Alveoläres Weichteilsarkom

Alveolar soft part sarcoma is a malignant soft part tumor the etiology of which has not yet been clarified. Histopathological examinations show an alveolar or pseudoglandular pattern. PAS-positive, diastase resistant intraplasmic inclusion bodies are characteristic for this tumor which occurs in the head and neck region; mainly the tongue and the orbita. Primary therapy includes total resection which can later be combined with radiotherapy or chemotherapy. The present study involves a 17 year old patient. We totally removed the tumor and then used radiotherapy. The postoperative examinations over 3 years showed neither local recurrence nor distant metastases.     

Effects of Antibiotics and <Emphasis Type="Italic">Saccharomyces boulardii</Emphasis> on Bacterial Translocation in Burn Injury

Purpose To investigate the effects of antibiotics and the probiotic, Saccharomyces boulardii, on indigenous microflora and bacterial translocation (BT) in burned rats.Methods Twenty-three male albino rats were divided into a sham burn group (group 1, n = 7) exposed to 21°C water, a burn + antibiotic group (group 2, n = 8), and a burn + antibiotic + S. boulardii group (group 3, n = 8) exposed to 95°C water for 10s, producing a full-thickness burn to 30% of the total body surface area. Ampicillin-sulbactam (1000mg/kg per day) was given as two doses via an orogastric feeding tube to groups 2 and 3. Saccharomyces boulardii (1mg/g body weight per day) was given as two doses via the same route to group 3. All rats were killed on the fifth day postburn and cultures of the mesenteric lymph nodes, liver, spleen, blood, and cecal contents were done.Results The incidences of BT were 0% (0/7) in group 1, 87.5% (7/8) in group 2, and 37.5% (3/8) in group 3. A significant increase in the BT incidence was found in group 2 (P 0.01), while a significant decrease was found in group 3 when compared with group 1. The total bacteria count of cecal flora was significantly lower in group 3 than in group 1 (P 0.01). The decrease in Gram-negative bacteria in the cecal flora was significant in group 3.Conclusion These results suggest that the incidence of BT in burn injury is enhanced by using an antibiotic, and that S. boulardii decreases the incidence of antibiotic-induced BT. Thus, we conclude that S. boulardii can effectively protect the intestinal ecologic equilibrium and prevent BT in burn injury victims.     

Catch-up growth in fetal malnourished term infants

AIM: The aim of this study is to show that the Clinical Assessment of Nutritional Status (CANS) score is an effective method to diagnose fetal malnutrition (FM) in term newborns and to monitor the catch-up growth of fetal malnourished newborns. METHODS: A group of infants have been screened at birth for fetal malnutrition status using the CANS score (malnutrition was defined by a CANS sore cut-off value). The study group (consisting of fetal malnourished and non-malnourished infants) has been monitored after birth by two follow-up exams at 3rd and 6th months. RESULTS: The study showed that the FM group, which is similar to non-FM group in terms of gender and gestational age but different in nutritional status (CANS, weight, length, head circumference) at birth, showed partial catch-up growth, more so in head circumference than in others (weight, length). CONCLUSION: The study used CANS score to determine malnutrition in term infants and showed that malnourished infants (as defined by this CANS score cut-off value) caught-up partly with respect to the non-malnourished group. Furthermore, our experience showed that CANS score is an easy and effective way to identify fetal malnourished infants, and the scores can be obtained readily by following the established clinical assessment steps.     

Influence of Cardiovascular Risk Factors on the Outcome of Coronary Artery Bypass Surgery

Purpose. To assess the impact of gender, age, and other cardiovascular risk factors on the outcomes of patients undergoing coronary artery bypass grafting (CABG).Methods. A total of 5?067 consecutive patients undergoing isolated CABG between 1995 and 2000 were divided into the age groups: 25–49 years, 50–59 years, 60–69 years, and 70–84 years. Data on patient age, gender, smoking, serum cholesterol, blood pressure, body mass index, diabetes, family history, morbid obesity, and renal failure were retrospectively analyzed.Results. The percentage of women aged >60 years undergoing CABG was higher than the percentage of men aged >60 years (45.6% vs 36.6%). Most of the cardiovascular risk factors, except for smoking, were favorable in women (P < 0.001). The in-hospital mortality was 2.0% in women and 1.7% in men (P = 0.409). CABG was performed on significantly more men than women, accounting for 80.7% and 19.3% of the 5?067 patients, respectively (P < 0.001). However, the incidence increased remarkably in women aged >60 years.Conclusions. The risks of CABG may vary to some degree in accordance with the major cardiovascular risk factors. The risk of operative mortality was independent of gender in this study.     

Diagnosis and Surgical Treatment of Morgagni Hernia: Report of Three Cases

Morgagni hernia is a rare congenital disorder, which is usually asymptomatic, but may cause respiratory or gastrointestinal symptoms. We reviewed the clinical findings of three patients with a Morgagni hernia, diagnosed and treated in our department between 1997 and 2000. The Morgagni hernia caused various symptoms in all three patients and surgery was performed via posterolateral thoracotomy in two, and via laparatomy in one. The hernial defect was closed by primary suturing in two patients and by synthetic mesh in one. All three patients had an uneventful postoperative recovery. We believe that the transthoracic approach is an effective way of repairing Morgagni hernia. Received: October 19, 2001 / Accepted: July 2, 2002 RID="*" ID="*" Reprint requests to: I.C. Kurkcuoglu, Ataturk Universitesi Tip Fakultesi, Gogus Cerrahisi ABD, 25240 Erzurum, Turkey     

The Effects of Melatonin on Angiogenesis and Wound Healing

Purpose The pineal gland hormone melatonin is a well-known neoroendocrine hormone. In addition to its immunomodulator effect, it also has a positive effect on monocyte, cytokine, and fibroblast proliferations, which also influence angiogenesis. This study investigated the effects of melatonin hormone on angiogenesis in wound healing on 100 Wistar-Albino rats.Methods The rats were divided into two groups. Melatonin dissolved in 0.9% NaCl was administered to the study group in a dose of 0.4mg/kg/rat per day (0.25cc/rat per day), and 0.9% NaCl to the control group in a dose of 0.25cc/rat per day. Incisions 5cm in length were made on the back skin of the rats and the wounds were closed with a skin stapler. Excisional biopsies from healing tissues were taken on the 3rd, 7th, 10th, 14th, and 21st postoperative days. Angiogenesis was evaluated in healing tissues by light and electron microscopy and by hydroxyproline level measurements.Results The commencement of neovascularization and a significant increase (P 0.05) in the number of vessels were observed at all stages of the study group but not in the control group. The tissue hydroxyproline levels were also higher in the study group than in the control group.Conclusions Melatonin may have a positive effect on both angiogenesis and wound healing.The preliminary results of this study have been published in the Turkish Journal of Surgery     

The effects of the nitric oxide donor molsidomine prevent in warm ischemia-reperfusion injury of the rat renal — A functional and histophatological study

Aim of this experimental study is to verify the protective effect of molsidomine on the renal function and structural modifications in the ischemia-reperfusion rat kidney. Sixty-eight male Sprague-Dawley rats, which were right nephrectomized and occluded left renal artery for 60 minutes were used. Group I (n = 10) Sham-Operated animals, which only underwent right nephrectomy. Group II (n = 20) Untreated ischemic rats, which underwent left renal ischemia by occlusion of the renal artery for 60 minutes before blood flow was restored. Group III (n = 18) Molsidomine treated ischemic rats, Group IV (n = 20) L-NAME (N^G-nitro-L-arginine methyl ester) treated ischemic rats. Serum creatinine and blood urea nitrogen (BUN) were measured daily and biopsies were obtained from the remaining left kidneys. At seventh day, 55% and50% of the rats remained alive at the G-II and G-IV respectively. Molsidomine treated rats (G-III) were alive and healthy at day 7. The serum creatinine and BUN levels were significantly higher in G-II and G-IV when compared with the sham-operated group (G-I). G-III rats showed a rapid return to the normal serum creatinine and BUN values on postoperative days 1, 2, 3 and 4. The obtained values in G-III were significantly lower in comparison to the values of G-II and G-IV. The most severe damage (grade3 to 4) was determined in the kidneys of rats from GII or GIV. The degree of renal tubular damage in GIII was evaluated as grade 1 or 2 tubular damage according to Jablonkski's scale. Our findings suggested that the administration of molsidomine may vanquish the pernicious effects of warm ischemia on kidney structure and function. This revised version was published online in June 2006 with corrections to the Cover Date.     

Multicentral clinical evaluation of the aetiology of erectile dysfunction: A survey report

Patients with erectile dysfunction, who admitted to 4 different urological centres in Turkey were evaluated in terms of aetiological factors to establish the aetiology of erectile dysfunction in our population and compare it with the data derived from Western communities. After the history, physical examination, psychological evaluation and laboratory testing, a clinical diagnosis was established as primarily psychogenic, organic, or mixed aetiology. Mean patient age was 43.5 years (range 17 to 69), and 9 of the patients were unmarried. Of the patients 53 had vascular risk factors, and 10 reported a history of alcohol abuse. Eleven patients were using drugs that might interfere with the disorder. In this multicentral study of 115 impotent men, an organic cause was found in 43%, psychogenic in 47%, and mixed in 19%. Mean age of the overall patients was 43.48. When the ages of the patients with organic erectile dysfunction and those with psychogenic erectile dysfunction were compared, it was clearly seen that those with organic erectile dysfunction were much older (52.73 versus 33.02). This revised version was published online in June 2006 with corrections to the Cover Date.     

Bone age in children with nocturnal enuresis

It is widely believed that nocturnal enuresis is caused by a hereditary delay in maturation of the various organ systems. In this study, growth and bone age were investigated in enuretic children. There was a significant bone age lag in the enuretic group compared to the control subjects of similar age (8.15 ± 1.56 years vs 9.45 ± 2.17 years, p < 0.05). It has been suggested that skeletal maturation also are retarded in nocturnal enuresis; and, it may be caused by the delayed maturation in regulatory functions of the central nervous system This revised version was published online in September 2006 with corrections to the Cover Date.     

Management of Esophageal Perforation

Despite recent advances in thoracic surgery, the management of esophageal perforation remains problematical and controversial. Thirty-one patients were treated for an esophageal perforation between 1986 and 1998. The esophageal perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10 cervical, 19 thoracic, and 2 abdominal perforations. The interval from perforation to operation was less than 24 h in 12 patients and more than 24 h in 19 patients. The surgical procedures included a primary repair in 12 patients, a resection in 8, and conservative treatment with minor surgical approaches in 11. The mortality rate was 20% (4/20 patients) in the surgical treatment group and 45.5% (5/11 patients) in the conservative treatment with minor surgery group. The overall mortality was 29% (9/31 patients). The prognosis is thus concluded to depend on the cause and location of the perforation, the presence of underlying esophageal diseases, and the surgical procedure chosen. Received: October 12, 1999 / Accepted: May 30, 2000