Coexistence of Colon Cancer and Diverticilutis Complicated with Diverticular Abscess

Coexistence of a diverticular abscess and colorectal cancer is an extremely rare phenomenon. The clinical presentation and the extension of a diverticular abscess could cause mis-staging of colon cancer. We are presenting an overstaged colon cancer due to a diverticular abscess penetrating into the abdominal wall. A 65-year-old male patient with a history of an enlarging mass in the left lower quadrant of the abdomen was admitted to our service. Diagnostic studies revealed a sigmoid tumor communicating with an abdominal wall mass. The patient was clinically staged as T4 N1. Exploration revealed a diverticular abscess penetrating into the abdominal wall and a sigmoid tumor. Histopathological examination reported an intermediately differentiated T3 N0 adenocarcinoma of the sigmoid colon. After an uneventful postoperative recovery, the patient was referred to chemotherapy. [Arch Clin Exp Surg 2015; 4(4.000): 231-233

A Rare Causing of Difficulty in Defecation: Rectal Schwannoma

Objective: Schwannomas are mainly benign, non-epithelial tumors originating in the Schwann cells, which form nerve sheaths. Schwannomas account for about 2-8% of all gastrointestinal mesenchymal tumors, encountered more frequently in the stomach and the small intestine. Schwannomas of the colon and rectum are extremely rare. Case Presentation: In this report, we present a thirty-nine-year-old woman admitted for complaints of rectal fullness and difficulty in defecation. At her rectal examination, a polypoid tumor 22x27x27mm in size was found filling the lumen of the rectum; it was well defined, with a homogeneous nature and benign appearance. Complete excision of the tumor was achieved by a transanal surgical approach. Histolopathological and immunohistochemical diagnosis of the tumor reported a rectal schwannoma. There has been no tumor recurrence at 18 months after surgical excision. Conclusion: A schwannoma of the rectum is rare; a benign tumor can usually be separated from GISTs with immunohistochemical staining, and it carries a good prognosis with local excision, which is the procedure of choice. [Arch Clin Exp Surg 2014; 3(1.000): 59-63

Spindle Cell Metaplastic Breast Cancer: Case Report

Objective: Spindle cell metaplastic breast cancer is a subtype of breast cancer, which is very rare and difficult to diagnose. There is no specific symptom in differentiation from the other breast cancers. It can only be diagnosed by histopathologic examination. Case Presentation: A 51-year-old woman presented with a mass on her left breast and invasive breast carcinoma at tru-cut needle biopsy was diagnosed. She underwent a modified radical mastectomy and axillar dissection, and histopathologic examination revealed spindle cell breast cancer. Cytokeratin and vimentin expressions were positive in immunohistochemical examination. Conclusion: Spindle cell metaplastic breast cancer must be considered in differential diagnosis of breast cancers, and preoperative immunohistochemical examination, including cytokeratin and vimentin, must be added to pathological examination in intervening cases. [Arch Clin Exp Surg 2013; 2(4.000): 259-262

Prognostic Value of the Lymph Node Ratio in Rectal Cancer

Objective: The pathologic staging of rectal cancer is an important prognostic factor. A sufficient number of harvested lymph nodes is necessary for accurate staging. In patients with an insufficient number of dissected lymph nodes, the lymph node ratio (LNR) can be used as a prognostic factor. The aim of this study was to determine the effect of the LNR on the prognosis of patients with rectal cancer. Materials and Methods: A total of 130 patients who had rectal adenocarcinoma and who underwent surgery between 1996 and 2011 were included in this study. Age, gender, serum carcinoembryonic antigen, type of surgery, and pathological features were retrieved retrospectively. Cut-off values for LNR were 1/12, 1/4, and 1/2; patients were stratified into four groups according to this ratio. The relationship between disease-free survival (DFS) and overall survival (OS) and LNR was investigated. Cumulative survival curves were calculated by the Kaplan Meier method, and survival differences between groups were calculated by the log-rank test. Results: The mean number of lymph nodes examined was 11.5+/-8. In 75 of all patients (57.7%), fewer than 12 lymph nodes were harvested. Seventy-six patients (58.5%) were evaluated as N0, 35 (26.9%) were N1, and 19 (14.6%) were N2. The number of patients in these LNR groups was 87 (66.9%), 13 (10%), 17 (13.1%), and 13 (10%), respectively. The 5-year survival rate was found to be 72.3% in the LNR1 group, 55.6% in the LNR2 group, 44.4% in the LNR3 group, and 22.2% in the LNR4 group. The difference in OS and DFS rates was significant (p<0.001 for both). Conclusion: The LNR for rectal cancer has a prognostic effect on both DFS and OS. Thus, it may be beneficial for adjuvant therapy decisions, especially in patients with an insufficient number of dissected lymph nodes. [Arch Clin Exp Surg 2014; 3(4.000): 207-212

Quantitative information extraction from gas sensor data using principal component regression

Several experiments are conducted using two industrial gases (toluene and ethanol) to validate the approach. The new approach is also compared with two classic principal component regression (PCR) methods. The results show that the new approach performs better than the classic PCR approaches

The Efficacy of Probiotic (Lactobacillus rhamnosus GG) and 5-ASA (Aminosalicylic Acid) in the Treatment of Experimental Radiation Proctitis in Rats

The aims of the study are to demonstrate the effect of probiotic use on the healing of radiation proctitis (RP) and evaluate the efficiency of fecal biomarkers at follow-up of the treatment. Thirty-two male/female rats were randomly separated into four groups of eight rats. The first group (control) was not radiated. RP was created by 17.5 Gy single dose rectal irradiation. The second group (RP) was subjected to RP, but not treated. The third group (RP+ASA) was treated with 5-aminosalicylic acid (5-ASA) 250 mg/kg daily by gastric lavage for 14 days after the irradiation, and the forth group (RP+LGG) was treated with Lactobacillus GG (LGG) 25x100 million CFU daily. Feces samples were taken at the 7th and 14th day of the treatment for fecal biomarkers. Rectums of the rats were resected at the 14th day by laparotomy. Samples were evaluated both macroscopically and microscopically. RP was achieved both macroscopically and microscopically. Weight loss of RP group is statistically significant (p<0.005) than other groups. The healing ratio of RP+ASA and RP+LGG groups was significantly better than the RP group (p<0.005) both macroscopically and microscopically. But there was no significant difference between ASA and LGG groups. Biochemically, fecal calprotectin was found to be more effective than fecal myeloperoxidase and fecal lactoferrin to show the efficacy of treatment of radiation proctitis. The results of our study demonstrate that probiotic is as effective as 5-aminosalicylic in the treatment of radiation proctitis, and fecal calprotectin is a useful biomarker in determining the response to the treatment

Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus

Background Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS