A tumoral mass (local recurrence of renal cell carcinoma) causing massive intraabdominal bleeding after blunt abdominal trauma

AbstractBackgroundSolid organ injury after abdominal trauma is a common condition, however, injury of the local recurrent tumoral masses following abdominal trauma is rare. The injuries and bleeding in recurrent tumors tend to be highly serious since they are more fragile. The bleedings caused by renal cell carcinomas and by the traumatic laceration of their recurrence commonly occur in the retroperitoneum.In this report, we present a 55-year-old female patient who underwent emergency surgery due to intraabdominal bleeding and bleeding was from the recurrence of a renal cell carcinomas.Presentation of caseThe 55-year-old female patient was admitted to the emergency service with intraabdominal bleeding. Physical examination revealed tenderness in the right lower quadrant, particularly in the traumatic area. Ultrasonography and computed tomography revealed diffuse intraabdominal fluid and a ruptured bleeding mass was excised. Pathological analysis indicated that the mass was isolated local recurrence of renal cell carcinoma.DiscussionSolid organ injury caused by blunt abdominal trauma may be accompanied by tumoral laceration; however, minor bleeding may occur in cases with blunt trauma, coexistence of blunt abdominal trauma with local recurrence and massive bleeding is extremely rare.Control of bleeding is more challenging in tumoral tissues compared to normal tissues. The bleeding intraabdominal area rather than the retroperitoneal area, and this condition was attributed to the peritoneal tear caused by the trauma.ConclusionLocal recurrent tumoral masses may be the source of the intraabdominal massive bleeding after blunt trauma

Targeting the anaphase-promoting complex/cyclosome (APC/C) enhanced antiproliferative and apoptotic response in bladder cancer

Improving the chemotherapy sensitivity of bladder cancer is a current clinical challenge. It is critical to seek out effective combination therapies that include low doses of cisplatin due to its dose-limiting toxicity. This study aims to investigate the cytotoxic effects of the combination therapy including proTAME, a small molecule inhibitor, targeting Cdc-20 and to determine the expression levels of several APC/C pathway-related genes that may play a role in the chemotherapy response of RT-4 (bladder cancer) and ARPE-19 (normal epithelial) cells. The IC20 and IC50 values were determined by MTS assay. The expression levels of apoptosis-associated (Bax and Bcl-2) and APC/C-associated (Cdc-20, Cyclin-B1, Securin, and Cdh-1) genes were assessed by qRT-PCR. Cell colonization ability and apoptosis were examined by clonogenic survival experiment and Annexin V/PI staining, respectively. Low-dose combination therapy showed a superior inhibition effect on RT-4 cells by increasing cell death and inhibiting colony formation. Triple-agent combination therapy further increased the percentage of late apoptotic and necrotic cells compared to the doublet-therapy with gemcitabine and cisplatin. ProTAME-containing combination therapies resulted in an elevation in Bax/Bcl-2 ratio in RT-4 cells, while a significant decrease was observed in proTAME-treated ARPE-19 cells. Cdc-20 expression in proTAME combined treatment groups were found to be decreased compared to their control groups. Low-dose triple-agent combination induced cytotoxicity and apoptosis in RT-4 cells effectively. It is essential to evaluate the role of APC/C pathway-associated potential biomarkers as therapeutic targets and define new combination therapy regimens to achieve improved tolerability in bladder cancer patients in the future

Determination of Growth Curve with Different Model in the Karacabey Merinos x Kıvırcık Crossbred Lambs Raised in Tekirdağ Provinces

Bu çalışma ile Karacabey Merinosu x Kıvırcık melezi kuzuların doğum - 101 günlük yaşlar arası dönemde göstermiş oldukları canlı ağırlıklar kullanılarak büyümenin zamana göre değişimini ifade eden çeşitli büyüme eğrilerine ilişkin parametrelerin tahmini ve büyüme modellerinin karşılaştırılması amaçlanmıştır. Bu amaçla Gompertz, Logistik ve doğrusal model kullanılmıştır. Uygulanan modeller içinden hangisinin daha uygun olup olmadığı konusunda belirleme katsayıları (R2 ) ile her modele ilişkin canlı ağırlık ortalamalarının gözlenen ve tahminlenen değerleri arasındaki sapmalarının kareleri toplamından (SKT) yararlanılmıştır. Analizler cinsiyet faktörünün etkisi dikkate alınarak erkek, dişi ve genel olmak üzere üç grup halinde değerlendirilmiştir. Araştırma sonunda sapma kareler toplamı dişi kuzularda Gompertz modelde 3.14, Logistik modelde 4.47 ve doğrusal modelde ise 4.73, erkek kuzular için ise sapma kareler toplamı Gompertz modelde 7.06 Logistik modelde 15.83 ve doğrusal modelde ise 15.85 olarak bulunmuştur.This study is aimed for estimation of variation of growth by time as the form of several growth curves of the data of Karacabey Merinos x Kıvırcık crossbred lambs raised in Tekirdağ province of Turkey. The Gompertz , Logistic and linear models were used to evaluate the best fit model. The best model was selected according to the values of determination coefficient (R2 ) and sum of squares of differences between observed and estimated values obtained as average live weights of lambs and values obtained by equation of interest for the same period of growth respectively. Data were divided three groups according to sexes and general groups. Sum of square differences were found 3,14 (Gompertz model), 4,47 ( Logistic model), 4,73 (Linear model) for female lambs. Similarly sum of square differences were found 7,06 (Gompertz model), 15,83 ( Logistic model), 15,85 (Linear model) for male lambs

Impact of Spleen Size on Outcomes in Laparoscopic Splenectomy in Children

Background. The aim of our study is to compare the efficacy of laparoscopic splenectomy (LS) between enlarged spleens and normal sized spleens. Methods. From June 2006 to September 2012, 50 patients underwent LS. The patients consisted of 24 girls and 26 boys with the mean age of 8.64 years (1–18). The patients are divided into two groups according to spleen’s longitudinal length on the ultrasonography. Group I consisted of the normal sized spleens; Group II consisted of spleens that are exceeding the upper limit. Groups are compared in terms of number of ports, operative time, rate of conversion to open procedure, and length of hospital stay. Results. The mean number of ports was 3.27 and 3.46, the mean length of the operation was 116.36 min and 132.17 min, rate of conversion to open procedure was 9.09% and 10.25%, and the mean length of hospital stay was 3.36 days and 3.23 days, respectively, in Group I and Group II. Although there is an increase in the number of the ports, the operative time, rate of conversion to open procedure, and the length of hospital stay, the difference was not significant between groups (P>0.05). Conclusion. LS is safe and effective in enlarged spleens as well as normal sized spleens

Metabolic dysfu nctio n-As socia ted fatty liver disease and fibrosis status in patients with Type 2 Diabetes Treated at Internal medicine clinics: Türkiye DAHUDER awareness of fatty liver disease (TR-DAFLD) study

Background/Aims: This awareness study aimed to determine the ultrasound (US) examination rates in relation to US-confirmed metabolic dysfunction-associated fatty liver disease (MAFLD) diagnosis in internal medicine outpatients with type 2 diabetes (T2D) across Turkiye. Materials and Methods: A total of 6283 T2D patients were included in this multicenter retrospective cohort study conducted at 17 internal medicine clinics across Turkiye. The presence and indications for US performed within the last 3 years were recorded along with US-confirmed MAFLD rates, laboratory findings on the day of US, and referral rates. Fibrosis-4 (FIB-4) index was calculated to estimate the risk of advanced liver fibrosis (FIB-4 index ≥ 1.3). Results: Overall, 1731 (27.6%) of 6283 patients had US examination, which revealed MAFLD diagnosis in 69.9% of cases. In addition, 24.4% of patients with US-confirmed MAFLD were at risk of advanced fibrosis (FIB-4 index ≥ 1.3), and the referral rate was 15.5%. Conclusion: In conclusion, our findings emphasize an insufficient MAFLD awareness among clinicians and the likelihood of most of T2D patients to be at risk of living with an unknown status regarding their MAFLD and advanced fibrosis ris

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Akut pulmoner tromboemboli olgularında kardiyak biyobelirteçlern ve ekokardiyografik verilerin değerlendirilmesi

Bu çalışma Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi’nin 17.05.2011 tarih ve 2011TPF007 nolu kararı ile desteklenmiştir.Pulmoner tromboembolizm (PTE), pulmoner arter veya dallarının sistemik derin venöz sistemden, çoğunlukla bacak derin venlerinden kaynaklanan trombüs ile tıkanması sonucu oluşan, mortalite ve morbiditesi yüksek bir hastalıktır. Pulmoner tromboembolili hastalarda prognoz ve PTE türünü (masif/submasif/nonmasif) belirlemede ve tedavi seçiminde Ekokardiyografi (EKO) ile sağ ventrikül fonksiyonel durumunun değerlendirilmesi son derece önemlidir. Bu çalışmanın amacı; PTE tanısı ile kliniğimize yatırılmış hastalarda EKO bulguları ile Heart type fatty acid binding protein (HFABP), N terminal pro-brain natriüretik peptid (NT-proBNP), kardiyak Troponin-T (cTn-T-T), Kreatin Kinaz Myokard Band (CK-MB), Myoglobin (Mb) gibi kardiyak biyobelirteçlerin farklı PTE türlerinde düzeyleri ile kısa dönem mortalite üzerine etkilerinin değerlendirilmektir. Çalışmaya akut PTE tanısı konulan 42 hasta dahil edildi. Hastaların klinik değerlendirilmesi yapılarak HT, DM, KAH ve kanser gibi komorbidite varlığı ile PTE için major risk faktörleri sorgulandı. İlk 2 saat içerisinde AKG, D-dimer, CRP, cTn-T-T, CK-MB, Myoglobin, NT-proBNP ve HFABP analiz edildi ve transtorasik ekokardiyografide hastaların özellikle sağ ventrikül çapları ve fonksiyonları, Triküspit kapak yetmezlikleri, sistolik ve ortalama pulmoner arter basınçları, interventriküler septal hareketleri, ventrikül içi aktif trombus varlığı değerlendirildi. Kardiyak biyobelirteçler ve EKO?ları trombolitik tedavi alan hastalarda 24. saatte ve tüm hastalarda 6 ay sonra tekrarlandı. Tedavinin 6. ayında da tekrarlandı. Sistolik PAB için 47,5mmHg değeri cut-off olarak kabul edildiğinde, %93 sensitivite ve %71 spesifite ile trombolitik tedavi öngörülebilir. PTE hastaları ağırlaştıkça NT-proBNP düzeyleri giderek artmaktadır. NT-proBNP için cut-off değeri 131,4pg/mL kabul edildiğinde %93 sensitivite ve %72 spesifite ile trombolitik tedavi öngörülebilir. Benzer şekilde HFABP düzeyleri en çok masif PTE grubunda artmaktadır ve cut-off değeri 1,4ng/mL kabul edildiğinde %87 spesifite, %88 sensitivite ile trombolitik tedaviyi öngördürebilir. PTE hastalarımızda kısa dönem (6 aylık) toplam mortalite oranı %29,3; PTE?den ölüm oranı %7,3 ve ölüm dışı komplikasyon gelişme oranı ise %12,2 olarak saptanmıştır. PTE'ye bağlı ölüm ve komplikasyonlar en sık masif PTE hastalarında gözlenmiştir.Pulmonary thromboembolism (PTE) is a disease with high morbidity and mortality caused by occlusion of the pulmonary arteries or their branches by thrombus coming from deep systemic veins generally from deep leg veins. Evaluation of the right ventricular functional status via echocardiography is very important to decide PTE type (massive/submassive/nonmassive), treatment modality and prognosis in patients with pulmonary embolism. Aim of that study is evaluation of cardiac biomarkers such as Heart type fatty acid binding protein (HFABP), N terminal pro-brain natriüretik peptid (NT-proBNP), cardiac Troponin-T (cTn-T-T), Creatinine Kinase Miocardial Band (CK-MB), Myoglobin (Mb) and their effects on short term mortality in different types of PTE together with echocardiographic data in PTE patients hospitalised to our clinic. 42 patients with PTE were included into the study. Clinical evaluation was made and comorbidies such as hypertension, diabetes mellitus, coronary artery disease, cancer were questioned together with major risk factors for PTE. Arterial blood gases, D-dimer, CRP, cTn-T-T, CK-MB, Myoglobin, NT-proBNP and HFABP were analysied in first 2 hours and right ventricul diameter and functions, tricupid valvular insufficiency, systolic and mean pulmpnary pressures, interventriculer septal movements and active thrombus in the ventricle were all analysed via echocardiography. These cardiac biomarkers and echocardiography were repeated in 24 th hour in patients having thrombolytic therapy and in all patients after 6 month. If cut-off point accepted as 47,5 mmHg for systolic PAB, thrombolytic therapy could be predicted with 93% sensitivity and 71% spesificity. NT-proBNP levels gradually increases as PTE severity increases. If cut-off point accepted as 47,5 mmHg for systolic PAB, thrombolytic therapy could be predicted with 93% sensitivity and 71% spesificity. If cut-off point accepted as 131,4pg/mL for NT-proBNP, thrombolytic therapy could be predicted with 93% sensitivity and 72% spesificity. Similarly, HFABP increases mostly in massive PTE group, and if cut-off point accepted as 1,4ng/mL, it could predict thrombolytic therapy with 88% sensitivity and 87% spesificity. Short term (6 months) mortality was 29.3% and mortality rate was 7.3% and complication risk out of mortality was 12.2% in our PTE patients. Complications and mortality were all seen in massive PTE cases

Gelenekselden Moderne Din Okuryazarlığının Sosyolojisi: Popüler Dini Kitaplar Örneği

Bu araştırmada Türkiye’de geniş kitlelerin beslendiği dini bilgi kaynaklarının başında gelen popüler dini kitaplardan hareketle nasıl bir din anlayışının gelişmekte olduğunun anlaşılması amaçlanmıştır. Bu anlama sürecinde geniş toplum katmanlarında ne türden dini bilgilerin dolaşımda olduğuna odaklanılmıştır. Bu amaçla Türkiye’de dini bilginin yayılım mecrası olarak kabul edilen ve dini kitapçılığın yıllardır devam edegeldiği birer merkez olarak Ankara Hacı Bayram Çarşısı ve İstanbul Yümni Pasajı kitapçıları ile derinlemesine görüşmeler yapılmıştır. Bu çerçevede uzun yıllar dini kitapçılık sektöründe toplumun okuryazarlık becerileri ile doğrudan muhatap olan kitapçıların görüşlerine başvurulmuştur. Bu yaklaşımın toplumsal gerçekliğin bir kesitine ulaşılması bakımından anlamlı olduğu düşünülmüştür. Elde edilen veriler betimsel analiz yöntemine tabi tutularak tematik kategoriler oluşturulmuştur. Bu şekilde geniş toplum kesimlerinin okuryazarlığı ve dini kitapla olan ilişkisi açığa çıkartılmaya çalışılmıştır. Çalışma ile Türk toplumunun geniş kesimlerinin dini bilgi düzeylerine dair sonuçlara ulaşılmıştır. Popüler dindarlık biçimleri, epistemolojik anlamda belirli bilgi kaynaklarını talep etmekte ve kendi dini gerçekliğine dâhil etmektedir. Bu anlamda toplumun geniş talebi uzun yıllar boyunca mistik ve menkıbevi anlatılar ile ibadet ve dua içerikli temel dini bilgi kitaplarını içermiştir. Toplumun okuryazarlık düzeyi arttıkça geleneksel dinî bilgi biçimlerine taleplerde de farklılaşma yaşanmış ve bu farklılaşma dini kitapların içerik ve form olarak değişimine neden olmuştur. Halen hem geleneksel hem de modern ve postmodern biçim ve söylemler içeren dini kitaplar geniş çaplı ilgi görmeye devam etmektedir. Klasik dini kitaplara son yıllarda ilgi azalırken popüler kültürün farklı kanallardan etki alanını genişletmesi ile geleneksel din anlayışlarını aşan yeni türler ülke çapında yaygınlaşma eğilimi göstermektedir. Bu ise dini bilginin popülerleşmesi ve söylemsel düzeyde yeniden üretiminin canlı bir örneği olarak dikkat çekmeye devam etmektedir