Reduced collagen accumulation after major surgery.
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Collagen↗
Biomedical subjects
I Sayek
Publications and source records attributed to I Sayek.
Laparoscopic surgery is associated with less tumour growth stimulation than conventional surgery: an experimental study.
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Analysis of Variance↗
Percutaneous treatment of a congenital splenic cyst with alcohol: a new therapeutic approach.
Percutaneous treatment of a huge congenital splenic cyst in a 23-year-old man is presented. The cyst had been catheterized and drained two times within a 3-month period without injecting any sclerosing agent into the cavity. On the third attempt, catheter drainage and injection of alcohol into the cyst cavity were performed because of insufficient response to drainage alone. He was discharged symptom-free after the procedure. The cyst diminished in size considerably 9 months after the treatment with alcohol. The volume of the cyst was reduced from 5200 to 8 ml. Although percutaneous treatment of a congenital splenic cyst with tetracyclin has been reported, to our knowledge this is the first case of a congenital splenic cyst treated with alcohol as a sclerosing agent. Percutaneous treatment of splenic cyst can obviate the need for partial or total splenectomy and may be an alternative to surgical treatment.
Adult↗
Study of interleukin-10 and experimental acute pancreatitis.
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Acute Disease↗
Evaluation of trauma care in a developing country highlighted by a major aircraft accident.
The aim of this study was to evaluate the day-to-day trauma care in a developing country highlighted by a major accident. In this accident, early management was not carried out according to triage principles. Scene mortality and in-hospital mortality were 72% (n = 55) and 14% (n = 3), respectively. Overall mortality rate was 76%. Five survivors were minor wounded. Three laparotomies, one thoracotomy and three tube thoracostomies were performed in the acute phase. Skeletal injuries, mainly rib fractures (43.3%) and haemothorax (10.8%), were the most frequent pathologies seen. One liver laceration, one splenic rupture, one intraabdominal bleeding due to rupture of mesenteric vessels, two major cranial traumas and an abruptio placenta were the other pathologies. The missed injury rate in this accident was 16% (n = 6). It is concluded that the missed injuries in this incident reflect the inadequacy of trauma care in the rural area of the developing country.
Accidents, Aviation↗
Clinical validation of the influence of P-glycoprotein on technetium-99m-sestamibi uptake in malignant tumors.
UNLABELLED: We prospectively studied 48 patients with either breast cancer (30 patients) or lung cancer (18 patients) to ascertain the relationship between the degree of accumulation of 99mTc-sestamibi and the expression of p-glycoprotein in tumor tissues. METHODS: During initial presentation (37 patients) or post-therapy evaluation (11 patients), the patients underwent contemporaneous 99mTc-sestamibi imaging and biopsy (30 patients) or surgery (18 patients). The interval between surgery/biopsy and imaging varied between 3 and 15 days. All patients had radiologically detectable tumors. Immunohistochemical studies were performed on paraffin sections using a monoclonal antibody, JSB-1, developed against the internal epitope of p-glycoprotein. Tumor-to-background ratios were correlated with the level of p-glycoprotein expression determined by immunohistochemical studies. RESULTS: Our results showed an inverse correlation between the tumor-to-background ratios of 99mTc-sestamibi and the density of p-glycoprotein expression in tumor tissues. The values for the tumor-to-background ratios were significantly lower for those tumors expressing p-glycoprotein at high levels than those with scattered and no expression (p < 0.01 and p < 0.001, respectively). CONCLUSION: Although our results warrant further studies at the molecular level using PCR techniques after the extraction of mRNA, our data strongly suggest that 99mTc-sestamibi imaging is useful to noninvasively determine the presence of multidrug resistance in patients with malignant tumors.
ATP Binding Cassette Transporter, Subfamily B, Mem↗
Effect of omentectomy on peritoneal defence mechanisms in rats.
OBJECTIVE: To assess the effect of omentectomy on peritoneal defence mechanisms in rats. DESIGN: Randomised study. MATERIAL: Sixty Wistar Albino rats. INTERVENTIONS: Rats were divided in three groups of 20. All rats underwent midline laparotomy and 10 rats in each group had omentectomy. Samples were taken two hours (early period) and 30 days (late period) after omentectomy. MAIN OUTCOME MEASURES: Effect of omentectomy on bactericidal activity of peritoneal fluid (PBA), chemotactic indices (CI) of polymorphonuclear leucocytes (PMNL), phagocytic activity of PMNL in the peritoneal fluid (PHA), total cell counts, and cell types of peritoneal washing fluid. RESULTS: In the early period omentectomy reduced total cell counts from 3440 (1400-4800) x 10(6)/10 ml to 1480 (800-2080) x 10(6)/10 ml (p = 0.0022), and the CI of PMNL from 2.86 (2.32-4.02) to 1.43 (1.29-1.77) (p = 0.0002), and increased the PHA from 11.9 (8.3-17) to 17 (16-19) (p = 0.0006). The PBA was not significantly altered. The proportion of macrophages decreased (p = 0.0001), while the proportion of lymphocytes increased in the peritoneal fluid (p = 0.0002). In the late period total cell counts in the control and omentectomy groups were 3440 (1400-4800) x 10(6) and 3160 (1040-5120) x 10(6)/10 ml fluid, respectively (p = 0.52). Omentectomy reduced the CI of PMNL from 2.86 (2.32-4.02) to 2.01 (1.82-1.49) (p = 0.0003). The difference between the proportion of PHA of either group was not significant (p = 0.06). PBA in the control and omentectomy groups was 99.03 (70-100) and 99.48 (71.5-100), respectively (p = 0.97). Although the total cell count in the peritoneal fluid did not differ, the proportion of macrophages decreased (p = 0.0003) while the proportion of lymphocytes increased (p = 0.0002). The proportion of PMNL did not change in either of the experimental settings. CONCLUSIONS: The omentum has an important role in local peritoneal defence mechanisms in experimental conditions. Its removal may effect some of these mechanisms adversely.
Animals↗
Factors that may increase morbidity in a model of intra-abdominal contamination caused by gallstones lost in the peritoneal cavity.
OBJECTIVE: To assess the effect of intraperitoneal gallstones with and without Escherichia coli and sterile bile on the incidence of intraperitoneal complications in mice. DESIGN: Prospective randomised study. SETTING: Teaching hospital, Turkey. MATERIAL: 180 Swiss albino mice in five groups, n = 20 in the control group, and n = 40 in each of the experimental groups. INTERVENTIONS: Group A laparotomy alone (controls); group B, laparotomy amd intraperitoneal instillation of E. coli 4 x 10(6) 0.1 ml; group C, laparotomy and insertion of sterilised gallstones; group D, laparotomy, insertion of gallstones and instillation of E. coli 4 x 10(6) 0.1 ml; and group E, laparotomy, insertion of gallstones, and instillation of E. coli 4 x 10(6) 0.1 ml and sterile bile 0.1 ml. A quarter of each group was killed after 1, 2, 4, and 8 weeks. MAIN OUTCOME MEASURES: Intra-peritoneal abscesses, adhesions, perforations, fistula, or obstruction. RESULTS: No mice died. Adhesions were found in 3(15%), 7(18%), 30(75%), 25(63%), and 24(60%) in the five groups, respectively. No mice in groups A, B, or C developed an abscess, but 8 did in each of groups D and E (20%). One mouse in group D developed obstruction. Logistic regression showed that abscess formation was significantly increased by the addition of gallstones and E. coli to the peritoneal cavity (p < 0.001) but the addition of bile had no effect. Gallstones increased the rate of adhesions more than nine fold (p < 0.001) but E. coli with or without bile had no effect (p = 0.75). CONCLUSIONS: Free gallstones within the peritoneal cavity with or without E. coli or sterile bile, or both, increased the rate of formation of both abscesses and adhesions in mice. These results suggest that efforts should be made retrieve gallstones that are dropped into the peritoneal cavity during laparoscopic cholecystectomy, particularly in patients with acute cholecystitis.
Abdominal Abscess↗
Liver hydatid disease: long-term results of percutaneous treatment.
PURPOSE: To evaluate the long-term effectiveness of percutaneous treatment of liver hydatid cysts. MATERIALS AND METHODS: Thirty-one patients (19 female patients and 12 male patients; age range, 8-78 years; mean age, 41 years) with 57 liver hydatid cysts underwent percutaneous treatment. The cysts were treated with hypertonic saline (15% NaCl) and/or absolute alcohol. Sonographic and/or fluoroscopic guidance was used. RESULTS: Repeated sonography revealed a gradual decrease in cyst size. Volume reduction was 18%-99% (mean, 83%). With the disappearance of the fluid component, pseudotumor appearance occurred. In all treated cases, the cyst wall became irregular and thicker during follow-up. No mortality occurred. No abdominal dissemination was encountered during follow-up. Major complications were infection of the cavity, hypersensitivity reaction, and development of biliary fistula. One cyst recurred 11 months after primary drainage. CONCLUSION: Long-term results indicate that percutaneous treatment of liver hydatid cysts is an effective and safe method in selected cases.
Adolescent↗
Effects of obstructive jaundice and external biliary diversion on bacterial translocation in rats.
OBJECTIVE: To find out the rate of translocation of bacteria to visceral organs in obstructive jaundice, and whether the absence of bile within the intestine or the presence of obstructive jaundice itself promotes bacterial translocation. DESIGN: Prospective, controlled experimental animal study. SETTING: University hospital, Turkey. SUBJECTS: 40 Inbred albino rats weighing 160-220 g. INTERVENTIONS: Three groups of rats were studied: sham operated controls (n = 15), ligation of the common bile duct (CBD) (n = 15), and CBD-ligation and proximal external biliary division through a Silastic catheter (n = 10). Specimens of distal small bowel mesenteric lymph nodes (MLN), liver, spleen, and lung were obtained on the 10th postoperative day, and quantitative bacteriological analysis done. Caecal aerobic microflora were also measured for qualitative and quantitative comparisons. RESULTS: The translocation of bacteria to MLN, liver, and spleen, but not to the lungs, was slightly but not significantly increased by ligation of the CBD. Ligation of the CBD with simultaneous external biliary diversion caused increase translocation to all organs examined (with the increases to the MLN (p = 0.012), liver (p = 0.009), and spleen (p = 0.028) being significant). There was no difference in the raised bacterial counts in MLN and visceral organs after ligation of the CBD or biliary diversion. The pattern of caecal microflora did not change in any group. CONCLUSIONS: These findings suggest that the absence of bile from the gut may promote bacterial translocation to visceral organs.
Animals↗
The effect of the pineal gland on liver regeneration in rats.
BACKGROUND/AIMS: We investigated the influence of pinealectomy on liver regeneration after partial hepatectomy in rats. METHODS: Thirty rats were allocated into four groups as follows: group 1 in which no operation was done (control), group 2 in which only midline scalp incision and craniotomy was performed (sham operation), group 3 in which pinealectomy was performed and group 4 in which the rats underwent pinealectomy and pineal transplantation. Eight weeks later all the rats underwent 70% hepatectomy. RESULTS: Hepatic regenerative capacity was observed 24 h after PH by bromodeoxyuridine incorporation into DNA and the mitotic index of hepatocytes. The bromodeoxyuridine labeling indices were 45.4, 35.8, 19.9 and 36.8 in groups 1, 2, 3 and 4, respectively. The mitotic indices of the same groups were 31.2, 28.7, 8.3 and 13.4, respectively. Both the bromodeoxyuridine labeling and mitotic indices were significantly lower in the pinealectomized rats than in the control and sham operation groups. CONCLUSIONS: These results suggest that the pineal gland stimulates liver regeneration after partial hepatectomy in rats.
Animals↗
Brown tumour as a complication of secondary hyperparathyroidism in uraemia: a case report.
A 15-year-old girl who developed "brown tumour" as a complication of secondary hyperparathyroidism while on maintenance haemodialysis therapy is described. Parathyroidectomy with implantation of a portion of one parathyroid gland was performed. Recovery of the lesion was noted 6 months after surgery and a ratio of about 1/12 was found when the systemic parathormone level was compared to that obtained from the vein draining the implanted parathyroid tissue. We would like to emphasize that signs and symptoms of secondary hyperparathyroidism should be sought for before complications develop; and if medical therapy is unsuccessful, this type of surgery is a justified option.
Adolescent↗
Leiomyomas of the small bowel: a rare cause of massive and recurrent gastrointestinal bleeding. Case report.
Three cases of leiomyoma of the small bowel presenting with recurrent gastrointestinal bleeding diagnosed angiographically in the preoperative period, are discussed. Selective visceral angiography seems to be the most sensitive radiological examination. New types of enteroscopes are being developed.
Adult↗
Does gastric adenocarcinoma develop after the treatment of gastric lymphoma?
Two adult patients with the diagnosis of gastric lymphoma who developed adenocarcinoma of the stomach 8 years after the treatment are presented. Both patients were treated by subtotal gastrectomy followed by irradiation of 4,000-4,500 cGy to the epigastric region and six courses of chemotherapy (vincristine, cyclophosphamide, prednisolone). In our review of the literature, 16 cases of gastric adenocarcinoma following the treatment of gastric lymphoma were found and listed with details. The factors influencing the development of this secondary carcinoma, mainly those treatment related are discussed. The possible role of both radiotherapy and chemotherapy in shortening the latent period for the development of stump carcinoma is emphasized.
Adenocarcinoma↗
Percutaneous treatment of abdominal hydatid cysts with hypertonic saline and alcohol. An experimental study in sheep.
RATIONALE AND OBJECTIVES: Seven naturally infected sheep with proper hepatic and peritoneal hydatid cysts were studied to assess a new percutaneous approach for cystic hydatid disease. METHODS: A needle was inserted into the cyst cavity of sheep under sonographic guidance. Immediately after instillation of hypertonic saline to inactivate protoscolices, ultrasound demonstrated that germinal and laminated membranes of the hydatid cysts were separated completely from the pericyst in all sheep. Later, a catheter was inserted into the cyst cavity using Seldinger technique. Alcohol was used as a sclerosing agent. RESULTS: Ultrasound showed reduction in cyst size and progressive solidification. No anaphylactic reaction was observed. After sonographic follow-up that lasted from 1 to 26 weeks, the sheep were killed to evaluate macroscopic and histologic changes. At autopsy, no secondary cyst formation was seen. The appearance of treated cysts was different from the others, and there were signs of involution. The histologic sections did not show any viable protoscolices or daughter cysts. The authors observed pericyst hyalinization, inflammatory cells in the cyst wall, cyst wall necrosis, calcification of cyst wall, degeneration of laminated membrane, severe degeneration or absence of germinal membrane, and inflammatory cells and necrotic material in the cyst cavity. CONCLUSIONS: Percutaneous treatment of hydatid disease was effective in the animal model. Ultrasound was useful in evaluating the intervention.
Animals↗
Effect of povidone-iodine lavage on peritoneal defence mechanisms in rats.
OBJECTIVE: To assess the effect of povidone iodine lavage on peritoneal defence mechanisms in rats. DESIGN: Randomised study. MATERIAL: 90 Wistar albino rats. INTERVENTION: Rats were divided in three groups of 30. All rats underwent midline laparotomy, and 20 rats in each group had peritoneal lavage with 20 ml 1% povidone iodine, samples being taken before lavage in 10 and after lavage in 10. MAIN OUTCOME MEASURES: Effect of povidone-iodine lavage compared with laparotomy alone on bactericidal activity of peritoneal fluid (group 1); chemotactic indices of polymorphonuclear leucocytes (PMNL) (group 2); and total cell counts, cell types, and peritoneal phagocytic activity (group 3). RESULTS: Lavage with povidone-iodine increased the total peritoneal cell count/washing from 10.4 x 10(6) to 12.4 x 10(6) (p < 0.005), peritoneal bactericidal activity from 69.2% to 92.7% (p < 0.05), and peritoneal phagocytic activity from 58.9% to 73.7% (p < 0.05) at the end of four hours. Chemotactic indices of peritoneal PMNL before and after lavage were 1.90 and 1.89, respectively. Among the cells in the peritoneal fluid, the proportion of PMNL increased, whereas those of macrophages, lymphocytes, and mast cells decreased (p < 0.005). CONCLUSIONS: These results differ from those that we found previously after saline lavage. Lavage with 1% povidone-iodine does not increase the detrimental effect of saline lavage; on the contrary, it may even enhance peritoneal defence mechanisms. Any detrimental effects of povidone-iodine lavage should be attributed to systemic rather than local toxicity.
Animals↗
Restoration of bactericidal activity of peritoneal fluid by cimetidine but not ranitidine or famotidine in burned mice.
OBJECTIVE: To find out the effect of 20%, third degree burns and H2 receptor antagonists on peritoneal bactericidal activity. DESIGN: Animal experiment. SETTING: Research laboratory of university school of medicine. SUBJECTS: 52 mice in five groups. INTERVENTIONS: Sham burn (n = 5, group I), burned, and received subcutaneous injections of saline (0.3 ml/kg day, n = 14, group II); ranitidine (10 ml/kg/day, n = 15, group III); cimetidine (10 mg/kg/day, n = 8, group IV); or famotidine (0.7 mg/kg/day, n = 10, group V); for 14 days. MAIN OUTCOME MEASURE: Peritoneal bactericidal activity in all groups measured 15 days after the burn. RESULTS: There was a significant difference in peritoneal bactericidal activity between the control and burned mice, but no significant difference between the control group and the burned mice that were given cimetidine and famotidine. CONCLUSION: Peritoneal bactericidal activity is suppressed in mice after 20% third degree burns and this effect may be partly reversed by cimetidine and famotidine.
Animals↗
Risk factors in perforated peptic ulcer disease: comparison of a new score system with the Mannheim Peritonitis Index.
OBJECTIVE: To construct a score that would accurately predict outcome for patients with perforated peptic ulcers. DESIGN: Retrospective study. SETTING: University Hospital. SUBJECTS: 173 patients who were operated on for perforated peptic duodenal ulcers over a 14 year period. MAIN OUTCOME MEASURES: Results of multivariate discriminant function analysis of derived set of clinical variables known to be associated with high mortality, and comparison with the Mannheim Peritonitis Index. RESULTS: Serious coexisting medical illness, acute renal failure, white cell count of more than 20 x 10(9)/l, and male sex were the most significant factors influencing mortality. The Hacettepe score for perforated peptic ulcer was established using these four variables. The sensitivity was 83%, the specificity 94%, and the overall predictive accuracy 93%. The corresponding figures for the Mannheim Peritonitis Index were 75%, 96%, and 94% respectively. CONCLUSION: The Hacettepe score is useful in predicting whether a patient will survive after perforation of a peptic duodenal ulcer.
Chi-Square Distribution↗