Modified autologous transobturator tape surgery — evaluation of short term results

Objectives: The aim of this study is to evaluate the short-term outcomes of our modified autologous transobturator tape(aTOT) technique with rectus abdominis muscle fascial graft for the treatment of female stress urinary incontinence (SUI).Material and methods: The data of 22 patients who underwent modified aTOT were recorded. Perioperative data regardingoperative time, complications and postoperative visual analogue scores were noted. Patients were assessed 18 monthsafter surgery. The primary endpoints of this study were the improvements in the International Consultation on IncontinenceQuestionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) subscores, one-hour pad test and cough stress testrates as an objective cure as well as the improvements in the PGI-I and ICIQ-FLUTS quality of life scores as a subjective cure.Results: Mean age and the mean follow-up period were 51.7 ± 9.8 years and 20.1 ± 0.9 months, respectively. Urethralhypermobility and a positive cough stress test were detected in all the patients. Mean operative time was 43.8 ± 8.1 min.and the overall complication rate was 9%. Mean VAS scores at postoperative 24 hours were 2.6 ± 1.2. At the postoperativeeighteenth month, no patient had a positive cough test and mean PGI-I score was 2 while two patients had moderateurinary incontinence according to the pad test. Pad test results, ICIQ subscores of voiding QoL, incontinence, incontinenceQoL, total score and total QoL score at baseline and eighteen months after surgery were 76.9 ± 19.9, 9.6 ± 4.1, 15.5 ± 4.0,39.5 ± 7.9, 27.9 ± 6.6, 68.4 ± 13.8 and 7.1 ± 2, 10.1 ± 2.4, 6.6 ± 2.1, 13.4 ± 4.5, 20.4 ± 4.8, 39.7 ± 9.2 respectively (p = 0.001,p = 0.004, p = 0.001, p = 0.001, p = 0.001, and p = 0.001, respectively)Conclusions: Modified aTOT is an effective and safe method with low morbidity for SUI treatment in short term

Synthesis and chemistry of endoperoxides derived from 3,4-dihydroazulen-1(2H)-one: An entry to cyclopentane-anellated tropone derivatives

Reduction of trienone 1 and subsequent treatment with acid in MeOH furnished 1-methoxy-1,2,3,4-tetrahydroazulene (13). Photo-oxygenation of 13 provided the two bicyclic endoperoxides 14 and 15. Pyrolysis of 14 and 15 gave the corresponding bis-epoxides 17 and 18, which have been synthesized also upon treatment with a catalytic amount of CoTPP (TPP = tetraphenylporphyrin). That an unusual endoperoxide-endoperoxide rearrangement has not been observed strongly supports the assumption that the carbonyl group in 2-4 is responsible for this unprecedented endoperoxide-endoperoxide rearrangement. Treatment of the endoperoxides 14 and 15 with a catalytic amount of Et3N at 0 degrees provided the azulenones 22 and 23 in high yield. Attempted cleavage of the O-O peroxide linkage in 14 and 15 with thiourea resulted, contrary to our expectation, in the formation of 22 and 23. That thiourea acts as a base instead of a reducing reagent has been observed for the first time in peroxide chemistry

A novel hydrocarbon, 8,10-dimethylidenetricyclo[7.1.1.0(2,7)]undeca-2,4,6-triene: Synthesis of benzopinane skeleton via Di-pi-methane rearrangement of benzonorbornadiene system

The [4 + 2] cycloadduct 17 of 2,3-dimethylidene-1,2,3,4-tetrahydro-1,3-methanonaphthalene and 4-phenyl-4H-1,2,4-triazole-3,5-dione (PTAD) was subjected to a tripler-sensitized di-pi-methane rearrangement. Hydrolysis of the resulting urazol 18 gave the hydrocarbon 7. Hydrolysis of 18 at lower base concentrations led to isomeric stable semicarbazides 24 and 25, which were submitted NiO2 or MnO2, oxidation, to give the target compound 7, and oxidation products 26 and 27

Lipogranuloma of the cervix in a postmenopausal patient with a uterine prolapse

Objective: Lipogranuloma is a rare inflammatory reactive process related to exogenous or endogenous lipids with an admission to the dermis and subcutis. It is described most frequently in the penis and scrotum of young adults. Lipogranuloma of the female genitalia is a rather uncommon condition. The lesion is histopathologically characterized by fat vacuoles with foreign body type giant cells and scattered lymphocytes. Case: We described an incidental lipogranuloma of the cervix in a 60-year-old woman who presented with total uterine prolapse. Conclusion: Although lipogranuloma mostly occurs in young male patients, especially in the genital tract, clinicians should be aware of this entity in the cervix of a postmenopausal woman with uterine prolapse, which may challenge the differential clinical diagnosis. © 2007 Springer-Verlag

Giant lipoleiomyoma of the uterine corpus

Objective: Lipoleiomyoma is a rare and easily recognized, benign uterine fatty tumor, composed of an admixture of mature adipocytes and smooth-muscle cells. They may associate with metabolic disorders and rarely reach giant size. Case: We report a case of symptomatic giant lipoleiomyoma of the uterine corpus that may be associated with diabetes mellitus and hypothyroidism. Conclusion: Lipoleiomyoma must be thought in the differential diagnosis of the giant uterine tumors and should be removed when diagnosed, because malignancy cannot otherwise be excluded. Also the peculiar features of this giant neoplasm, histogenesis, concomitant metabolic disorders and the diagnostic methods are discussed. © 2008 Springer-Verlag

Karadeniz Kalkan Balığının (Psetta maximaLinnaeus, 1758) Karanfil Yağı ile Bayıltılmasında Sıcaklık, Balık Büyüklüğü ve Konsantrasyonun Etkileri

Bu çalışmada, Karadeniz kalkan balığının karanfil yağı ile bayıltılmasında sıcaklık (10, 15 ve 20°C), balık büyüklüğü (57,0±11,3, 103,0±11.9 ve 457,0±89,8 g) ve konsantrasyonun (150, 300, 450 ve 600 mg L-1) bayılma ve ayılma sürelerine etkileri araştırılmıştır. Çalışmada balıklar tek tek 10, 20 ve 50 L'lik kaplarda bayıltılmış ve sürekli su değişimi sağlanan 500 L tankta ayıltılmışlardır. Su sıcaklığı, balık büyüklüğü ve karanfil yağı konsantrasyonunun bayılma ve ayılma sürelerini etkilediği belirlenmiştir (P<0,01). Su sıcaklığı 10°C'den 20°C'ye yükseldiğinde bayılma ve ayılma süreleri azalmıştır (P<0.01). Küçük balıkların bayılma ve ayılma süreleri su sıcaklığına bağlı olarak değişmesine rağmen, genel olarak büyük balıklardan daha kısa olmuşlardır. Karanfil yağı konsantrasyonu 150 mg L-1den 600 mg L-1'ye çıkarıldığında bayılma süresi 2,3 kat azalmış, buna karşılık ayılma süresi 1,92 kat artmıştır. Bütün gruplarda 150 mg L-1konsantrasyonda 4,45 dakika ve 600 mg L-1konsantrasyonda 2 dakikanın altında cerrahi anesteziye ulaşılmıştır. Ayılma süresi 4,32 dakika (150 mg L-1) ile 8,92 dakika (600 mg L-1) arasındadeğişmiştir. Elde edilen sonuçlara göre, Karadeniz kalkan balığının hızlı bayılması ve nispeten kısa sürede ayılması için 180-220 mg L-1karanfil yağı konsantrasyonlarının uygun seviyeler olduğu görülmektedir. Karanfil yağının ortalama etkili konsantrasyonu (EK50) %95 güven aralığında 190,00 ± 10,34 mg L-1hesaplanmıştır. Bu çalışma, Karadeniz kalkan balığının bayıltılmasında karanfil yağının güvenle kullanılabileceğini göstermiştir.The effects of four concentrations of clove oil (150, 300, 450 and 600 mg L-1) as ananaesthetic substance at three temperature levels (10, 15 and 20°C) and three fish size (as weight) groups (57.0±11.3, 103.0±11.9 and 457.0±89.8 g) on induction and recovery times in turbot (Psetta maxima) were investigated in this study. The fish were individually exposed to each clove oil bath in 10, 20 or 50L buckets with respect to fish size and were recovered in a 500-L tank with running seawater. Temperature, fish size and clove oil concentrations were found to have significant effects on induction and recovery times in turbot (<0.01). Induction and recovery times were both less than half when the temperature was increased from 10 to 20°C (<0.01). The duration to reach surgical anaesthesia and recovery times of small size turbot varied in relation to temperature, but were generally shorter than big size turbot (<0.01). Overall, the increase of clove oil concentration from 150 to 600 mg L-1decreased the induction time by a factor of 2.3 but on the contrary, prolonged the full recovery time by a factor of 1.92. The surgical anesthesia was attained in all the groups under 4.45 min at 150 mg L-1or even under 2 min at 600 mg L-1clove oil concentration. However, the time of recovery ranged from 4.32 min (150 mg L-1) to 8.29 min (600 mg L-1). Based on our results, the clove oil concentrations around 180-220 mg L-1 appeared to be adequate to be used for fast anaesthesia and relatively short recovery time for turbot. Mean effective concentration (EC50) of clove oil was calculated as 190.00 ± 10.34 mg L-1 with 95% confidence limits for overall three temperature and fish sizes. This study has demonstrated that clove oil can be safely and effectively used in the anaesthesia of turbot

Tanycytic ependymoma of the spinal cord: Case report

Tanycytic ependymoma is a rare fibrillary variant of ependymoma with preferentially located along the length of spinal cord. This report documents a 41-year-old woman underwent surgical treatment for a cervical intramedullary tumor. Magnetic resonance imaging showed intramedullary cystic lesion, in the cervical spine. Histologically the tumor was consisted of markedly elongated spindle-shaped cells, which were immunopositive for glial fibrillary acidic protein and EMA. Although only a few in number, detection of ependymal rosettes led the diagnosis as a tanycytic ependymoma. Since a complete resection was performed at surgery, no further treatment was proposed. It is important for both management and prognosis, to distinguish pathologically tanycytic ependymoma from pilocytic astrocytoma and schwannoma

The effects of intestinal ischemia on the levels of serum immunoglobulin A in rats

Many biochemical markers have been investigated in intestinal ischemia. However, the effects of intestinal ischemia on the level of serum immunoglobulin A (IgA) has apparently not been investigated in the literature, although the gastrointestinal system is one of the main sources of serum IgA. The aim of our study was to evaluate the changes of serum IgA levels during intestinal ischemia of varying duration in rats. Group 1 (n = 5) was created for control purposes, including the detection of the baseline values and the effects of the anesthetic agents. Group 2 (n = 20) rats underwent sham laparotomy. Group 3 (n = 20) had 50% of small intestine ischemia by the strangulated obstruction model. Serum samples were obtained by cardiac puncture 1 h after anesthetic agents were given in group 1. On the other hand, serum and intestine samples were obtained at 1 (T1, n= 5), 2 (T2, n= 5), 4 (T4, n=5) and 6 (T6, n= 5) h after the operation in groups 2 and 3. The levels of serum IgA, lactic dehydrogenase (LDH) and alkaline phosphatase (ALP) were determined. Pathologic specimens were graded in a masked manner. IgA levels were abruptly decreased to 8.49 ± 1.58 mg/dl in rats with intestinal ischemia at 1 h after the operation. This decrease in serum IgA at T1 in group 3 was statistically significant compared with the control and sham-operated groups (18.80 ± 1.15 mg/dl, 22.07 ± 1.54 mg/dl, respectively; P<0.01). On the other hand, IgA levels were significantly elevated at T2 in the sham-operated group compared with control and intestinal ischemia groups (26.99 ± 2.96 mg/dl, 18.80 ± 1.15 mg/dl, 14.354 ± 2.62 mg/dl, respectively; P < 0.05). The serum IgA levels decreased to above baseline values at T6 in group 2 (19.60 ± 2.78 mg/dl), while they increased to below baseline values in group 3 (17.60 ± 1.28 mg/dl). In group 3, IgA levels were elevated to baseline values, while a significant ischemia occurred at 4 and 6 h after operation. These results suggested that serum IgA is affected earlier by intestinal ischemia and intestinal manipulation. The increase in serum IgA levels may be related to stimulation of the local immune responses in the intestine. On the other hand, abruptly decreasing serum IgA levels in this experimental study may be related to inadequate transport of the synthesized IgA to the systemic circulation, because serum IgA levels were returned to baseline values while a significant ischemia occurred at T4 and T6. According to these results, we conclude that serum and peritoneal fluid IgA levels may be changed by intestinal ischemia and may be used to make an early diagnosis of intestinal ischemia in humans

Infarction after fine needle aspiration biopsy of pleomorphic adenoma of the parotid gland: A case report

BACKGROUND: Fine needle aspiration (FNA) is a well-established and safe method for the rapid diagnosis of pleomorphic adenoma. A few clinically important complications, including bleeding, infection and inflammatory reactions, result from FNA. In a small number of cases FNA has been followed by varying degrees of necrosis in some organs. In the literature there are a few reports associated with necrosis in a pleomorphic adenoma of the parotid gland following FNA. CASE: A 27-year-old female had a two-year history of a right parotid mass. FNA revealed pleomorphic adenoma. A histologic diagnosis of pleomorphic adenoma of the right parotid with infarction was made. CONCLUSION: Necrosis associated with infarction may cause diagnostic problems. It is not a sufficient sign of malignant transformation