Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors

PURPOSE: Sacrococcygeal pilonidal disease is a source of one of the most common surgical problems among young adults. While male gender, obesity, occupations requiring sitting, deep natal clefts, excessive body hair, poor body hygiene and excessive sweating are described as the main risk factors for this disease, most of these need to be verified with a clinical trial. The present study aimed to evaluate the value and effect of these factors on pilonidal disease. METHOD: Previously proposed main risk factors were evaluated in a prospective case control study that included 587 patients with pilonidal disease and 2,780 healthy control patients. RESULTS: Stiffness of body hair, number of baths and time spent seated per day were the three most predictive risk factors. Adjusted odds ratios were 9.23, 6.33 and 4.03, respectively (p<0.001). With an adjusted odds ratio of 1.3 (p<.001), body mass index was another risk factor. Family history was not statistically different between the groups and there was no specific occupation associated with the disease. CONCLUSIONS: Hairy people who sit down for more than six hours a day and those who take a bath two or less times per week are at a 219-fold increased risk for sacrococcygeal pilonidal disease than those without these risk factors. For people with a great deal of hair, there is a greater need for them to clean their intergluteal sulcus. People who engage in work that requires sitting in a seat for long periods of time should choose more comfortable seats and should also try to stand whenever possible

Effect of Royal Jelly on new bone formation in rapid maxillary expansion in rats

Background: The aim of this study was to evaluate the effects of long and short term systemic usage of royal jelly on bone formation in the expanded maxillary suture in a rat model. Material and Methods: Twenty eight Wistar albino rats were randomly divided into 4 equal groups: Control (C); Only Expansion (OE), Royal Jelly (RJ) group, Royal Jelly was given to rats by oral gavage only during the expansion and retention period; Royal Jelly plus Nursery (RJN) group, Royal Jelly was given to rats by oral gavage during their nursery phase of 40 days and during the retention period. After the 5 day expansion period was completed, the rats underwent 12 days of mechanical retention. All rats were sacrificed in same time. Histological examination was performed to determine the number of osteoclasts, number of osteoblasts, number of capillaries, inflammatory cell infiltration, and new bone formation. Results: New bone formation, number of osteoclasts, number of osteoblasts, and the number of capillaries in the expanded maxillary sutures were higher in the RJ and RJN groups than in the other groups. Statistical analysis also demonstrated that new bone formation and the number of osteoblasts was also highest in the RJN group. Conclusions: The systemic administration of Royal Jelly in conjunction with rapid maxillary expansion may increase the quality of regenerated bone

Testicular fibrous hamartoma: A case report

Fibrous hamartoma (FH) of childhood is uncommon benign tumor. They are generally seen in the head and neck region, gastrointestinal system and lung. As in the case we report, they may also occur in other unusual sites such as groin and testis. The clinical presentation is almost always a mass or swelling. We hereby report a case with FH in atrophic testis which is unusual location and clinical presentation

AMELANOTIC MALIGNANT MELANOMA IN THE LOWER EXTREMITY MIMICKING SQUAMOUS CELL CARCINOMA AND PYOGENIC GRANULOMA

Amelanotik malign melanom; pigment eksikliği ile karakterize ve klinik olarak tanıda zorluk yaratan ve tedavide gecikmeye yol açabilen sınıflandırılmamış bir melanom alt grubudur. Bu çalışmada da alt ekstremite de klinik olarak epidermoid karsinom ve piyojenik granülomu taklit eden iki amelanotik malign melanom olgusu sunulmuştur. Yanıltıcı klinik görünümleri nedeniyle bu lezyonların eksizyonunun gecikmesi veya benign lezyonlar gibi tedavi edilmesi tümör derinliğinin artmasına ve hayatı tehdit eden bir lezyon haline gelmesine neden olabilir. Amelanotic malignant melanoma that is characterized with lack of melanin pigment in the tumor cells, is an unclassified sub-type of malignant melanoma. Because of the lack of pigmentation, there are difficulties in clinical diagnosis, which can lead delays in the treatment. Two cases of amelanotic malignant melanoma in the lower extremity are reported. These lesions were mimicking epidermoid carcinoma and pyogenic granuloma on the heel . The misleading clinical appearance of this form of cutaneous melanoma can have serious implications for the patient if such a misdiagnosed malignant melanoma is treated as benign lesion. This delay in diagnosis can allow a thin melanoma to become a more invasive, life-threatening lesion

Living donor liver transplantation with replacement of vena cava for Echinococcus alveolaris: A case report

AbstractINTRODUCTIONThere is no medical treatment for alveolar echinococceal disease (AED) of liver till now. Curative surgical resection is optimal treatment but in most advanced cases curative resection can’t be done. Liver transplantation is accepted treatment option for advanced AED. AED in some case invade surrounding tissue especially inferior vena cava (IVC). Advanced AED with invasion to IVC can be treated with deceased liver transplantation. Although living donor liver transplantation is very difficult to perform in patients with advanced AED with resected IVC, it come into consideration, since there is very few cadaveric liver.PRESENTATION OF CASEHere we present a case with advanced stage of AED of liver which cause portal hypertension and cholestasis. AED invaded surrounding tissue, right diaphragm, both lobes of liver and retrohepatic part of IVC. Invasion of IVC forced us to make resection of IVC and reconstruction with cryopreserved venous graft to reestablish blood flow. After that a living donor liver transplantation was done.DISCUSSIONCurative surgery is the first-choice option in all operable patients with AED of liver. Advanced stage of AED like chronic jaundice, liver abscess, sepsis, repeated attacks of cholangitis, portal hypertension, and Budd-Chiari syndrome may be an indication for liver transplantation. In some advanced stage AED during transplantation replacement of retrohepatic part of IVC could be done with artificial vascular graft, cadaveric aortic and caval vein graft.CONCLUSIONAlthough living donor liver transplantation with replacement of IVC is a very difficult operation, it should be considered in the management of advanced AED of liver with IVC invasion because of the rarity of deceased liver

Can gestational exercise have a positive effect on cognitive functions resulting from brain injury? A rat study

Aim: The effects of gestational exercise on potential pathological conditions is not known yet.&nbsp; Therefore, in the present study, it was aimed to evaluate the effects of forced running exercise on LPS-induced brain damage in pregnant rats. Method: Pregnant females in the experimental group were forced to exercise 30 min daily for five days a week. Lipopolysaccharide (LPS) induced brain injury model was created by administering 500 µg/kg body weight of LPS on gestational days 18 and 19.&nbsp;&nbsp; To evaluate injury histopathologically, brain tissues were fixed at the postnatal day seven through transcardial perfusion (n=4 pups/group). When the remaining pups reached 30-day of age, Morris water maze test (MWM) was performed to assess memory and learning, open filed (OP) and elevated plus maze (EPM) for testing anxiety, and Porsolt test (PT) for evaluating depression. The groups were defined as brain injury group (BI, n=13) and exercise+brain injury group (E+BI, n=7).&nbsp; Results: The results obtained from MWM test indicated that animals found the platform in a shorter duration and distance at the day five compared to the day three. However, there was no significant difference between the groups. No significant difference was found in OP test regarding the distance traveled, time spent at the margins, movement at the center and the time spent as immobile. However, in the EPM test, the offspring at the BI group displayed higher mobility and increased number of entry to the open arms compared to the E+BI groups (p=0.01).&nbsp; There was no significant difference regarding mobility duration and total distance traveled in the PT test. Conclusion: In the present study, we tested the impact of gestational exercise using the brain injury model. The results of the EPM test suggests that the gestational exercise can suppress the stress factors in the pregnant females with brain injury leading to the prevention of hyperactivity-induced negative learning behavior