Jejunogastric Intussusception: A Rare Complication of Gastric Surgery

Jejunogastric intussusception is a rare complication of gastric surgery. It usually presents with severe epigastric pain, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate and early diagnosis which calls forth an urgent surgical intervention. Only reduction or resection with revision of the previously performed anastomosis is the choice which is decided according to the operative findings. We present a case of JGI in a patient with a history of Billroth II operation diagnosed by computed tomography. At emergent laparotomy, an efferent loop type JGI was found. Due to necrosis, resection of the intussuscepted bowel with Roux-en-Y anastomosis was performed. Postoperative recovery was uneventful

Case Report Jejunogastric Intussusception: A Rare Complication of Gastric Surgery

Jejunogastric intussusception is a rare complication of gastric surgery. It usually presents with severe epigastric pain, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate and early diagnosis which calls forth an urgent surgical intervention. Only reduction or resection with revision of the previously performed anastomosis is the choice which is decided according to the operative findings. We present a case of JGI in a patient with a history of Billroth II operation diagnosed by computed tomography. At emergent laparotomy, an efferent loop type JGI was found. Due to necrosis, resection of the intussuscepted bowel with Roux-en-Y anastomosis was performed. Postoperative recovery was uneventful

Remission of Ulcerated Necrobiosis Lipoidica Diabeticorum after Bariatric Surgery

A 32-year-old woman with type 2 diabetes mellitus suffering from morbid obesity with BMI 45,14 kg/m(2) was operated on. Not only the type 2DM but also one of its complication known as necrobiosis lipoidica diabeticorum remitted postoperatively. Obesity should no longer be regarded simply as a cosmetic problem affecting certain individuals but an epidemic that threatens global well-being. It causes or exacerbates many health problems, and in particular, it is associated with the type 2 diabetes. Necrobiosis lipoidica is a granulomatous skin disease of unknown etiology, associated mainly with diabetes mellitus. We presented in this paper a morbid obese case of necrobiosis lipoidica diabeticorum with dramatic good response to bariatric surgery

Analysis of the DOK1 gene in breast cancer

Breast cancer, which is the most common type of cancer among women, is a heterogenous disease. It results from progressive accumulation of genetic and epigenetic alterations in different genes. The Dok1 protein has been identified as the major substrate of protein tyrosine kinases in hematopoietic cells. It is considered as a tumor suppressor due to the reports which describe its inhibitory effect on major oncogenic signaling pathways such as Mek/Erk/PI3k/Akt and Wnt/beta-catenin. In this study, we investigated the mutation frequency of the DOK1 gene in 118 breast tumors using Sanger sequencing and DOK1 mRNA expression level in 63 breast cancer samples using qRT-PCR methods. Although the mutation frequency was low DOK1 mRNA expression levels were significantly reduced (63.5%) in the tumors compared to adjacent non-cancerous tissue. We also correlated expression changes with clinicopathological characteristics. Low mRNA levels correlated with age (p = 0.01) and c-erbB-2 (p = 0.05). In most of the previous reports, down-regulation of DOK1 mRNA expression has been associated with promoter methylation. We identified four different coding sequence alterations in 5.1% (6/118) of the tumor samples. However, all of these alterations were located in the functional domains of the protein. Therefore, these mutations may affect the function and/or cellular localization of the protein and contribute to cancer progression by this way. In conclusion our data indicate that DOK1 acts as a tumor suppressor in breast cancer and association of Dok1 with the c-erbB-2 mediated mechanism of action in breast cancer needs to be investigated

Downregulation of SCARA5 may contribute to breast cancer via promoter hypermethylation

Breast cancer is the most common malignant tumor in women worldwide. Breast tumors mostly exhibit aberrant gene expression and DNA hypermethylation patterns that predispose the disease. Understanding the genetic and epigenetic factors that contribute to breast cancer development is important to identify novel diagnostic and prognostic markers. SCARA5: Scavenger receptor class A, member 5; is a member of the scavenger receptor family located on chromosome 8p21 which is a frequently deleted region in human cancers. SCARA5 has been identified as a candidate tumor suppressor gene in various kinds of cancer. However, its role in breast cancer remains unclear. Therefore, in the present study SCARA5 expression levels in breast tumors and matched noncancerous tissue samples from 77 patients were analyzed by qRT-PCR and the expression levels were correlated with the methylation level of SCARA5 gene promoter. We found that SCARA5 expression was significantly decreased in tumors (92.2%) compared to non-cancerous tissue samples and this down-regulation was associated with hypermethylation of the promoter (p < 0.001). A significant correlation was also detected between SCARA5 expression and the histological grade of the breast tumors (p = 0.017). Taken together, our results indicate that SCARA5 may play an important role in tumorigenesis of breast cancer via promoter methylation

Laparoscopic incisional lumbar hernia repair

Incisional lumbar hernia is an uncommon hernia type. Open surgical procedures have significant postoperative morbidity and patient dissatisfaction, therefore, for the repair of seven incisional lumbar hernias, we attempted using an intraperitoneal laparoscopic technique that was described to have good short-term results and decreased morbidity

p53 expression and relationship with MDM2 amplification in breast carcinomas

Carcinoma of the breast, like other malignancies, is a genetic disease with multiple genetic events leading to the malignant phenotype. p53 mutations are the most common genetic events in human cancer. Inactivation of p53 can be a result of mutation in gene sequence. One of the main structures that regulate p53 stabilization is MDM2. It suppresses p53 transcriptional activation by recognizing transactivation domain of p53. The loss of MDM2 function on p53 regulation results in deprivation of p53 tumor suppressor ability. Single nucleotide polymorphisms (SNP309 T->G exchange) or MDM2 amplification has been proposed to play a role in this issue. In the present study, our aim is to analyze p53 and MDM2 status and investigate their interactions in human sporadic breast carcinoma. The study groups were separated according to their molecular classifications. In each group, histologic type of the tumor, conventional prognostic parameters, p53, and MDM2 interactions were compared statistically. Tumors are divided into 4 subtypes due to estrogen and progesterone receptor status, HER-2, and Ki-67 proliferation index results. According to this classification, 23 cases are in the luminal A, 32 cases are in the luminal B, 15 cases are in the HER-2 positive, and 22 cases are in the triple-negative group, with a total of 92 cases. p53 expression is low in luminal breast carcinomas than HER-2 and triple-negative subtypes. MDM2 amplification frequency was found to be 5.4% in total. MDM2 gene amplification does not have a significant role in breast carcinogenesis, but other possible mechanisms may play a role in its inactivation. (C) 2016 Elsevier Inc. All rights reserved

Use of "house" advancement flap in anorectal diseases

Background A retrospective review of 28 patients who had "house flap" anoplasty was carried out to evaluate the therapeutic effectiveness of the procedure

Mikroenkapsüle edilen paratiroid hücrelerinin in - vitro optimizasyonu

Amaç: Enkapsülasyon, bir maddenin ya da bir karışımın diğer bir malzeme ya da sistemle kaplandığı ya da içine sıkıştırıldığı tekniktir. Mikroenkapsülasyon tekniği, tıp dahil olmak üzere pek çok farklı disiplin tarafından uygulanmaya çalışılan ve halen en uygun enkapsülasyon tekniğinin bulunması için araştırmaların yürütüldüğü bir tekniktir. Mikroenkapsülasyon tekniğinde birbirinden farklı maddeler uygulanabilir. Bu maddeler elde edilme kaynaklarına göre doğal ya da sentetiktir. Mikroenkapsülasyon tekniği tıp pratiğinde özellikle pankreas beta hücrelerinin, Tip 1 Diabetes Mellitus (DM) hastalarına verilmesinde kullanılmaktadır. Mikroenkapsülasyonun uygulandığı bir başka durum ise hipoparatiroidi tanılı hastalara paratiroid hücrelerinin verilmesidir. Paratiroid hücrelerinin, mikroenkapsülasyon işleminde kullanılabilebilmesinin en önemli özelliklerinden biri, hücrelerin göre ce homojen yapıda olmaları, eksikliğinin organizmada doğrudan gözlemlenebilir semptomlara neden olması dolayısıyla oluşacak yanıtın hızlıca belirlenebilmesidir. Yöntemler: Çalışmamızda paratiroidhiperplazisi tanısı almış insandan elde edilen paratiroid dokularından izole edilen hücrele r, %2’lik ultra saf aljinat ile muamele edildi. İşlem sırasında her bir kapsül sayısı hesaplandı ve kapsül başına 5X106, 10X106, 20X106 ve 50X106 hücre eklendi. Sonrasında 75 gün boyunca içlerinde paratiroid hücresi bulunan kapsüllerin morfolojik özellikleri ve parathormonsekresyon yeteneklerinin zaman bağlı değişimi gözlemlendi. Bulgular: 75 gün sonrasında tüm gruplar için korele olarak parathormon düzeyinde düşüş tespit edildi. Kapsüler formasyonda ciddi bir bozulmanın görülmediği grup, 20X106 hücre uygulanan grup oldu. Sonuç: Çalışmamızda model olarak değerlendirdiğimiz paratiroid hücrelerinin kapsülasyonu için en uygun koşulları (kapsülasyonda kullanılacak madde, destekleyici tampon, uygulanan maddelerin yüzdeleri, miktarları) belirlendi. Ayrıca günlere bağlı olarak kapsüllerdeki bozulmalar da tespit edildi. İlerleyen çalışmalarda optimize ettiğimiz koşulların hipoparatiroidizm tanılı hasta gruplarında denenmesi ve sonuçların burada sunduğumuz in vitro deney sonuçları ile karşılaştırılması gerekmektedir

Remission of Ulcerated Necrobiosis Lipoidica Diabeticorum after Bariatric Surgery

A 32-year-old woman with type 2 diabetes mellitus suffering from morbid obesity with BMI 45,14 kg/m2 was operated on. Not only the type 2DM but also one of its complication known as necrobiosis lipoidica diabeticorum remitted postoperatively. Obesity should no longer be regarded simply as a cosmetic problem affecting certain individuals but an epidemic that threatens global well-being. It causes or exacerbates many health problems, and in particular, it is associated with the type 2 diabetes. Necrobiosis lipoidica is a granulomatous skin disease of unknown etiology, associated mainly with diabetes mellitus. We presented in this paper a morbid obese case of necrobiosis lipoidica diabeticorum with dramatic good response to bariatric surgery