[show abstract][hide abstract] ABSTRACT: To evaluate the prevalent topical therapeutic modalities available for the treatment of acute radiation proctitis compared to formalin.
A total of 120 rats were used. Four groups (n = 30) were analyzed with one group for each of the following applied therapy modalities: control, mesalazine, formalin, betamethasone, and misoprostol. A single fraction of 17.5 Gy was delivered to each rat. The rats in control group rats were given saline, and the rats in the other three groups received appropriate enemas twice a day beginning on the first day after the irradiation until the day of euthanasia. On d 5, 10, and 15, ten rats from each group were euthanized and a pathologist who was unaware of treatment assignment examined the rectums using a scoring system.
The histopathologic scores for surface epithelium, glands (crypts) and lamina propria stroma of the rectums reached their maximum level on d 10. The control and formalin groups had the highest and mesalazine had the lowest, respectively on d 10. On the 15th d, mesalazine, betamethasone, and misoprostol had the lowest scores of betamethasone.
Mesalazine, betamethasone, and misoprostol are the best topical agents for radiation proctitis and formalin has an inflammatory effect and should not be used.
World Journal of Gastroenterology 09/2006; 12(30):4879-83. · 2.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Lower gastrointestinal bleeding is a commun clinical entity. Although colonoscopic examination is the first choice for diagnosis, it may not be enough to reveal the cause of bleeding in all subjects. METHODS: Eight patients who had massive lower gastrointestinal bleeding having normal colonoscopic findings were retrospectively evaluated at the Department of Trauma and Emergency Surgery, Istanbul University, Faculty of Medicine RESULTS: There were 5 male and 3 female patients with mean age of 51 (28 to 82). Patients received a mean of 13 U (range 2 to 23) with transfused erythrocyte concentrates. Four patients had found to be normal during angiographic, scintigraphy or enterocylytic examinations. Angiography was diagnostic in 4 patients, and identified bleeding from ileocolic pseudoaneurisms (n= 2) branches of jejunal artery (n=2). Embolization procedure were performed in these 4 patients and 3 of them developed intestinal necrosis and underwent surgery. One did not require further treatment. Two of the patients who underwent surgery expired due to sepsis. Patients were hospitalized for a mean of 17 days (range 5 to 37). CONCLUSION: Despite employment of all diagnostic procedures, the cause of bleeding were not detected in half of patients who had normal colonoscopic findings. If angiographic treatment is necessary, superselective arterial embolization should be performed.
Ulusal travma dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2005; 11(4):299-305.
[show abstract][hide abstract] ABSTRACT: Controversy remains regarding the best surgical approach for toxic multinodular goiter (MNG). The aim of this study was to evaluate the results of various thyroid operations for managing toxic MNG. A group of 100 patients with toxic MNG were divided into three groups and managed with total thyroidectomy (TT; group I, n-17), near-total thyroidectomy (NTT; group II, n = 48), or bilateral subtotal thyroidectomy (BST; group III, n = 35). Patients were compared with regard to age, gender, surgical operations, complications, thyroid hormone status, duration of hospitalization, and the reoperation rate for incidentally found thyroid carcinomas. There were 14 men (14%) and 86 women (86%) with a mean age of 47.03 +/- 13.56 years (range 19-77 years). After the operation two patients had a hematoma, and one patient had a seroma. Four patients had unilateral vocal cord paralysis, and one had permanent paralysis. Moreover, 18 patients had transient and 2 patients permanent hypocalcemia. There was no significant difference between the groups regarding complications (p < 0.05). Permanent hypothyroidism was achieved in all patients in group I and 44 patients (92%) in group II, whereas in group III only 10 (29%) patients had hypothyroidism. Conversely, hyperthyroidism, both subclinical and clinical, was noted only in group III (12 patients, 34%) during follow-up. We think that TT and NTT are safe, effective approaches in the treatment of toxic MNG, preventing recurrence of thyrotoxicosis and reoperation for incidentally found thyroid cancers. The complication rates for TT and NTT were similar to that for BST. Hence these operation should be considered for patients referred for surgical treatment of toxic MNG.
World Journal of Surgery 08/2005; 29(7):921-4. · 2.23 Impact Factor
[show abstract][hide abstract] ABSTRACT: NAD+ glycohydrolase activities in serum samples from cancer patients were two- to three-fold higher than the activities in samples from healthy controls. SDS-PAGE analysis of serum samples followed by Western blotting revealed the presence of two proteins of ~45 and ~21 kDa that were immunoreactive with human CD38-specific monoclonal antibodies T16, HIT2 and OKT10. These proteins appeared to be more abundant in serum from cancer patients. NAD+ glycohydrolase activity in serum could be enriched by immunoaffinity chromatography by using T16-Sepharose 4B. The results suggest that the relative abundance of proteins immunologically related to CD38 may account for the elevated levels of glycohydrolase activities in serum of tumour patients.