Torasemide Improves the Propionic Acid-Induced Autism in Rats: A Histopathological and Imaging Study

Objective: Autism spectrum disorder is a neurodevelopmental disease in which impaired social behaviors, impaired sociality, and restricted and repetitive behaviors are seen. Bumetanide is a loop diuretic that inhibits Na+-K+-2Cl(-) cotransporter 1 and it is currently used in clinical phase studies in patients with autism spectrum disorder. In present research, it is purposed to demonstrate the beneficial effects of torasemide which is another Na+-K+-2Cl(-) cotransporter 1 inhibitor on an experimental autism model induced with propionic acid by providing imaging and brain tissue investigations. Methods: Male Wistar rats were used in the present study (n = 30). Propionic acid of 250 mg/kg/day was administrated intraperitoneally in rats to induce autism for 5 days. Three groups were created for present study as follows: group 1, normal control (n = 10); group 2, propionic acid and saline given group (n = 10); group 3, propionic acid + torasemide -administrated group (n = 10). Results: Torasemide group scored higher on behavioral tests compared to saline group. The brain levels of malondialdehyde, tumor necrosis factor-alpha, interleukin-2, interleukin-17, and Nuclear Factor kappa B (NF-kappa B), Glial fibrillary acidic protein (GFAP) were remarkably higher in propionic acid + saline group. In histopathology assessments, torasemide group had higher neuronal count of Cornu Ammonis 1, neuronal count of Cornu Ammonis 2 in hippocampus, and Purkinje cells in cerebellum. GFAP immunostaining index (Cornu Ammonis 1) and cerebellum were lower in torasemide group. Magnetic resonance spectroscopy revealed that mean lactate value was higher in propionic acid + saline group compared to torasemide group. Conclusion: Our experimental results showed that torasemide might enhance gamma-aminobutyric acid activity. Torasemide can be considered another promising Na+-K+-2Cl(-) cotransporter 1 inhibitor in the treatment of autism with a longer half-life and less side effects after further studies

A Rare Case For Awareness: Metaplastic Carcinoma of Breast

DergiPark: 379065tmsjAims: Metaplastic breast carcinoma is an infrequent kind of breast carcinoma, more aggressive and has poorer prognosis than other breast carcinomas. With this case report, we aim to reveal pathologic and clinical features of the metaplastic breast carcinoma and its similarities to ductal invasive carcinoma. However its differentation is possible and should not be skipped in diagnosis. Case Report: A BIRADS category of 4c mass that measured 38x31 mm in the ultrasonography was detected in a 71-year-old female patient who applied with a complaint of a palpable mass under the right areola. The result of biopsy was interpreted morphologically as spindle cell proliferation containing necrosis. Thereafter, the mass was excised with simple mastectomy. The results of the immunohistochemical examination of the tumor with the diameter of 6 cm revealed progesterone receptor, estrogen receptor and HER2 to be negative, p63 staining to be positive. The mass was histopathologically diagnosed as metaplastic carcinoma with well differentiated squamous cell and malignant mesenchymal component (osteosarcomatous area). Conclusion: Metaplastic breast carcinoma which resembles invasive ductal carcinoma with general characteristics is differentiated from invasive ductal carcinoma with larger tumor size, less lymph node involvement, less hormone receptor positivity. In order to prevent the delay of diagnosis, invasive ductal carcinoma should be considered in the definitive diagnosis in the elderly patients. Treatment should be started immediately and followed closely because of the high risk of local recurrence

The outcomes of an impaired powerhouse in KRAS mutant lung adenocarcinoma cells by Elesclomol

Objectives: Lung cancer stands out as the most common cancer type worldwide. The most common genetic alteration detected in adenocarcinoma patients is KRAS. KRAS mutated patients still cannot get benefit from precision medicine approaches andlackatargetedtherapy.Elesclomolisaninvestigationalagentformelanomaand other malignancies. In this study, we evaluated its effect on cellular apoptosis, survival, and metastasis mechanisms on KRAS mutant A549 and Calu-1 cell lines. Methods: The cytotoxic effects of Elesclomol on A549 and Calu-1 cells were determinedby3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide(MTT) cell viability test. Cells were treated with IC50 concentration and then apoptosisrelated (Casp-3, Casp-9, Bcl-2, and Bcl-xL), survival-related (Akt, p-Akt, Erk, and pErk), and metastasis-related (E-cadherin, Vimentin, MMP-2, and MMP-9) protein expressions were determined by Western blot analysis. Elesclomol’s effect on cell migration was evaluated by wound healing. Total oxidant, malondialdehyde (MDA), and glutathione (GSH) levels after Elesclomol treatment were assessed. Results: Elesclomolnotonlyinducedapoptoticproteinsbutalsoinhibitedmetastatic protein expressions and migration in both cells. Also, p-Erk activity was diminished by Elesclomol treatment as a reflection of decreased proliferation. However, p-Akt was enhanced as a cellular survival mechanism. Although Elesclomol’s effects on oxidative stress parameters were puzzling, it induced total oxidant status (TOS), and MDA in Calu-1 cells. Conclusion: Elesclomol might provide an alternative treatment approach for patients with KRAS mutant lung adenocarcinoma and other solid tumor malignancies that harbor KRAS mutations. This would enable the development of biomarker-driven targeted therapy for KRAS mutant adenocarcinoma patient

Monitoring Food Images After Rectal Surgery To Accelerate Recovery Of Postoperative Bowel Motility: A Quasi-Experimental Study

Objective: Considering the role of nurses in the postoperative care of patients, simple nursing interventions can prevent gastrointestinal motility problems. This study aimed to assess the impact of viewing food images on the recovery of intestinal motility after surgery in patients who were operated for rectal cancer. Methods: This quasi-experimental study was carried out with 48 patients who underwent rectal surgery in the general surgery clinic of a university hospital in Türkiye from May 2016 to December 2018. The control group had 25 participants and the experimental group had 23. From the first morning after surgery until defecation, patients in the experimental group were asked to monitor food pictures thrice a day, parallel to their meals. Results: In the experimental group, patients’ first flatus (3.30 ± 1.52, day) and defecation time (4.91 ± 1.27, day) were significantly shorter compared with the first flatus (4.28 ± 1.64, day) and defecation time (5.84 ± 1.40, day) of the control group (respectively; p = 0.037, p = 0.027). Conclusion: Monitoring food images supports the cephalic phase and could be a nursing intervention to speed up intestinal functions by increasing the release of gastrointestinal hormones and activating the parasympathetic nervous system. To accelerate bowel motility after rectal surgery, displaying the food images to the patients is a very simple intervention with low risk and cost and nurses should use it in the care of the patients who underwent surgery because of rectal cancer. It is recommended that further studies examining the effectiveness of monitoring food images on gastrointestinal surgeries should be performed

Peritonitis karsinomatozayı taklit eden abdominal tüberküloz olgusu

Abdominal tüberküloz nadir bir durumdur ve bulguları çoğu zaman nonspesifiktir. Birçok değişik patolojik durumu taklit edebilir. Abdominal tüberküloz tüm gastrointestinal sistemi, mezenteri ve peritonu tutmasının yanı sıra, solid organlar olan dalak, karaciğer ve pankreasıda tutabilmektedir. Karın içinde kitle nedeniyle ameliyat edilen ve ameliyat sırasında makroskopik olarak peritonitis karsinomatoza tanısı düşünülen 42 yaşındaki kadın hastaya ilişkin olgu literatür bilgileri eşliğinde sunuldu.Abdominal tuberculosis is a rare disease, with non-specific findings. Abdominal tuberculosis can mimic different pathologies. Abdominal tuberculosis could affect the entire gastrointestinal tract, peritoneum, mesentery as well as the solid organs like liver, spleen and pancreas. We present a 42-year-old woman with intra-abdominal mass of unknown origin which was interpreted as peritoneal carcinomatosis intraoperatively

Comparison between Karydakis flap repair and primary closure for surgical treatment of sacrococcygeal pilonidal sinus

Amaç: Bu prospektif çalışmada, pilonidal sinüsün cerrahi tedavisi için son dönemlerde yaygın kullanılan bir teknik olan Karydakis flep ameliyatı ile primer kapama tekniği karşılaştırıldı. Hastalar ve Yöntemler: Pilonidal sinüs nedeniyle ameliyat edilen 48 hasta (46 erkek, 2 kadın) çalışmaya alındı. Hastalar iki gruba ayrıldı. Sinüs eksizyonundan sonra 33 hastaya (grup 1) primer kapama, 15 hastaya (grup 2) ise Karydakis flep ameliyatı uygulandı. Ortalama takip süresi grup 1'de 6.8 ay (dağılım 4-11 ay), grup 2'de 6.2 ay (dağılım 3-10 ay) idi. Bulgular: Grup 1'de dört hastada (%12.1), grup 2'de iki hastada (%13.3) yara yerinde seröz sıvı birikimi ve akıntı saptandı. Grup 2'de bir hastada (%6.7) yara yerinde ciltaltı hematom oluştu. Takipler sırasında her iki grupta da hiçbir hastada yara yerinde enfeksiyon görülmezken, grup 1'de bir (%3), grup 2'de yine bir hastada (%6.7) erken dönemde nüks görüldü. Sonuç: Uygulanması diğer yöntemlere göre daha kolay ve basit, iyileşme süresi daha kısa ve skar dokusu daha az olduğundan, eksizyon ve primer kapama yöntemi uygun olgularda tercih edilen bir ameliyat şekli olabilir.Objectives: In this prospective study, we compared primary closure and Karydakis flap repair which has recently proved a popular technique for surgical treatment of pilonidal sinus. Patients and Methods: The study included 48 patients (46 males, 2 females) who were operated on for pilonidal sinus. The patients were randomized to two groups. After sinus excision, 33 patients (group 1) underwent primary closure, and 15 patients (group 2) underwent Karydakis flap surgery. The mean followup was 6.8 months (range 4 to 11 months) in group 1, and 6.2 months (range 3 to 10 months) in group 2. Results: Serous liquid collection and discharge were seen at the site of the lesion in four patients (12.1%) in group 1, and in two patients (13.3%) in group 2. Subcutaneous hematoma was detected in one patient (6.7%) in group 2. During the follow-up period, none of the patients developed wound infection. Recurrences were seen in one patient (3%) in group 1, and in one patient (6.7%) in group 2. Conclusion: Excision and primary closure can be the preferred method for the treatment of pilonidal sinus in selected patients due to its advantages such as ease and simplicity, shorter recovery time, and limited scar formation

Combined Effects of Tauroursodeoxycholic Acid and Glutamine on Bacterial Translocation in Obstructive Jaundiced Rats:

Background: Bacterial Translocation is believed to be an important factor on mortality and morbidity in Obstructive Jaundiced. .Aims: We investigated the probable or estimated positive effects of tauroursodeoxycholic acid, which has antibacterial and regulatory effects on intestinal flora, together with glutamine on BT in an experimental obstructive jaundiced rat model. Study Design:Animal experimentation.Methods: Forty adult, male, Sprague Dawley rats were used in this study. Animals were randomised and divided into five groups of eight each: sham (Sh); control (common bile duct ligation, CBDL); and supplementation groups administered tauroursodeoxycholic acid (CBDL+T), glutamine (CBDL+G), or tauroursodeoxycholic acid plus glutamine (CBDL+TG). Blood and liver, spleen, MLN, and ileal samples were taken via laparotomy under sterile conditions for investigation of bacterial translocation and intestinal mucosal integrity and hepatic function tests on the tenth postoperative day. Results: There were statistically significant differences in BT rates in all samples except the spleen of the CBDL+TG group compared with the CBDL group (p=0.041, p=0.026, and p=0.041, respectively). Conclusion: It is essential to protect hepatic functions besides maintaining intestinal mucosal integrity in the active struggle against BT occurring in obstructive jaundice. The positive effect on intestinal mucosal integrity can be increased if glutamine is used with tauroursodeoxycholic acid, which also has hepatoprotective and immunomodulatory features

Rectal foreign bodies: A report of three cases

Yaşları 25, 66 ve 67 olan üç erkek hastada rektumda yabancı cisim saptandı. Yabancı cisimler; demir çubuk, ağaçtan şekillendirilmiş özel çubuk ve çay bardağı idi. Cisimler, iki olguda genel anestezi altı nda litotomi pozisyonunda, birinde lokal anestezi ve sedasyon desteği altında diz dirsek pozisyonunda anal dilatasyon sonrası dışarı çıkarıldı. iki olguda uygulanan tedavi yöntemiyle ilgili komplikasyon gözlenmezken, bir olguda rektum mukozası nda yüzeysel laserasyonlar meydana geldi. Hastalar 24 saat süreli gözlemden sonra sorunsuz taburcu edildi. Rektum ve sigmoid kolonda yerleşen yabancı cisimler son yıllarda giderek artan oranda görülmekte ve yol açtığı komplikasyonlar nedeniyle önemli acil cerrahi sorunlardan birini oluşturmaktadı r.Different foreign bodies were found in rectum in three male patients, whose ages were 25, 66 and 67. These foreign materials were iron stick, special wooden stick and tea cup. In two patients, materials were taken out under general anesthesia in lithotomy position and the other one in knee-elbow position by anal dilatation under local anesthesia with sedation. In two patients there were not any complications related with the treatment method but one of them had superficial lacerations on rectal mucosa. All of the patients were discharged after 24 hours observation. Foreign bodies in rectum and sigmoid colon is increasingly being seen recently and is one of the significant surgical emergency problems due to the complications it may cause

Benign pneumoperitoneum: A case report

Fleksibl kolonoskopi kolon patolojilerinin tanı, tedavi ve takibinde kullanılan en iyi yöntem olarak kabul edilmektedir. Kolonoskopi sonrası karın ağrısından yakınan her hastada, perforasyondan şüphelenilmelidir. Kolonoskopi sonrası perforasyon sıklığı tanısal amaçlı yapılan kolonoskopide %0.01 ile %0.4 arasında değişmektedir. Yaygın peritoneal irritasyon bulguları olması durumunda cerrahi girişim şarttır. Erken cerrahi girişim birçok yazar tarafından mortalite ve morbiditeyi azaltan en iyi stratejik yaklaşım olarak görülmektedir. Seçilmiş olgularda, peritoneal irritasyon bulguları olmaması durumunda ameliyatsız (non-operative) yaklaşım denenebilir. Geniş olgu çalışmaları incelendiğinde ameliyatsız yaklaşılan olguların tüm kolonik perforasyon olgularının ortalama %1 ila %5'ini oluşturduğu görülmektedir. Bu yazıda, kolonoskopi sonrasında intraperitoneal alanda serbest gaz tespit edilen ve ameliyatsız tedavi edilen olgu sunuldu.Flexible colonoscopy is the gold standard in diagnosis, treatment, and follow-up of colonic pathologies. The acute onset of abdominal pain after colonoscopy may be a clinical sign of colonic perforation. Perforation rate after diagnostic colonoscopies varies between 0.01%-0.4%. If the patient develops signs of peritoneal irritation, the surgical intervention is obligatory. According to the literature, early surgical treatment is the best strategic approach that decreases the morbidity and mortality. Nonoperative treatment could be a choice in selected patients without signs of peritoneal irritation. In large colonoscopy series, only 1-5% of the cases with colonic perforation secondary to the colonoscopy were treated conservatively. We reported a case with colonic perforation after diagnostic colonoscopy which we successfully treated nonoperatively without further need of surgery

Perforated primary small bowel lymphoma: A case report

İnce bağırsak malign tümörleri nadir görülen ve tanı aşamasındaki güçlükler nedeniyle ileri evrelerde tanı konan tümörlerdir. Lenfoma gastrointestinal sistem malign tümörlerinin %1'ini oluşturur. Primer gastrointestinal lenfoma ender görülür ve ameliyat öncesi tanı konması oldukça zordur. Primer gastrointestinal lenfoma tanısı genellikle laparotomi ile konur. Bu yazıda, subileus tanısı ile takip edilmekteyken akut karın kliniği gelişen ve acil cerrahi eksplorasyona alınarak ince bağırsak tümör perforasyonu saptanan 77 yaşında erkek hasta sunuldu. Hastaya geniş ince bağırsak rezeksiyonu ve uç uca çift kat ince bağırsak anastomozu yapıldı. Histopatolojik inceleme sonucu indolent B-hücreli non-Hodgkin lenfoma olarak bildirildi. İnce bağırsak tümörlerinin nadiren subileus tablosu ile karşımıza çıkabileceği ve tanının çoğu zaman gecikebileceği unutulmamalıdırMalignant tumors of the small bowel are rarely seen and are usually diagnosed in advanced stages because of the difficulties in diagnosis. Lymphomas account for %1 of malignant gastrointestinal system tumors. Primary gastrointestinal lymphoma is very rare and its preoperative diagnosis is difficult. Its diagnosis is usually made through laparotomy. A 77-year-old male patient developed acute abdomen during observation for partial mechanic intestinal obstruction. Emergent explorative laparotomy revealed perforation of a small bowel tumor. A wide small bowel resection was performed with a double-layer end-to-end anastomosis. Histopathological examination of the surgical specimen was reported as indolent B-cell non–Hodgkin's lymphoma. It should be kept in mind that small bowel tumors can present as mechanic intestinal obstruction, resulting in delayed diagnosis