Laparoscopically Treated Giant Gastric Bezoar Complicated with Large Ulcer in Young Patient

Gastric bezoars are rare but well known intraluminal formations in the gastrointestinal system. Reports for gastric bezoar treatment include dissolution, endoscopic retrieval and surgery (open and laparoscopic). We are presenting a case of 32 years old male patient presented with giant gastric bezoar complicated with large ulcer. The patient was operated laparoscopically with success. Laparoscopic surgery is safe alternative to open surgery for giant gastric bezoars treatment

Snapshot atmospheric parameters for the Istanbul metropolitan area during the course of two major wind regimes

At present scientific community is greatly concerned with extreme weather events due to their potential adverse effects that is associated with mesoscale weather events which can often be embedded in synoptic scale events that may be influenced by climatic variabilities. Extreme weather events can also change associated chemical compositions of the atmospheric parameters over metropolitan region. In this paper, we have used two major wind directions (N and SW) to characterize the upper and lower limits of atmospheric pollutants (PM10 and SO2) over Istanbul/Turkey rather than the wind or precipitation events that are associated with such events. In contrast to expectations, northerly air mass that originates from polar regions and traverses the industrialized or semi-industrialized countries and the Black Sea sets the lower limits for both PM10 and SO2 as 13 and 2.9 mu g/m(3), while southwesterly winds with its Saharan dust load set upper limits for PM10 as an average 300 mu g/m(3) reaching to 800 mu g/m(3) as peak hourly averages. SO2 levels during SW winds were also below 15 mu g/m(3). It has been further shown that the pristine northerly air mass can be used to delineate anthropogenic hot spots that can otherwise impossible to identify due to local perturbations

The conversion ofRASstatus in metastatic colorectal cancer patients after first-line biological agent treatment

Aim The aim was to investigate theRASdiscordance between initial and recurrent metastasectomy specimens in metastatic colorectal cancer (mCRC) patients treated with chemotherapy (CT) plus biological agents in a first-line setting. Methods Patients who had been treated with CT plus bevacizumab or cetuximab or panitumumab followed by R0 resection for potentially resectable colorectal cancer liver metastases were scanned. Among these, patients who developed resectable new metastases after a disease-free interval longer than 6 months were included in the study. We compared theRASmutation status between the first biopsy and the second metastasectomy specimen. Results A total of 82 mCRC patients treated with CT plus biological agents in a first-line setting were included in the study. The first biopsy assessment showed wild-typeRAStumours in 39 (47.6%) patients and mutantRAStumours in 43 (52.4%) patients. The mean time for new operable liver metastasis after R0 resection was 15.5 months. In the second metastasectomy specimens, the numbers of wild-type and mutantRAStumours were 30 (36.6%) and 52 (63.4%), respectively. The comparison with the first biopsy specimens showedRASstatus conversions in 17 (20.7%) patients. Univariate comparison between patients with and withoutRASstatus conversion revealed that grade, pathological T stage, wild-typeRAStumour and longer biological agent use time in the first-line treatment were significant factors forRASconversion. Conclusion Our results suggest that re-biopsy is needed for an optimal second-line treatment decision in mCRC patients regardless of backbone biological agent, especially in patients with wild-typeRASmCRC.Interdisciplinary Oncology Associatio