice.

İleri yaş hastalarda lokal anestezi altında kasık fıtığı tamiri

Objectives: The incidence of inguinal hernia and the frequency of comorbidity increase in the elderly. Therefore, in operations of these patients, anesthesia methods are important. The aim of our study was to investigate the feasibility of local anesthesia in the operation of the elderly. Materials and methods: The patients operated for inguinal hernia were analyzed retrospectively. They were divided into two groups: the elderly (>60 years) and the younger. Anesthesia methods, additional anesthesia requirement and complications were compared. Results: Of totally 177 patients, 30.5% were elderly. Operation type, anesthesia method and score of operational risk differed between groups. The percentage of co morbidity (55.6%) in the elderly was significantly high (p< 0.001). Among elderly, the frequency of co morbidity was slightly higher in patients who had local anesthesia compared to spinal and general anesthesia. Patients in young and middle ages preferred to be operated less under local anesthesia (34.1%) compared to elderly (70.4%). There was one case (2.6%) converted to general anesthesia as an additional anesthesia in the elderly group. Postoperative complications were slight more frequent in elderly. These cases were five in number (31.3%) and were oper ated under spinal or general anesthesia (p=0.002). Conclusions: The frequency of co morbidity and risk score of operation (ASA category) rise in the elderly. However, inguinal hernioraphy can be performed under local anesthesia without complication and conversion to general anesthesia.

Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis

OBJECTIVE Hashimotos thyroiditis (HT) is an autoimmune inflammatory disorder. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with HT and to compare these values with those from healthy subjects. METHOD A total of 154 participants were included in the study, 90 HT patients and 64 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institutions database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases, hematologic disorders and patients on aspirin or steroid treatment were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of HT patients were the baseline values obtained at the time of HT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. RESULTS Age, gender and CBC parameters were not different between the HT group and the control group; however, the NLR of HT group (2.1 [1.3-5.8]) was significantly higher than the control group (1.9 [0.6-3.3]), p=0.04. CONCLUSION Increased NLR may be useful as an indicator of the presence of HT, especially in complicated cases. NLR is inexpensive and easy to determine. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in HT patients.