Comparison of standard 4-row versus 6-row3-D linear cutter stapler in creation of gastrointestinal system anastomoses: a prospective randomized trial

OBJECTIVE: This prospective study was conducted to compare the clinical outcomes of a 6-row 3-D linear cutter with the standard 4-row linear cutter in patients who underwent elective gastrointestinal surgery anastomosis. METHOD: Patients who underwent elective open gastrointestinal surgery that included stapled anastomosis using a linear cutter (Proximate®, Ethicon Endo-Surgery, Cincinnati, OH) between January 2011 and May 2011 were included in the study. The patients were randomly assigned to two groups according to the linear cutter that was used in the surgery: the standard 4-row cutter (the S group) or the new 6-row cutter (the N group). The groups were compared based on the patient demographic data, the laboratory parameters, the preoperative diagnosis, the surgery performed, the operation time, intra-or postoperative complications, the time to oral tolerance and the length of the hospital stay. RESULTS: The S group included 11 male and nine female patients with a mean age of 65 ± 12 (35-84) years, while the N group included 13 male and eight female patients with a mean age of 62 ±11 (46-79) years (p =0.448, p = 0.443, respectively). Anastomotic line bleeding was observed in eight (40%) patients in the S group and in one (4.7%) patient in the N group (p = 0.006). Dehiscence of the anastomosis line was observed in two (10%) patients in the S group and none in the N group (p =0.131). Anastomotic leakage developed in three (15%) patients in the S group and in one (4.7%) patient in the N group (p = 0.269). The mean hospital stay was 12.65 ± 6.1 days in theS group and 9.52 ± 2.9 days in the N group (p = 0.043). CONCLUSION: The 6-row 3-D linear cutter is a safe and easily applied instrument that can be used to create anastomoses in gastrointestinal surgery. The new stapler provides some usage benefits and is also superior to the standard linear cutter with regard to anastomotic line bleeding

Glaucoma after Penetrating Keratoplasty: Incidence, Risk Factors, and Management

Purpose. To report the incidence and risk factors for postkeratoplasty glaucoma (PKG), as well as its management. Subjects and Methods. 122 eyes, (43% with pseudophakic and aphakic bullous keratopathy (PABK)) which underwent penetrating keratoplasty (PK), were analyzed. Results. The rate of PKG development was 34% within 39 months of follow-up. PABK, corneal perforations, keratitis, and previous high intraocular pressure (PHIOP) were high risk factors for PKG. Glaucoma was controlled medically in 62% of PKG cases. Surgery (Ex-PRESS shunt in 63%) and diode laser cyclophotocoagulation were applied in others (38%). The rate of postoperative complications and graft survival was similar in eyes with and without PKG. Conclusion. PHIOP, preoperative diagnoses other than keratoconus, and corneal dystrophies were highly associated with PKG. Ex-PRESS shunts were effective in refractory PKG. If glaucoma is controlled, it is possible to obtain similar rates of graft survival and postoperative complications in eyes with and without PKG

A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

OBJECTIVE: This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations. METHODS: A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99) or a regular diet (n = 100). Patients’ characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed. RESULTS: The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3), defecation (3.4±0.77 vs. 4.38±1.18) and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81) were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5) was shorter in the early feeding group. CONCLUSIONS: The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions

Do Leadership Styles Influence Organizational Health? A Study in Educational Organizations

This research aims to investigate the effect of leadership styles of school principals on organizational health. Causal-comparative research model was used to analyze the relationships between leadership types and organizational health. For data collection, a Likert type Multifactor Leadership scale questionnaire and Organizational Health scale were administered to 151 teachers working primary and secondary schools in Osmaniye city. Data were analyzed by using multiple regression analysis method. Findings of this study indicated significant relationships between school principals' leadership styles and health of schools, that leadership style of school leaders influence organizational health level of a school. Transformational leadership style was also found out to be closely related to a healthy school environment while transactional leadership style is negatively correlated with organizational health. Individual consideration, inspirational motivation, idealized influence, and intellectual stimulation sub-dimensions are found to effective in the formation of organizational health. In the light of the findings, some recommendations were also presented

Synthesis and evaluation of lipase inhibitory activities of substituted 1,2,4-triazole derivatives

Pancreatic lipase (PL) plays a major role in the hydrolysis of dietary triglycerides to monoglycerides and free fatty acids in the small intestine before absorption of fats. The excessive consumption of dietary fat (triglyceride) and not to utilize it for energy production can cause an increase in obesity. Obesity is one of the serious health problem in the world and leads to many diseases such as some types of cancer, heart disease, gallstones, sleep apnea, fatty liver disease, type-2 diabetes, hypertension, coronary artery disease. Therefore, lipase is the target enzyme to prevent these diseases and the inhibitors of lipase are very important molecules as drug candidate molecules. In this study, fifteen new heterocyclic compounds have been synthesized starting from 2-[3-(4-chlorobenzyl)-5-(4-chlorophenyl)-1H-1,2,4-triazol-4-yl]-acetohydrazide and their anti-lipase activities have been examined. According to in vitro inhibition studies, molecule 2e is found to be the most potent inhibitor with the lowest IC50 value. Docking studies' results have substantially supported this result and it is seen that compound 2e is one of the four molecules with the highest binding affinity. This molecule binds to the enzyme in its binding pocket by means of weak interactions with mainly Ile79, Asp80, Val260, Arg257 and His264.

Synthesis and evaluation of lipase inhibitory activities of substituted 1,2,4-triazole derivatives

1409-1417Pancreatic lipase (PL) plays a major role in the hydrolysis of dietary triglycerides to monoglycerides and free fatty acids in the small intestine before absorption of fats. The excessive consumption of dietary fat (triglyceride) and not to utilize it for energy production can cause an increase in obesity. Obesity is one of the serious health problem in the world and leads to many diseases such as some types of cancer, heart disease, gallstones, sleep apnea, fatty liver disease, type-2 diabetes, hypertension, coronary artery disease. Therefore, lipase is the target enzyme to prevent these diseases and the inhibitors of lipase are very important molecules as drug candidate molecules. In this study, fifteen new heterocyclic compounds have been synthesized starting from 2-[3-(4-chlorobenzyl)-5-(4-chlorophenyl)-1H-1,2,4-triazol-4-yl]-acetohydrazide and their anti-lipase activities have been examined. According to in vitro inhibition studies, molecule 2e is found to be the most potent inhibitor with the lowest IC50 value. Docking studies' results have substantially supported this result and it is seen that compound 2e is one of the four molecules with the highest binding affinity. This molecule binds to the enzyme in its binding pocket by means of weak interactions with mainly Ile79, Asp80, Val260, Arg257 and His264

Cephalometric Evaluation of Turkish Children With Class III Malocclusion in the Mixed Dentition

Objective:To investigate the cephalometric characteristics of Turkish children with Class III malocclusion and compare them with to those of children with clinically normal occlusion during the mixed dentition phase.Materials and Method:Lateral cephalometric radiographs of 80 children with Class III malocclusion (mean age, 10.23 years) and 80 subjects with normal occlusion (mean age, 10.79 years) were examined for the study. Mean values of 13 linear and 21 angular cephalometric parameters were measured and compared.Results:Sagittal skeletal measurements included SNB (Class III, 81.82 ± 4.26; control group, 74.5 ± 3.86; p<.001), ANB (Class III, −2.35 ± 2.02; control group, 2.4 ± 1.17; p<.0001), Pg to Nasion vertical (Class III, −5.70 ± 2.68; control group, −9.60 ± 3.21; p<.05), Wits appraisal (Class III, −5 ± 4.57; control group, −0.8 ± 2.44; p<.05), Co-A (Class III, 79.38 ± 2.19; control group, 83.94 ± 2.64; p<.01) and Co-Gn (Class III, 105.7 ± 2.04; control group, 102.4 ± 1.15; p<.05). Vertical skeletal analysis included Gonial angle (Class III, 132.6 ± 7.15; control group, 122.1 ± 6.6; p<.01), and S-Ar length (Class III, 28.31 ± 0.9; control group, 30.2 ± 1.4; p<.05). Dentoalveolar measurements included U1 to SN (Class III, 107.96 ± 8.13; control group, 98.4 ± 8.19; p<.05). Soft tissue measurements included soft tissue convexity (Class III, 173.4 ± 3.68; control group, 165.9 ± 3.25; p<.01).Conclusion:The findings of the study indicated that effective mandibular length was larger in Class III groups and effective maxillary length was smaller in Class III groups

Clinical Study Glaucoma after Penetrating Keratoplasty: Incidence, Risk Factors, and Management

properly cited. Purpose. To report the incidence and risk factors for postkeratoplasty glaucoma (PKG), as well as its management. Subjects and Methods. 122 eyes, (43% with pseudophakic and aphakic bullous keratopathy (PABK)) which underwent penetrating keratoplasty (PK), were analyzed. Results. The rate of PKG development was 34% within 39 months of follow-up. PABK, corneal perforations, keratitis, and previous high intraocular pressure (PHIOP) were high risk factors for PKG. Glaucoma was controlled medically in 62% of PKG cases. Surgery (Ex-PRESS shunt in 63%) and diode laser cyclophotocoagulation were applied in others (38%). The rate of postoperative complications and graft survival was similar in eyes with and without PKG. Conclusion. PHIOP, preoperative diagnoses other than keratoconus, and corneal dystrophies were highly associated with PKG. Ex-PRESS shunts were effective in refractory PKG. If glaucoma is controlled, it is possible to obtain similar rates of graft survival and postoperative complications in eyes with and without PKG

The Phenolics and Antioxidant Properties of Black and Purple versus White Eggplant Cultivars

The total phenolic content, anthocyanins, phenolic acids, antioxidant capacity and α-amylase inhibitory activity of black (Aydin Siyahi), purple (Kadife Kemer) and white (Trabzon Kadife) eggplants grown in Turkey were subjected to a comparative investigation. The black cultivar exhibited the highest total phenolic (17,193 and 6552 mg gallic acid equivalent/kg fw), flavonoid (3019 and 1160 quercetin equivalent/kg fw) and anthocyanin (1686 and 6167 g delphinidin-3-O-glucoside equivalent/kg fw) contents in crude extracts of the peel and pulp. The majority of the caffeic acid was identified in the ester (2830 mg/kg fw) and ester-bound (2594 mg/kg fw) forms in the peel of ‘Kadife Kemer’ and in the glycoside form (611.9 mg/kg fw) in ‘Aydin Siyahi’, as well as in the pulp of these two eggplants. ‘Kadife Kemer’ (purple eggplant) contained the majority of the chlorogenic acid in free form (27.55 mg/kg fw), compared to ‘Aydin Siyahi’ in the ester (7.82 mg/kg fw), glycoside (294.1 mg/kg dw) and ester-bound (2.41 mg/kg fw) forms. The eggplant cultivars (peel and pulp, mg/kg fw) exhibited a relatively high delphinidin-3-O-rutinoside concentration in the peel of ‘Aydin Siyahi’ (avg. 1162), followed by ‘Kadife Kemer’ (avg. 336.6), and ‘Trabzon Kadife’ (avg. 215.1). The crude phenolic extracts of the eggplants exhibited the highest antioxidant capacity values (peel and pulp, µmoL Trolox equivalent/kg fw) of 2,2-diphenyl-1-picrylhydrazyl (DPPH, 8156 and 2335) and oxygen radical absorbance capacity (ORAC, 37,887 and 17,648). The overall results indicate that black and purple eggplants are the cultivars with greater potential benefits in terms of their phenolics and antioxidant values than the white eggplant