Revisiting stapled and handsewn loop ileostomy closures: a large retrospective series

OBJECTIVE: To compare the surgical outcomes of stapled and handsewn closures in loop ileostomies. METHODS: The data of 225 patients requiring loop ileostomies from 2002 to 2007 were retrospectively evaluated. The patients underwent partial small-bowel resections and either handsewn or stapled anastomoses for the ileostomy closures. They were followed up postoperatively with routine surgical examinations. RESULTS: The study group consisted of 124 men and 101 women with a mean age of 49.12 years. The ileostomy closure was performed with handsewn in 129 patients and with stapled in 96 patients. The mean time to the first postoperative flatus was 2.426 days in the handsewn group and 2.052 days in the stapled group (p <0.05). The mean time to the first postoperative defecation was 3.202 days in the handsewn group and 2.667 days in the stapled group (p <0.05). The mean duration of patient hospital stay was 8.581 days for the handsewn group and 6.063 days for the stapled group (p <0.05). CONCLUSIONS: Patients who underwent ileostomy closure with stapled recovered faster in the postoperative period and required shorter hospital stays than those whose closures were performed with handsewn. In our opinion, stapled should be considered the gold standard for loop ileostomy closure

An Alternative Surgical Procedure for a Patient with Critically Restenosed and Kinked Carotid Artery: Graft Interposition

According to the literature data, the prevalence of restenosis after carotid endarterectomy ranges between 6 and 36%. The etiological factor is intimal hyperplasia for early period, whereas it is atherosclerosis for late period. A 67-year-old male patient admitted to our clinic with a history of headache and minor stroke. His medical history was significant for right carotid endarterectomy 8 years ago. Recent Doppler ultrasound and digital substraction angiography revealed 75% stenosis and kinking corresponding to the segment distal to the endarterectomy region. Surgical endarterectomy is the treatment of choice in critical carotid stenosis. Endovascular therapy is primarily considered for patients if there is restenosis after carotid endarterectomy. However, the treatment modality is controversial in cases with concomitant carotid stenosis and kinking of internal carotid artery. We present our surgical approach to a case with significant stenosis and kinking of internal carotid artery. We performed a 6-mm-PTFE graft interposition between common and internal carotid artery and resection of the kinking segment

Understanding the effects of chitosan, chia mucilage, levan based composite coatings on the shelf life of sweet cherry

Sweet cherry (Prunus avium L.) fruits are prone to quality and quantity loss in shelf-life conditions and cold storage due to their short post-harvest life. Until now efforts have been made to extend the shelf life of the sweet cherry. However, an efficient and commercially scalable process remains elusive. To contribute to this challenge, here in this study, biobased composite coatings consisting of chitosan, mucilage, and levan, were applied on sweet cherry fruits and tested for postharvest parameters in both market and cold storage conditions. Results demonstrated that the shelf life of sweet cherries can be extended until the 30th day while retaining important post-harvest properties like decreased weight loss, fungal deterioration, increased stem removal force, total flavonoid, L-ascorbic acid, and oxalic acid. Given the cost-effectiveness of the polymers used, the findings of this study indicate the feasibility of extending the shelf-life of sweet cherries on a larger scale

Atherosclerosis burden and coronary artery lesion complexity in acute coronary syndrome patients

Background: Syntax score (SS) is a prognostic marker in patients with acute coronary sydromes (ACS). Carotid intima media thickness (CIMT) and cardio ankle vascular index (CAVI) are well known surrogate marker of atherosclerosis burden. But association between atherosclerosis burden and coronary artery disease (CAD) complexity in ACS patients has not been investigated yet. Methods and Results: Consecutive patients with first time diagnosis of ACS (n = 172) were enrolled. SS, a marker of CAD complexity, was assessed by dedicated computer software. CIMT was examined by B-mode ultrasound. CAVI was assessed by VaSera VS-1000 cavi instrument. SS for low, intermediate and high tertiles of CIMT value were 10.1 &#177; 8.2 vs 11.4 &#177; &#177; 7.9 and 15.2 &#177; 8.8; p = 0.02). SS for normal, borderline and abnormal CAVI values were 4 &#177; 3.7 vs 11.1 &#177; 7.2 and 14.1 &#177; 9.1, respectively p = 0.009). Also, there was independent association between SS and CIMT (95% coinfidence interval [CI] 2.1&#8211;19, p = 0.014) and CAVI (95% CI 15&#8211;29, p = 0.021]. Neither traditional cardiovascular risk factor nor thrombolysis in myocardial infarction (TIMI) risk score was independent determinant of SS. Conclusions: We have shown that patients with higher atherosclerosis burden have more complex coronary artery lesions. Also these patients may be identified early by using surrogate markers of atherosclerosis. Its clinical significance requires further research

Biochemical fingerprint of colorectal cancer cell lines using label-free live single-cell Raman spectroscopy

Label-free live single-cell Raman spectroscopy was used to obtain a chemical fingerprint of colorectal cancer cells including the classification of the SW480 and SW620 cell line model system, derived from primary and secondary tumour cells from the same patient. High-quality Raman spectra were acquired from hundreds of live cells, showing high reproducibility between experiments. Principal component analysis with linear discriminant analysis yielded the best cell classification, with an accuracy of 98.7±0.3% (standard error) when compared to discrimination trees or support vector machines. SW480 showed higher content of the disordered secondary protein structure amide III band, whereas SW620 showed larger α-helix and β-sheet band content. The SW620 cell line also displayed higher nucleic acid, phosphates, saccharide, and CH2 content. HL60, HT29, HCT116, SW620 and SW480 live single-cell spectra were classified using PCA/LDA with an accuracy of 92.4±0.4% (standard error), showing differences mainly in the β-sheet content, the cytochrome C bands, the CH-stretching regions, the lactate contributions and the DNA content. The lipids contributions above 2900 cm-1 and the lactate contributions at 1785 cm-1 appeared to be dependent on the colorectal adenocarcinoma stage, the advanced stage cell lines showing lower lipid and higher lactate content. The results demonstrate that these cell lines can be distinguished with high confidence, suggesting that Raman spectroscopy on live cells can distinguish between different disease stages, and could play an important role clinically as a diagnostic tool for cell phenotyping

Effect of different irrigant activation protocols on push-out bond strength

Erdemir, Ali/0000-0003-1140-3887; Erdemir, Ali/0000-0002-6489-9620WOS: 000362583600013PubMed: 26022731The study aimed to evaluate the effect of various final irrigant activation protocols on push-out bond strength of fiber post. Thirty-two single-rooted human maxillar central teeth were sectioned below the cementoenamel junction, instrumented and obturated. Post-space preparation was performed, and roots were randomly divided into eight groups (n = 4) according to the final irrigant activation protocols; distilled water was used as an irrigant in group 1. The other groups were treated with 2.5 % NaOCl and 17 % EDTA. Conventional syringe irrigation (CSI, no activation) was used in group 2. Irrigation solutions were activated using passive ultrasonic irrigation (PUI, group 3), EndoVac apical negative pressure (ANP, group 4), diode laser (group 5), neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (group 6), erbium:yttrium-aluminum-garnet (Er:YAG) laser (group 7), and Er:YAG laser using with photon-induced photoacoustic streaming (PIPS (TM)) technique (group 8). In all groups, fiber posts (White Post DC, FGM) were luted using Panavia F 2.0 (Kuraray, Osaka, Japan). The specimens were transversally sectioned, and all slices from coronal and apical regions were subjected to push-out tests. The data were calculated as megapascals and analyzed by using two-way analysis of variance followed by post hoc Tukey honestly significant difference (HSD) tests. Removing the smear layer increased the bond strength to dentine when compared with the control group (p < 0.05). The highest bond strength was obtained in the PIPS laser-activated irrigation group (p < 0.05). Coronal root region presented significantly higher bond strength than the apical region (p < 0.05). PIPS laser-activated irrigation showed higher efficiency as a final irrigant activation protocol on push-out bond strength of fiber post.Scientific Research Projects Coordination Center of Kirikkale University, Kirikkale, TurkeyKirikkale University [2012/93]This research, as part of the doctoral thesis of Dr. Sefika Nur Akyuz Ekim, was supported by the Scientific Research Projects Coordination Center (project no: 2012/93) of Kirikkale University, Kirikkale, Turkey. The authors would also like to thank Dr. Zafer Kazak for his kindness in helping and for supplying the laser devices from Medikadent/Turkey