Effect of Mitomycin C in the prevention of tendon adhesion after surgery and the effect of biomechanical stretching on tendon histology

Objective: In this study, optimal dose to reduce tendon adhesion, by using the dose-dependent fibroblast proliferation inhibition effect of Mit-C, and the level, which the tendon histologies are affected, using biomechanical stretching, is investigated. Methods: 56 chicken flexor tendons were used in this study. A total of 9 groups were formed. Mit-C were applied between the tendon and the sheath; 0.9% NaCl for surgical control groups (groupII, groupIII), 0.1mg/ml Mit-C (groupIV, groupVII), 0.2mg/ml Mit-C (groupV, groupVIII) 0.5 mg/ml Mit-C (groupVI, groupIX). Macroscopic, microscopic, synovial sheath thickness and active fibroblast count were compared between the groups that underwent biomechanical stretching (groups III,V,VII,IX) and groups without biomechanical stretching (groups I,II,IV,VI,VIII). Results: After the macroscopic and microscopic examination, it was observed that the groups with the most adhesion were surgical control groups. The best results from the experimental groups were seen in group VIII, but the results of the groups were similar. When active fibroblast count was examined, it was seen that group VIII had the least active fibroblast count. Conclusion: According to the results of the evaluation, Mit-C, by inhibiting fibroblast proliferation and decreasing synovial sheath thickness, decreased adhesion formation. At the same time, it was concluded that the optimal dose for adhesion prevention was 0.2mg/ml, biomechanical stretching affected tendon histology and the drug was suitable for clinical studies

Dealing with the gray zones in the management of gastric cancer: The consensus statement of the Istanbul Group

The geographical location and differences in tumor biology significantly change the management of gastric cancer. The prevalence of gastric cancer ranks fifth and sixth among men and women, respectively, in Turkey. The international guidelines from the Eastern and Western countries fail to manage a considerable amount of inconclusive issues in the management of gastric cancer. The uncertainties lead to significant heterogeneities in clinical practice, lack of homogeneous data collection, and subsequently, diverse outcomes