Application of stem cells and adipose-derived stem cell exosomes on dermal wound healing

The skin is the largest organ in the human body and plays a significant role in protecting the body from external threats, containing tissues that sustain the body's homeostasis. Wound healing in the skin is a complex process involving the interaction of various cell types in the target tissue, including but not limited to cytokines and growth factors. In extreme cases, disorders of the cardiorespiratory system, such as chronic diseases, may prevent the process of wound healing entirely. Numerous studies have been conducted to discover methods to restore the ability of chronic wounds to cure themselves, but this remains one of the most significant medical problems. Exosomes derived from stem cells have been extensively proposed as a treatment for dermal wound recovery. Different types of stem cells have varying therapeutic potential. Exosomes, a component of paracrine, have the function of enhancing the effectiveness of stem cells. This article discusses the wound healing process as well as the mechanism of stem cell and adipose-derived exosome therapy on cutaneous wound healing and its clinical applications

Decision Making in Surgical Oncology

As can be seen from ancient Egyptian writings, cancer has been a major health problem for at least 3.500 years. Significant progress has been achieved in the battle against cancer in conjunction with increased knowledge and technological developments. However, cancer remains one of the leading causes of deaths worldwide. In the last century, as genetics and histopathological studies have fostered our understanding of the nature of the disease, oncology has become a subdiscipline within some of the major medical branches, i.e. surgical oncology. Several studies have been conducted on the decision-making process in cancer patients and it has been emphasized that correct decision-making is essential for proper management of the disease. In this article, we aimed to create a foundation based on what we already know on this important issue, to understand the difficulties of the decisionmaking process, and to emphasize the developments needed to overcome these difficulties

Acute Appendicitis in Pregnant Women: Our Clinical Experience

Purpose: The purpose of this study was to analyse 13 patients who were treated in our clinic due to acute appendicitis during pregnancy. Methods: Records of the patients who received appendectomy with appendicitis diagnosis in our Turgut Özal University Research and Application Hospital between January 2007 and December 2015 have been analyzed retrospectively. Results: Appendectomies were performed on 13 pregnant patients with an acute appendicitis diagnosis. Average age of the patients was 27.69 years (between 22-37 years). Most frequent complaint of the patients was abdominal pain and most frequent examination finding was tenderness at right lower quadrant. Ultrasonography was used in all cases for diagnosis. Surgery was decided with clinical diagnosis for five cases (38.5%) where appendix had not been identified with ultrasonography. While laparoscopic appendectomy was applied in one case (7.7%) and open appendectomy was applied using a McBurney incision in 12 cases (92.3%). Average hospitalization duration was 1.69 days. All patients were tracked together through the Gynaecology Department for two weeks after they had been discharged from the hospital. Preterm delivery, maternal and fetal loss did not occur. Conclusion: It is considered appropriate to apply ultrasonography routinely to all pregnant patients in whom acute appendicitis is suspected. Concern for maternal or fetal complication that may occur in consequence of an unnecessary surgery should not be at a level that will delay surgical treatment needed by the patient

Altered VEGF, Bcl-2 and IDH1 expression in patients with adenomyosis

Purpose Adenomyosis is a benign uterine disease resulting from the myometrial invasion of the endometrial gland and stroma. In the current study, angiogenesis, apoptosis and energy metabolism were investigated in adenomyosis. Methods A retrospective study was performed using paraffin archival tissues. Three groups were included in the study: Group I and Group II; ectopic and eutopic endometrial tissues of patients with adenomyosis, respectively, and Control Group; endometrial tissue of individuals without adenomyosis. Vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), intercellular adhesion molecule 1 (ICAM-1) and hypoxia-inducible factor 1 alpha (HIF-1A) levels were evaluated as angiogenic markers. Bcl-2, caspase-9 and caspase-3 levels were investigated as apoptotic indicators, and isocitrate dehydrogenase 1 (IDH1), succinate dehydrogenase complex subunit C (SDHC) and fumarate hydratase (FH) levels were also examined as energy metabolism markers. Gene expression levels of all parameters were determined by RT-PCR. Result VEGF expression levels were found to be increased in Group I according to the control group and Group II. Bcl-2 expression levels were found to be increased in the Group I compared to the Group II. It was determined that expression levels of IDH1 were decreased in the Group I and Group II compared to the Control Group. There was no significant difference in the other examined parameters. Although we did not find a significant difference in HIF-1A levels between the groups, we found a positive correlation between VEGF and HIF-1A in the Group I. Conclusion These results point out that VEGF, HIF-1A, Bcl-2 and IDH1 may be associated with the etiology of adenomyosis

Endometriosis mimicking incisional hernia detected in the rectus abdominis muscle after caesarean section

Azerbaycan Tıp Üniversitesi, 3. Cerrahi Hastalıklar Kliniği, BaküNumune Eğitim ve Araştırma Hastanesi, Genel Cerrahi (Cerrahi Onkoloji) Kliniği, AnkaraYıldırım Beyazıt Üniversitesi, Tıp Fakültesi Genel Cerrahi Anabilim Dalı, AnkaraMedical Park Ankara Hastanesi, Genel Cerrahi Kliniği, AnkaraEndometriozis, fonksiyonel endometrium bez ve stromanın, uterus boşluğu dışında büyümesi olarak tanımlanır. Sezaryen, histerektomi, apendektomi ve laparoskopi sonrası trokar yerinde; epizyotomi ve amniyosentez sonrasında skar dokusunda endometriozis saptanabilmektedir. Karın duvarı endometrioması ise sezaryen başta olmak üzere yapılan jinekolojik girişimler sonrası, insizyon skar dokusunda veya komşuluğunda gelişebilen endometrium bez ve stromasından oluşan bir kitledir. Bu yazıda, rektus abdominis kası içinde insizyonel herniyi taklit eden ağrılı kitlesi olan, beş yıl önce sezaryen ile doğum öyküsü olan, 41 yaşında bir kadın hasta sunuldu. Geniş eksizyonla tedavi edilen hastanın histopatolojik incelemesi endometriozis olarak rapor edildiEndometriosis is defined as the growth of functional endometrial gland and stroma outside the uterine cavity. Endometriosis can be detected at the trocar site after caesarean section, hysterectomy, appendectomy, and laparoscopy; and within the scar tissue after episiotomy and amniocentesis. Abdominal wall endometrioma, on the other hand, is a mass composed of endometrial gland and stroma that may develop within or adjacent to incisional scar tissue after gynecological procedures, mainly caesarean section. In this article, we present a 41-year-old female patient with a history of giving birth via caesarean section five years ago, who presented with a painful mass mimicking an incisional hernia within rectus abdominis muscle. The patient was treated with a large excision and we report the histopathological examination to be endometriosis