Pulmonary echinococcosis mimicking multipl lung metastasis of breast cancer: The role of fluoro-deoxy-glucose positron emission tomography

<p>Abstract</p> <p>Background</p> <p>Echinococcosis is still a serious problem particularly in endemic areas such as South and Central America, Mediterranean countries, and Russia. Furthermore, hydatid cysts of the lung are often indistinguishable from a variety of other pulmonary lesions such as lung tumors</p> <p>Case presentation</p> <p>We herein present a 56 year old woman with breast cancer who presented with bilateral pulmonary nodules due to echinococcosis granulosis that mimicked metastatic breast cancer to the lung.</p> <p>Conclusion</p> <p>During the evaluation of the malignancies which could metastasize to the lung, it must be kept in mind that the appearance of bilateral multiple pulmonary masses can also be the sign of a pulmonary echinococcosis especially in endemic areas. FDG-PET with its known high negative predictive value in characterizing indeterminate pulmonary nodules >1 cm is very helpful to characterize this kind of lesions.</p

Türkiye’de stoma açılan hastaların kesitsel değerlendirilmesi

Aim: Despite recent technological developments, a stoma formation is needed for the treatment of many diseases, especially in colorectal surgery. Due to the radical principles of cancer treatment, the number of patients living with stoma is increasing. However, there is no study that quantitatively evaluates the stoma patients nationally. In this study, it was aimed to retrospectively evaluate the demographic data, indications, preferred types of stoma and the outcomes of patients who had a stoma formation in our country in the last three years. Method: In our country, there are 3 companies that operate in the field, provide materials for 95% of stoma patients. The data of patients who had a stoma between 2017 and 2019 were collected from these companies retrospectively by protecting personal privacy of patients. The distribution of indications and type of stoma acording to indications were determined. Average age, stoma closure rates and mortality rates were calculated. All data are presented as numbers and percentages and categorical variables are shown as median (minimum-maximum), continuous variables are shown as ± standard deviation. Results: The most common indication for stoma creation was colorectal malignancy (58.4%) and followed by mechanical bowel obstructions (29.6%). Other malignancies (4.16%), inflammatory causes (4.58%), traumatic causes (1.88%) and congenital anomalies (1.17%) constituted a total of 11% stoma indications. It was observed that. ostomies opened due to colorectal malignancy,were closed in 40% of patients with loop ileostomy, 30.1% of patients with loop colostomy, and only 13% of patients with end colostomy. Conclusion: We aimed to obtain a national perspective by evaluating the patients who had a stoma in the last 3 years and to show up the distribution of stoma formation indications in our country. We have determined the demographic data of patients with stoma and calculated the stoma closure and mortality rates according to stoma types. Although this study is a cross-sectional evaluation of patients in the whole country, weak point of our study is there are deficiencies in our evaluation due to the lack of retrospective data. We think that prospective studies should be planned by detailing subgroups.Amaç: Ülkemizde stomalı bireyleri niceliksel olarak inceleyen çalışma henüz bulunmamaktadır. Bu çalışmada ülkemizde son üç yıl içinde stoma açılmış olan hastaların demografik verilerinin, endikasyonlarının, tercih edilen stoma tiplerinin ve hastaların akıbetlerinin retrospektif olarak değerlendirilmesi amaçlanmıştır. Yöntem: Ülkemizde stoma alanında faaliyet göstermekte olan ve stoma hastalarının stoma malzemelerini sağlayan 3 firmanın 2017-2019 yılları arasında, malzeme temin ettiği stoma hastalarının bilgileri, kişisel verilerin gizliliği kurallarına dikkat edilerek retrospektif olarak derlenmiştir. Endikasyona göre hastalara hangi tip stoma açıldığı, bu hastaların cinsiyete göre dağılımı (minimum-maksimum), yaş ortalamaları, stoma kapatılma oranları, ölüm oranları hesaplanmıştır. Bulgular: En sık stoma oluşturma endikasyonunun kolorektal malignite olduğu ve tüm stomaların %58,4’ünü oluşturduğu görüldü. Bunu mekanik barsak tıkanıklıkları (%29,6) takip etmekte idi. Diğer maligniteler (%4,16), enflamatuvar sebepler (%4,58), travmatik sebepler (%1,88) ve doğumsalanomaliler (%1,17) toplamda yaklaşık %11 oranında stoma açılmasına endikasyon oluşturmaktaydı. Kolorektal malignite nedeni ile açılan stomalar değerlendirildiğinde loop ileostomi uygulanan hastların %40’ının, loop kolostomi uygulanan hastaların %30,1’inin stoması kapatılabilmişken, uç kolostomi uygulanan hastaların sadece %13’ünün stomasının kapatıldığı görülmüştür. Sonuç: Ülkemizde son 3 yıl içinde stoma açılmış olan hastaları değerlendirerek ulusal anlamda geniş bir perspektif elde etmeyi amaçladık. Stoma ile yaşamak durumunda olan hastaların demografik verilerini, kaçının stomasının kapatılabildiğini ve stoma tiplerine göre stoma kapatılma ve ölüm oranlarını tespit ettik. Stomalı bireylerin analizini gerçekleştirdiğimiz bu çalışma, ulusal anlamda gerçekleştirilen ilk çalışma olmasına rağmen, retrospektif verilerdeki eksiklikler nedeni ile değerlendirmemizde yetersizlikler mevcuttur. Alt grupların detaylandırılarak, prospektif özellikte çalışmaların planlanması gerektiğini düşünüyoruz

Time course of collagen peak in bile duct-ligated rats

<p>Abstract</p> <p>Background</p> <p>One of the most useful experimental fibrogenesis models is the "bile duct-ligated rats". Our aim was to investigate the quantitative hepatic collagen content by two different methods during the different stages of hepatic fibrosis in bile duct-ligated rats on a weekly basis. We questioned whether the 1-wk or 4-wk bile duct-ligated model is suitable in animal fibrogenesis trials.</p> <p>Methods</p> <p>Of the 53 male Wistar rats, 8 (Group 0) were used as a healthy control group. Bile duct ligation (BDL) had been performed in the rest. Bile duct-ligated rates were sacrificed 7 days later in group 1 (10 rats), 14 days later in group 2 (9 rats), 21 days later in group 3(9 rats) and 28 days later in group 4 (9 rats). Eight rats underwent sham-operation (Sham). Hepatic collagen measurements as well as serum levels of liver enzymes and function tests were all analysed.</p> <p>Results</p> <p>The peak level of collagen was observed biochemically and histomorphometricly at the end of third week (P < 0.001 and P < 0.05). Suprisingly, collagen levels had decreased with the course of time such as at the end of fourth week (P < 0.01 and P < 0.05).</p> <p>Conclusion</p> <p>We have shown that fibrosis in bile duct-ligated rats is transient, i.e. reverses spontaneously after 3 weeks. This contrasts any situation in patients where hepatic fibrosis is progressive and irreversible as countless studies performed by many investigators in the same animal model.</p

A Rare Cause of Acute Abdomen: Perforation of Duodenal Diverticulum Containing Ectopic Pancreatic Tissue

Perforation is a rare but serious complication of a duodenal diverticulum and often presents itself with nonspecific symptoms and signs. Ectopic pancreatic tissue within a duodenal diverticulum is another rare situation. In this article, we report a case of an 87 year-old woman who presented with spontaneous perforation of the duodenal diverticulum. Operative resection and simple closure of the duodenum was performed. Ectopic pancreatic tissue was observed within the diverticulum at histological evaluation

Derin Boyun Apsesi ve Peritoneal Sepsis Birlikteliği Nadir Ölüm Olgusu

Derin boyun enfeksiyonları, sıklıkla üst solunum yolu ve odontojenik enfeksiyonlara bağlı gelişebilirler. Gastrointestinal sistem perforasyonları ise birçok nedenle meydana gelebilir ve erken tanı ve acil cerrahi tedavi gerektiren durumlardır. Her iki durumda da geç veya yanlış tam, artmış morbidite ve yüksek mortaliteye neden olabilir. Diş apsesine bağlı derin boyun enfeksiyonu gelişen ve yatarak tedavi edilen bir olgunun “septik şok ve çoklu organ yetmezliği” sonucunda hayatım kaybettiği bildirilmiştir. Otopside “retrofaringeal apse” tanısı doğrulanmış ve ilave olarak antemortem dönemde tam almamış “duodenum perforasyonu” tespit edilmiştir. Otopside tıbbi uygulama hatasına ait bulgu tespit edildiğinde, bunun otopsi raporunda açıkça bildirilmesi gerektiğini düşünmekteyiz. Anahtar Kelimeler: Diş apsesi; Retrofaringeal apse; Pep- tik ülser perforasyonu; Peritonit; Sepsis; Otopsi