Do Molecular Tests Really Differentiate Malignant Ipmns From Benign?

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Utility Of M30, An Apoptotic Serum Marker, In Liver Diseases

The aim of this paper is to evaluate the role of apoptosis in some common liver diseases, and the utility of M30, an apoptotic serum marker, in the diagnosis of the severity of underlying hepatic injury. As is widely known, apoptosis is programmed cell death, and its deregulation results in an uncontrolled inflammatory process leading to upregulation of liver fibrogenesis. Both extrinsic and intrinsic pathways are crucial in apoptosis, and caspase cleavage of cytokeratin proteins occurs in both. Therefore, the measurement of caspase-cleaved cytokeratin fragments could be a novel method to assess the intensity of apoptotic cell numbers in epithelial tissue damage. M30 levels were found to increase not only in acute liver disorders, but also in some chronic liver injuries. We tried to summarize the recent studies focused on the role of apoptotic processes in liver diseases, mainly those that investigated the use of M30 in determining the severity of, or in predicting, ongoing liver injury.WoSScopu

Laparoscopic Resection of Cholecystocolic Fistula and Subtotal Cholecystectomy by Tri-Staple in a Type V Mirizzi Syndrome

The Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann’s pouch that mechanically obstructs the common bile duct (CBD). We would like to report laparoscopic subtotal cholecystectomy (SC) and resection of cholecystocolic fistula by the help of Tri-Staple™ in a case with type V MS and cholecystocolic fistula, for first time in the literature. A 24-year-old man was admitted to emergency department with the complaint of abdominal pain, intermittent fever, jaundice, and diarrhea. Two months ago with the same complaint, ERCP was performed. Laparoscopic resection of cholecystocolic fistula and subtotal cholecystectomy were performed by the help of Tri-Staple. At the eight-month follow-up, he was symptom-free with normal liver function tests. In a patient with type V MS and cholecystocolic fistula, laparoscopic resection of cholecystocolic fistula and SC can be performed by using Tri-Staple safely

Laparoscopic Resection of Cholecystocolic Fistula and Subtotal Cholecystectomy by Tri-Staple in a Type V Mirizzi Syndrome

The Mirizzi syndrome (MS) is an impacted stone in the cystic duct or Hartmann’s pouch that mechanically obstructs the common bile duct (CBD). We would like to report laparoscopic subtotal cholecystectomy (SC) and resection of cholecystocolic fistula by the help of Tri-Staple™ in a case with type V MS and cholecystocolic fistula, for first time in the literature. A 24-year-old man was admitted to emergency department with the complaint of abdominal pain, intermittent fever, jaundice, and diarrhea. Two months ago with the same complaint, ERCP was performed. Laparoscopic resection of cholecystocolic fistula and subtotal cholecystectomy were performed by the help of Tri-Staple. At the eight-month follow-up, he was symptom-free with normal liver function tests. In a patient with type V MS and cholecystocolic fistula, laparoscopic resection of cholecystocolic fistula and SC can be performed by using Tri-Staple safely

Raised Adenosine and Adenosine Deaminase in Bladder Cancer Require Less Postoperative Analgesia Compared with Benign Prostatic Hyperplasia After Transurethral Resection

Transurethral resection of the prostate (TUR-P) and transurethral resection of bladder tumor (TUR-BT) are common urological operations. Our aim was to show whether there was an association of the adenosine molecular pathway with postoperative pain level and malignancy status. A total of 93 patients with ages between 55 and 72 years old who underwent TUR-P (n = 47) and TUR-BT (n = 46) under spinal anesthesia between August 2017 and July 2018 were retrospectively analyzed. On the day of surgery, at the postoperative 24th and 48th hours, plasma adenosine levels and serum adenosine deaminase (ADA) levels were measured. The malignant group had significantly higher adenosine (median 171.51 IQR = 147.69-196.32 vs. median 57.82, IQR = 54.06-62.34, p < 0.001) and ADA levels (median 19.10, IQR = 12.85-22.05 vs. median 7.00, IQR = 5.80-10.80, p < 0.001) preoperatively. Although their levels decreased at the postoperative 24th and 48th hours, the levels remained significantly higher in the malignant group until the postoperative 24th hour (p < 0.001). Lower pain level during the first 36 h and less analgesic requirement during the first 24 h were observed in the malignant group (p < 0.001). In addition, patients with higher tumor grades experienced less pain up to the postoperative 6th hour (p < 0.016). A strong positive correlation was observed between adenosine and ADA levels before surgeries for all patients (rho = 0.637, p < 0.001). There were also negative correlations between VAS score and adenosine level (rho = - 0.721, p < 0.001) or VAS and ADA (rho = - 0.658, p < 0.001). In multivariate analysis, preoperative adenosine level (OR = 4.742, p < 0.001) was found to be the most important parameter affecting postoperative non-opioid analgesic requirement. According to our preliminary results, lower postoperative pain scores and less additional analgesic requirement may be associated with an increase in endogenous adenosine levels in malignant cases

Determination of Material Handling Equipment for Lean In-Plant Logistics Using Fuzzy Analytical Network Process Considering Risk Attitudes of the Experts

Using right material handling equipment (MHE) is substantial in terms of manufacturing costs even if related manufacturing environment is lean. In this paper, right materials handling equipment selection problem is investigated at the line feeding systems such as kitting and milk-run systems. Each system has three alternatives for selection and main problem is the difficulty in selecting the appropriate one, since these equipments are integrated with each other by means of a total of nine possible combinations. In order to select most appropriate combination, alternative equipment is evaluated separately at first and then, resulting priorities are aggregated to find the best alternative. In the equipment selection decision model, there are four main criteria and seventeen sub-criteria. Since the dependencies are appeared within the criteria, Fuzzy Analytic Network Process (FANP) technique is preferred. Besides that, risk attitude of the experts are also incorporated into the model using linguistic terms in order to reach accurate results. The real world application is implemented in an electronic device assembly plant located in Istanbul. The result of the numerical application demonstrated that Tugger Automated Guided Vehicle (AGV) should be used for the milk-run system and a Belt conveyor should be acquired for the kitting system