Maternal serum interlukin-6 level in preterm labor

Objective: The aim of this study was to measure interleukin-6 (IL-6) levels in maternal serum of women undergoing preterm labor without a clear infection. Materials and Methods: Twenty two pregnant women with diagnosis of preterm labor who presented to the outpatient clinic of 19 Mayıs University Faculty of Medicine from July 2011 through December 2011 were enrolled in the study group. Twenty two healthy pregnant women who were at the same gestational age as the study group were selected as the control group. Results: Gestational age in the study and control groups varied from 24 weeks and 4 days to 34 weeks and 6 days. In the study group, 11 patients (50%) underwent preterm birth. Pregnant women in preterm labor were compared to healthy pregnant women with regards to serum IL-6 levels. No significant difference was found in the IL-6 levels of maternal serum between the 2 groups. Conclusion: In this study, we have shown that there is no increase in IL-6 levels in patients undergoing preterm labor without clinical or biochemical infection signs

Effects of evening primrose oil and 5-fluorouracil on the healing of colonic anastomoses in rats

Aim: This study was designed to evaluate the efficacy of evening primrose oil (EPO) on colonic anastomosis. Methods: Sixty rats with colonic anastomosis were randomly divided into six groups. EPO and 5-Fluorouracil (5-FU) were administered at doses of 5 g/kg/day and 20 mg/kg/day, respectively.  Group 1 served as sham control. The rats in Group 2 (EPO) received EPO (14 days preoperatively), in Group 3 (Extended EPO) received EPO (14 days preoperatively and 7 days postoperatively), in Group 4 (5-FU) received intraperitoneally 5-FU (5 days preoperatively), in Group 5 (5-FU+EPO) received EPO (14 days preoperatively), and 5-FU (5 days preoperatively), in Group 6 (5-FU+ extended EPO) received EPO (14 days preoperatively and 7 days postoperatively)  and 5-FU (5 days preoperatively). Histopathological examination, bursting pressure, and hydroxyproline content were used for evaluation. Results: Significant differences were found between the Groups 1, 2, and 3 and Groups 4, 5, and 6 in bursting pressures. Polymorphonuclear leukocyte (PMNL) and lymphocyte infiltration was significantly less in group 3, compared to the control and group 2. The least PMNL infiltration was in group 6 compared to groups 4 and 5.  The hydroxyproline level was different in group 3 compared to the control and group 2. Furthermore, groups 5 and 6 were different compared to group 4. Conclusion: EPO had favorable effects on colonic anastomosis even in groups where 5-FU was used

Factors affecting the outcome of surgically treated non-iatrogenic traumatic cervical esophageal perforation: 28 years experience at a single center

<p>Abstract</p> <p>Background</p> <p>We reviewed our experience with non-iatrogenic traumatic cervical esophageal perforations, paying particular attention to factors affecting the outcome of such cases.</p> <p>Methods</p> <p>In total, 30 patients treated surgically between 1980 and 2008 for non-iatrogenic traumatic cervical esophageal perforation in our clinic were reviewed.</p> <p>Results</p> <p>There were 25 male and 5 female patients with a median age of 27.5 years. The type of injury was external trauma in 21 (70%) patients and endoluminal injury in the remaining 9 (30%) patients. The mechanism of injury was gunshot in 16 patients, stabbing in 4, falling in 1 (extraluminal injury), and foreign body in 9 (endoluminal injuries). The overall mortality rate was 16.6% (5/30). The mortality rate for extraluminal injuries was 19%, and for endoluminal injuries was 11.1%. Mortality in patients treated within 24 h of sustaining injury was substantially less than in those for whom diagnosis and treatment were delayed (12.5 and 21.4%, respectively). The mortality rate was 33.3% (3/9) for patients with tracheal injuries and 9.5% (2/21) for those without tracheal injuries.</p> <p>Conclusions</p> <p>A treatment delay greater than 24 h, the presence of tracheal injury, or extraluminal perforation significantly affected the outcome of surgically treated non iatrogenic traumatic cervical esophageal perforation.</p

A branch-and-cut approach for the distributed no-wait flowshop scheduling problem

The distributed no-wait flowshop scheduling problem (DNWFSP) is an extension of the permutation flowshop scheduling problem with multiple factories and no-wait constraints. The DNWFSP consists of two decisions, namely, assigning jobs to the factories and sequencing the set of jobs assigned to the same factory. The no -wait constraints require that jobs have to be processed without any interruption between operations. Since the introduction of the DNWFSP, a number of metaheuristic approaches were developed to solve it. However, there exists no exact solution approach for the DNWFSP to the best of our knowledge. In this regard, a branch -and-cut (BC) algorithm is proposed to solve the DNWFSP. The proposed BC is integrated with a heuristic algorithm to obtain good upper bounds. Moreover, a set of symmetry breaking constraints are employed in the models to strengthen the formulations. The performance of BC is evaluated on a set of benchmark problem instances available in the related literature. The proposed BC is numerically compared with mixed-integer programming formulations of the DNWFSP which are solved by a commercial solver. The results obtained from the computational experiments reveal the effectiveness of the proposed approach. The proposed BC is able to solve all small-size instances, as well as, 206 out of 660 large-size instances to optimality. Besides, it is worth to mention that the average percentage gap for the large-size instances with two factories is only 0.43%

The Role of Sublobar Resections in the Treatment of Small Cell Lung

WOS: 000446224000008Lobectomy is the standard treatment in the early stages of non-small cell lung cancer. Today, however, it is questioned whether lobectomy should be performed in all early diagnosed patients. Sublobar resection remains a treatment option in elderly patients with low cardiopulmonary reserve who cannot tolerate sublobar resection lobectomy. In small tumors measuring 2 cm in diameter, sublobar resections can provide local recurrence rates and long survival rates equivalent to lobectomy when performed with the appropriate techniques in eligible patients. The addition of brachytherapy can further improve the results

Cusum analysis for learning curve of video-thoracoscopic lobectomy

WOS: 000394240400028PubMed ID: 28352848Background: Video assisted thoracoscopic (VATS) lobectomy has a demanding learning curve due to its technical complexity and risk of uncontrollable bleeding. We investigated the case number required for gaining technical proficiency by applying cumulative sum analysis on initial VATS lobectomy operations of a single surgeon. Methods: CALGB definition was used for the definition of VATS lobectomy. The data of the initial cases evaluated and cumulative sum (CUSUM) analysis was applied to duration of the operations and length of hospital stay. Results: Fifty-eight patients underwent VATS lobectomy. Of those 51 were malignant and 7 were benign. Fifty-five of the procedures were lobectomy, 2 were inferior bi-lobectomy and 1 was left upper lobectomy with chest wall resection. CUSUM analysis reached to proficiency at 27 cases for duration of the operations. Conclusions: The length of learning curve depends on previous experience of the surgeon on open lobectomy and simpler VATS operations, potential number of VATS lobectomy cases and VATS capability of the surgeon. Depending on these factors, it is possible to obtain technical proficiency with an inferior number of procedures compared with existing literature (50-200)

Risk factors affecting outcome and morbidity in the surgical management of bronchiectasis

ObjectiveBronchiectasis continues to be a major cause of morbidity and mortality in developing countries. The purpose of this study was to present the results of our 14 years of surgical experience to re-evaluate our indications for using surgical therapy and to analyze several factors that might affect the outcome and postoperative complications of this disease.MethodAge, sex, etiologic factors, symptoms, the duration of symptoms, radiologic and radionuclide examinations, preoperative evaluation, surgical procedures, postoperative morbidity and mortality, and the follow-up results from 143 patients operated on for bronchiectasis between January 1992 and January 2006, were reviewed retrospectively.ResultsOne hundred forty-three patients underwent 148 operations for bronchiectasis. The mean age was 23.4 years. Complete resection was achieved in 118 patients. The morbidity rate was 23.0% and the mortality rate was 1.3%. Postoperatively, 75.9% of the patients were free of symptoms, 15.7% were improved, and 8.2% showed no improvement or were worse. The logistic regression analysis showed that a history of tuberculosis and incomplete resection were independent predictors of the operative result. Moreover, the lack of a preoperative bronchoscopic examination, a forced expiratory volume in 1 second of less than 60% of the predicted value, a history of tuberculosis, and incomplete resection were independent predictors of postoperative complications.ConclusionsA history of tuberculosis and incomplete resection were risk factors both for postoperative complications and for a worse operative result. The lack of a preoperative bronchoscopic examination and a low forced expiratory volume in 1 second were risk factors for postoperative complications. Surgery for multiple segments on different lobes should be performed whenever possible