Metin Sen

Gastric Necrosis and Perforation Caused by Acute Gastric Dilatation : Report of a Case

Abstract.We report the case of an 18-year-old, mentally retarded boy who suffered acute abdominal symptoms and signs after eating a heavy meal. Laparotomy showed massive gastric dilatation with near-total infarction and perforation. Total gastrectomy and esophagojejunostomy were performed, but the patient died a few hours after the operation.

Chlorhexidine Gluconate: An Ideal Scolicidal Agent in the Treatment of Intraperitoneal Hydatidosis?

Hydatid disease is a parasitic disease that is treated primarily by surgery. The most important complication of surgical treatment is spillage of the contents of the cyst, leading to secondary dissemination. In this study, the effect of chlorhexidine gluconate (Chx-Glu) was investigated in the treatment of experimental intraperitoneal hydatidosis (IPH). IPH was reproduced in 100 Wistar albino rats by inoculation with 1 ml of a suspension contained approximately 1500 viable protoscolices of Echinococcus granulosus following determination of scolicidal activity of chlorhexidine gluconate in vitro. Five minutes after protoscolex inoculation, 5 ml of the scolicidal solution was instilled into the peritoneal cavity: 0.9% NaCl (control group), 4.0% Chx-Glu, 0.4% Chx-Glu, and 0.04% Chx-Glu. After 6 months of follow-up, the rats were sacrificed, and the number of isolated cysts, peroperative and postoperative deaths, and toxicity were evaluated. Cyst formation did not occur in any of the Chx-Glu groups compared to the control group (p < 0.05), whereas it was detected in all of the control rats. In addition, to 4.0% Chx-Glu was found to be more toxic and to cause a high mortality rate compared to the 0.4% and 0.04% Chx-Glu groups and the control group (p < 0.05). Chx-Glu 0.04% was found to be the most potent, nontoxic agent; it is easily available, inexpensive, and highly potent in a short period of time at the low concentration. Chx-Glu 0.04% can be used safely in the treatment of intraperitoneal hydatidosis and hydatid cyst.

Sigmoid colon perforation as an unusual complication of Behçet's syndrome: report of a case.

Abstract.A 47-year-old man with long-standing Behçets syndrome presented with an acute abdomen, and was found to have perforation of the sigmoid colon. Laparotomy revealed gangrenous changes in the sigmoid colon and perforation in the center of the affected segment. This is a very rare complication of Behçets disease, and we report this case to stress the importance of performing careful abdominal examination while evaluating patients with Behçets disease.

Could prolactin receptor gene polymorphism play a role in pathogenesis of breast carcinoma

SUMMARY Objective: Constitutive activation of various hormone and growth factor receptors is newly recognised as a common cause of tumour development. This study investigated the presence of any mutation or polymorphism of prolactin receptor (PRLR) in 38 patients with breast cancer. Research methods: Genomic DNA was extracted and PCR amplification was carried out for exon 1–10 of PRLR from tumoral and adjacent non-cancerous breast tissue of tumour specimens from 38 breast cancer patients. PCR products were analysed by SSCP and automatic sequencing for mutations. Results: For the first time, A150C (Leu→Ile) transversion at exon 6 of PRLR in tumour tissues, in adjacent non-cancerous breast tissues, and in blood samples of two (5.3%) out of 38 patients with breast cancer were detected. In contrast to this finding, no polymorphism of PRLR in blood samples of 100 normal individuals were found. Conclusion: Polymorphism of prolactin receptors might play a role in mammary carcinogenesis as a consequence of intracellular changes of PRLR signalling.

Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process

BACKGROUND/AIMS The sigmoid colon is the most frequent site for a volvulus. In this report, we review our experience with sigmoid colon volvulus. METHODOLOGY We present our experience of 81 cases of sigmoid volvulus admitted to our department. RESULTS Preoperative endoscopic volvulus detortion was attempted in all patients, and in 39 of them the procedure was successful. The success rate of endoscopic detortion for sigmoid colon volvulus with a flexible colonoscope (60%) was higher than with a rigid rectosigmoidoscope (42%). In 19 of these 39 non-operatively devolvulated patients, sigmoid resection with primary anastomosis was performed within 7-10 days after reduction, but 20 patients did not accept the elective operation after a non-operative treatment. Among the 61 patients undergoing urgent or elective operation for sigmoid volvulus, there were 17 laparotomies with only detortion, 19 resections with elective anastomosis, 6 resections with primary anastomosis, and 19 resections with a Hartmanns pouch. There were 9 deaths (21%) among 42 patients who underwent an emergency operation, and one (5.2%) among the 19 patients who had elective surgery died because of a cerebral embolus. CONCLUSIONS Initial therapy with endoscopy affords decompression and an adequate preparation of patients for surgical resection, and a flexible colonoscope has notable advantages over rigid instruments for the detortion process.

Thyroid Hormone Supplementation in Sepsis : An Experimental Study

Abstract.Purpose: The levels of thyroid hormones decrease in septic, critically ill, and major trauma patients who show a bad prognosis. The aim of this study was to investigate the effects of thyroid hormone supplementation on the sepsis criteria and mortality in an experimental sepsis model. Methods: Forty-eight Wistar-Albino rats were divided into four experimental groups. A cecum ligation and puncture was used as a sepsis model. Group I: sham; group II: a cecum ligation and puncture (control); group III: a cecum ligation and puncture +T3 (0.4 μg/100 g body weight/day) intraperitoneally; group IV: a cecum ligation and puncture +T4 (1 500 ng/100 g body weight/day) intramuscularly. The PCO2, leukocyte count, peritoneal bacterial content, neutropenia, and mortality rates were assessed in all groups. Results: The PCO2 levels decreased only in the control group (P < 0.05). The leukocyte counts were lower in the therapy groups (P < 0.05). The rate of neutropenia was seen much more in the control group (P < 0.05). The peritoneal bacteria content decreased in the therapy groups (P < 0.05). The mortality rate significantly decreased in the thyroid hormone-treated animals (P < 0.05). Conclusions: Thyroid hormone supplementation in septic rats had a beneficial effect on the sepsis criteria and also resulted in a lower rate of mortality.

Antitumoral effects of Melissa officinalis on breast cancer in vitro and in vivo.

BACKGROUND There is a long standing interest in the identification of medicinal plants and derived natural products for developing cancer therapeutics. Here we investigated the antiproliferative properties of Melissa officinalis (MO) from Turkey on breast cancer. METHODS MO extracts were studied for cytotoxicity against breast cancer cell lines (MCF-7, MDA-MB-468 and MDA-MB-231). In vitro apoptosis studies were performed by annexin V staining and flow cytometry analyses. Immunohistochemistry for Ki-67 and caspase 7 in the tumoral tissue sections of DMBA-induced mammary tumors in rats was also performed, along with TUNEL assays to detect apoptotic cells. In vivo anticancer activity testing was carried out with reference to inhibition of growth of DMBA induced mammary tumors in rats. RESULTS MO showed cytotoxicity against three cancer cell lines, inducing increase in Annexin-positive cells. Expression of caspase-7 protein and TUNEL positive cells were much higher in rats treated by MO, compared with the untreated control group, while expression of Ki-67 was decreased. Furthermore, in vivo studies showed that mean tumor volume inhibition ratio in MO treated group was 40% compared with the untreated rats. CONCLUSION These results indicated that MO extrcts have antitumoral potential against breast cancer.

The Effects of Various Scolicidal Agents on the Hepatopancreatic Biliary System

Sclerosing cholangitis is a rare but dreadful complication of liver hydatid surgery. Almost all scolicidal agents were shown to be potentially associated with this complication clinically or experimentally. This experimental study was designed to examine the effects of 0.04% chlorhexidine gluconate and 95% ethanol on the hepatobiliary system and pancreas and also to compare their effects with 10% povidone iodine and hypertonic 20% saline. Materials and Methods: 50 Wistar rats were divided into equal five groups identified as: 0.9% NaCl (control group), 0.04% chlorhexidine gluconate, hypertonic 20% saline, 10% povidone iodine, and 95% ethanol. Scolicidal agents were injected into the biliary tract through a duodenal puncture. The animals were kept for 3 months. The animals were sacrificed, and histopathological examinations of the liver, biliary tract, and pancreas were performed. Results: The most severe histopathological changes of the liver, biliary tract, and pancreas were found in the ethanol group, and the least changes were detected in the chlorhexidine gluconate group. Conclusion: This experimental study confirms the deleterious effect of 95% ethanol on hepatopancreatic biliary system when used for the percutaneous drainage of hydatid diseases. For treatment of hydatid cysts in the hepatobiliary system, 0.04% chlorhexidine gluconate should be used as scolicidal agent.

Relaxant effect of omeprazole and lansoprazole in guinea pig gallbladder muscle strips in vitro

Background. The aim of this study was to investigate the role of omeprazole and lansoprazole, H+-K+ ATPase inhibitors, in gallbladder smooth muscle contractility in vitro. Methods. Gallbladder muscle strips obtained from guinea pigs were mounted in an organ bath. The responses of both precontracted strips and strips under basal tension to omeprazole and lansoprazole were determined. Results. Spontaneous contractile activity was blocked following omeprazole and lansoprazole administration. The agents also caused concentration-dependent relaxation in carbachol- and KCl-precontracted gallbladder muscle strips. Pretreatment with atropine (1 µM), NW-nitro l-arginine methyl ester (l-NAME; 30 µM), indomethacin (10 µM), ammonium chloride (7.5 mM), sodium acetate (7.5 mM), tetraethylammonium chloride (0.5 mM), glibenclamide (1 µM), 4-aminopyridine (0.1 mM), or clotrimazole did not inhibit this relaxation. Gallbladder strips were placed in high-concentrtion potassium (80 mM), calcium-free solution. The contraction produced with the addition of Ca2+ (2.5 mM) was completely relaxed by omeprazole, lansoprazole, and nifedipine separately. Conclusions. These results demonstrate that omeprazole and lansoprazole have potent inhibitory effects on spontaneous contractions and cause dose-dependent relaxation in precontracted gallbladder smooth muscle strips of guinea pig in vitro. This effect could be due to blockade of the calcium channels.

Higher glutathione transferase GSTM1 0/0 genotype frequency in young thyroid carcinoma patients.

OBJECTIVE Glutathione S-transferases (GSTs) comprise a large supergene family and detoxify a variety of endogenous and exogenous electrophilic compounds. Since many GSTs are polymorphic, there has been considerable interest in determining whether particular allelic variants are associated with altered risk for various disorders. RESEARCH DESIGN AND METHODS In this study the association between the variant GSTM1 0/0 genotype and thyroid carcinoma was investigated. A hospital-based, case-controlled study was carried out. Polymorphisms of GSTM1 0/0 (i.e. the null allele of GSTM1) in samples from 32 cases and 44 controls were detected by polymerase chain reaction (PCR) methodology. The proportions of GSTM1 deleted genotype in cases and controls were 59.4% and 54.5%, respectively. RESULTS There were significant increments of GSTM 0/0 genotype frequency in a group of patients aged under 40 (p = 0.033, odds ratio (OR) = 4.78, 95% confidence interval (CI) = 1.30-7.13) and in former smokers compared with controls (p = 0.039, OR 2.45, 95% CI 0.216-4.72). CONCLUSION GSTM1 deleted genotype may be a useful genetic biomarker for thyroid carcinoma susceptibility in young subjects. The absence of this enzyme seems to have a role in the development of thyroid carcinoma; however, the mechanism still needs further study.