Fibromatosis of the cecum presenting with acute appendicitis: a case report

Although acute appendicitis is a common clinical condition in general surgical practice, <1% of them are associated with malignancies. Appendiceal carcinoids make up most of those malignancies and acute appendicitis cases associated with benign cecal neoplasias are very uncommon. In this study, a 25-year-old female patient who presented with distinct acute appendicitis symptoms is reported. The patient was operated on via open technique. Exploration revealed an appendix with advanced edema and hyperemia. While the cecum was observed to be normal, a solid mass of 2.5 cm diameter was palpated in the appendiceal base. Following the ileocecal resection, histopathological examination revealed the mass as a fibromatosis. The goals of this report are to remind health care professionals that some very rare etiologies may be involved in acute appendicitis diagnosis and treatment, and to underscore the place of laparoscopic approach and preoperative computed tomography in this disease

Karaciğer Nakli Alıcılarında Hepatit B Virus Proflaksisi

Amaç: Karaciğer nakli alıcılarında kullanılan immunsüpresif ilaçlar Hepatit B Virus HBV reaktivasyonunu kolaylaştırır. Bu hastalarda, virüs reaktivasyonunu önlemek için verilen proflaktik tedaviler çok önemlidir.Bu çalışmanın amacı karaciğer nakli alıcılarında nüks HBV enfeksiyonlarının proflaksisini değerlendirmektir. Gereç ve Yöntem: Bu çalışma retrospektiftir. Karaciğer nakli alıcılarını Ocak 2016 ile Ocak 2019 tarihleri arasında HBVDNA ve proflaktik tedavi sonuçları ile inceledik. Bulgular: 34 alıcı hastaya proflaktik tedavi için Tenofovir ya daEntacavir verilmişti. Ortalama 27,3 aylık takipte hastalarda nüks tespit edilmedi. Sonuç: Tenofovir ve Entacavir, karaciğer nakli alıcılarında nüks HBV enfeksiyonunun proflaktik tedavisinde başarılı görünmektedi

Hepatocellular carcinomas with granulomatous inflammation in tumor stroma: Clinicopathologic characteristics

Objective: To determine the frequency of granulomatous inflammation within hepatocellular carcinoma (HCC) and its clinicopathologic associations. Material and Method: Fifty-eight HCCs (51 explants, 3 lobectomies, and 4 segmentectomies) were reviewed. Results: Five (8.6%) cases (F/M=1/4, mean age: 63.6) were identified with granulomas.1/5 had history of neoadjuvant therapy. 4/5 patients presented with early stage (pT1/2). All were well-differentiated (Grade1-2/4). The mean number of tumor foci was 3.6, with a median size of 2.2 cm. All of them had advanced fibrosis. No difference was identified from cases without granulomas (n=53) in terms of prognosis and aforementioned parameters (p> 0.05). Granulomas were mainly concentrated in peripheral parts of the tumors. One case with nodule-in-nodule formation had granulomas lined along the border of the inner nodule. In 2 cases, granulomas were identified in steatohepatitic areas, while another had clear cell change. Only 1 had necrotizing granulomas, none with acid resistant bacilli. Two cases revealed concomitant granulomas in the adjacent liver parenchyma in addition to the tumor stroma. Except for one with a history of tuberculosis, none of the cases had a granulomatous disease. Conclusion: This is the largest case series of HCCs with granulomas by far. Our data revealed neither clinicopathologic and prognostic difference nor definite etiology related to granulomas. Yet, association with steatotic and clear tumor cells suggests the role of cytoplasmic content, while distribution of granulomas points to host immune response

Use of tramadol and meperidine combination for postoperative analgesia in kidney transplant recipients

Amaç: Ameliyat sonrası ağrı, tüm ameliyatlardan sonra gelişebilen ve hastanın iyileşmesini olumsuz yönde etkileyen bir durumdur. Böbrek nakli alıcılarında da yaygındır. Özellikle bu hasta grubunda kullanılacak analjeziklerin seçimi önemlidir. Bu retrospektif çalışmanın amacı, böbrek nakli alıcılarında postoperatif analjezi için kullanılan tramadol + meperidine kombinasyonunun etkinliğinin değerlendirilmesidir. Gereç ve Yöntem: Nisan 2014 - Nisan 2019 tarihleri arasında İstanbul Medipol Üniversitesi Tıp Fakültesi Hastanesi Organ Nakli Bölümü’nde, böbrek nakli sonrası postoperatif analjezi için tramadol + meperidine kombinasyonu kullanılan 100 alıcı hasta retrospektif olarak incelendi. Bu hastaların demografik ve klinik özellikleri değerlendirildi. Bulgular: Hastaların yaş ortalaması 47,4 ± 13,1 yıl idi. Hastaların 67’i (% 67) erkek, 33’ü (% 33) kadın idi. Hastaların ortalama vücut kitle indeksi 30.8 ± 4.4 kilogram / metrekare (kg / m2) idi. 12. saat ortalama VAS skoru 2.9 ± 0.8, 24. saat ortalama VAS skoru 3.1 ± 0.9 idi. Bu hastalarda analjezik yöntemle ilişkili ciddi bir yan etki saptanmadı. Sonuç: Böbrek nakli alıcılarında, postoperatif analjezi için kullanılan tramadol + meperidine kombinasyonu başarılı görülmektedir.Aim: Postoperative pain is a condition that can develop after all operations and negatively affect the patient’s recovery; it is also common in kidney transplant recipients and choosing the right analgesic is important specifically in this patient group. Especially the choice of analgesics to be used in this patient group is important. The aim of this retrospective study is to evaluate the effectiveness of the combination of tramadol and meperidine used for postoperative analgesia in kidney transplant recipients. Materials and Methods: Between April 2014 and April 2019, 100 recipient patients who used tramadol and meperidine combination for postoperative analgesia after a kidney transplant at Istanbul Medipol University Medical Faculty Organ Transplant Department were retrospectively analyzed. Demographic and clinical characteristics were evaluated. Results: The mean age of the patients was 47,4 ± 13,1 years. 67 (67%) of the patients were male and 33 (33%) were female. The mean body mass index of the patients was 30.8 ± 4.4 kilograms / square meter (kg / m2). In these patients, the 12th hour mean VAS score 2.9 ± 0.8 and the 24th hour mean VAS score was 3.1 ± 0.9. No serious side effect associated with the analgesic method in these patients was detected. Conclusions: The combination of tramadol and meperidine used in kidney transplant recipients appears to be successful for postoperative analgesia

Effects of Hot Isostatic Pressing and Heat Treatments on Structural and Corrosion Properties of Direct Metal Laser Sintered Parts

Purpose – This paper aims to investigate the effects of various heat treatments on microstructure, hardness, porosity and corrosion properties of the parts. Design/methodology/approach – Hot isostatic pressing (HIP) process, various heat treatments and their combinations were applied to the AlSi10Mg parts produced by direct laser metal sintering (DMLS). Findings – It has been found that the HIP process, which is a post-processing process, reduces the amount of porosity in DMLS-AlSi10Mg material, thus improves corrosion resistance significantly. Originality/value – In this study, the HIP process and subsequent T6 heat treatments were applied to AlSi10Mg parts produced by the DMLS technique. The study aims to increase the corrosion resistance of AlSi10Mg parts by reducing porosity with the HIP process and by altering the microstructure with the T6 process

Reduced folate carrier 1 is present in retinal microvessels and crucial for the inner blood retinal barrier integrity

BackgroundReduced folate carrier 1 (RFC1; SLC19a1) is the main responsible transporter for the B9 family of vitamins named folates, which are essential for normal tissue growth and development. While folate deficiency resulted in retinal vasculopathy, the expression and the role of RFC1 in blood-retinal barrier (BRB) are not well known.MethodsWe used whole mount retinas and trypsin digested microvessel samples of adult mice. To knockdown RFC1, we delivered RFC1-targeted short interfering RNA (RFC1-siRNA) intravitreally; while, to upregulate RFC1 we delivered lentiviral vector overexpressing RFC1. Retinal ischemia was induced 1-h by applying FeCl3 to central retinal artery. We used RT-qPCR and Western blotting to determine RFC1. Endothelium (CD31), pericytes (PDGFR-beta, CD13, NG2), tight-junctions (Occludin, Claudin-5 and ZO-1), main basal membrane protein (Collagen-4), endogenous IgG and RFC1 were determined immunohistochemically.ResultsOur analyses on whole mount retinas and trypsin digested microvessel samples of adult mice revealed the presence of RFC1 in the inner BRB and colocalization with endothelial cells and pericytes. Knocking down RFC1 expression via siRNA delivery resulted in the disintegration of tight junction proteins and collagen-4 in twenty-four hours, which was accompanied by significant endogenous IgG extravasation. This indicated the impairment of BRB integrity after an abrupt RFC1 decrease. Furthermore, lentiviral vector-mediated RFC1 overexpression resulted in increased tight junction proteins and collagen-4, confirming the structural role of RFC1 in the inner BRB. Acute retinal ischemia decreased collagen-4 and occludin levels and led to an increase in RFC1. Besides, the pre-ischemic overexpression of RFC1 partially rescued collagen-4 and occludin levels which would be decreased after ischemia.ConclusionIn conclusion, our study clarifies the presence of RFC1 protein in the inner BRB, which has recently been defined as hypoxia-immune-related gene in other tissues and offers a novel perspective of retinal RFC1. Hence, other than being a folate carrier, RFC1 is an acute regulator of the inner BRB in healthy and ischemic retinas.Hacettepe Universit

Obsessive- compulsive disorder in the parkinson disease

Purpose: Obsessive disorder assessment using Leyton Obsessional Inventory was done in patients with idiopathic Parkinson's Disease. Materials and Methods: Fifty patients diagnosed with Parkinson's disease according to United Kingdom Parkinson's Disease Society Brain Bank (UK-PDSBB) criteria and 37 healty individuals were included in the study.All subjects were assesed by the same psychiatrist using the Leyton obsessional inventory. Results: The Leyton obssesional scores were higher in the Parkinson's disease group than in the control group (p<0,001). In addition, correlation was found between the severity of disease and degree of obsession (p:0,771). Conclusion: Parkinson's disease is a neurodejenerative disorder with predominant motor symptoms but with progression , nonmotor symptoms also emerge. The patient's qualty of life may be much affected by these nonmotor symptoms. Diagnosis and treatment of the pyschiatric symptoms in Parkinson's disease may help improve life quality

Prophylaxis for hepatitis B virus in liver transplant recipients

Amaç: Karaciğer nakli alıcılarında kullanılan immunsüpresif ilaçlar Hepatit B Virus (HBV ) reaktivasyonunu kolaylaştırır. Bu hastalarda, virüs reaktivasyonunu önlemek için verilen proflaktik tedaviler çok önemlidir.Bu çalışmanın amacı karaciğer nakli alıcılarında nüks HBV enfeksiyonlarının proflaksisini değerlendirmektir. Gereç ve Yöntem: Bu çalışma retrospektiftir. Karaciğer nakli alıcılarını Ocak 2016 ile Ocak 2019 tarihleri arasında HBVDNA ve proflaktik tedavi sonuçları ile inceledik. Bulgular: 34 alıcı hastaya proflaktik tedavi için Tenofovir ya daEntacavir verilmişti. Ortalama 27,3 aylık takipte hastalarda nüks tespit edilmedi. Sonuç: Tenofovir ve Entacavir, karaciğer nakli alıcılarında nüks HBV enfeksiyonunun proflaktik tedavisinde başarılı görünmektedir.Objective: Immunosuppressive drugs predispose the liver transplant recipients to reactivation of Hepatitis B virus. Prophylactic therapies given to this patient are very important for prevention of infections. The aim of this study was to evaluate the prophylaxis recurrence HBV infections in liver transplant recipients. Material and Methods: This study is retrospective. We examined liver transplant recipients Between January 2016 and January 2019 with results of HBV DNA and prophylactic treatment. Results: 34 recipient patients were treated with Tenofovir or Entacavir prophylaxis. There was not recurrence of HBV infections during follow-up of 36 months. Conclusion: Tenofovir or Entacavir appears to be successful prophylactic treatment of recurrence HBV infections in liver transplant recipients