Influence of grafting on fatty acid profile and some physicochemical properties of watermelon seed and seed oil

This study aimed to investigate the effects of grafting on the fatty acid profile and some physicochemical properties of watermelon seed and seed oil. The ‘Crimson Tide’ cultivar was used as the scion while two wild watermelon (Citrullus lanatus var. citroides (A1 and A2)), one Lagenaria siceraria (A3) and one Cucurbita maxima Duchesne x Cucurbita moschata Duchesne (A4) were used as rootstocks. The use of rootstock significantly influenced the fatty acid profile and the physical parameters of seeds and seed oils. The highest linoleic acid ratio was found in the seed oil from A1 and A2, the oil from A3 had the highest oleic acid ratio. The results showed that the content and acid value in seed oils were improved, and that total phenolic compounds and antioxidant activity of both seed and oil were decreased by grafting. Wild rootstocks can be used in watermelon cultivation to obtain a watermelon seed which is rich in linoleic acid.

The variations and degenerative changes of sacroiliac joints in asymptomatic adults

BACKGROUND

The sacroiliac joint has a structure in which the direction of the load relative to the articular surface is irrational, as the joint surface is not perpendicular to the trunk load axis; it is likely to incur more degenerative changes than other weight-bearing joints.

MATERIALS AND METHODS

This retrospective study consisted of a total of 145 cases - 104 (71.7%) men and 41 (28.3%) women - who were referred to Gaziantep University Medical Faculty Radiology Department Polyclinic for pelvic computed tomography (CT) from 2013 to 2018. The mean age was 33.5 years (range: 18-60 years). Pelvis CT images were performed according to the exclusion criteria specified by the experienced orthopaedic surgeon. Patients were excluded from the study if they were younger than the age of 18, had a condition involving the sacroiliac joint, had an endocrine disorder, or had a history of a trauma affecting the pelvis CT examination.

RESULTS

In this current study, six types of anatomic variations were detected. Iliosacral complex variation has been determined as the most common type of variation. The incidence of variations of sacroiliac joint in all cases was 28.9%. Degenerative changes were seen in 5.5% of patients fewer than 30 years of age. When it comes to the patients whose age range is 30-60, the percentage of the degenerative changes is 12.4%. In patients who were 30 years and older, the prevalence of degenerative changes increased progressively with increasing age.

CONCLUSIONS

In this study, it is thought that the knowledge of variations in normal population and degenerative changes will contribute to the better understanding of normal morphological structure of sacroiliac joint and to the anatomical literature. It's seen that there is not a statistically significant relationship between degenerative changes and anatomical variations.

Scale-Up of Shear Thinning Fluid Mixing in an Unbaffled Stirred Vessel with Eccentrically Located and Modified Impellers

Mixing of a shear thinning fluid was scaled-up by maintaining equal Reynolds number (Re), tip speed, and power per volume. A standard 45° four-blade pitch blade turbine (PBT) and a modified version of the same impeller (DF-PBT) which provided simultaneous upward and downward flow were used. The impellers were located eccentrically, and the effects of scale-up were determined. The distribution of a tracer solution to evaluate mixing progress, power consumption, and flow fields were analyzed to compare the three different scale-up rules. The same endpoint of mixing was achieved in all cases of PBT with noticeable differences in flow profiles. Higher power consumption and less time were necessary to complete mixing with equal power per volume compared to that with equal Re and tip speed rules. For DF-PBT, only equal Re rule resulted in values similar to that obtained at the small scale. At a scale-up ratio of 2, the selection of scale-up rule should be based on the time and power requirements of the process. As the effects of scale-up on eccentrically located impellers do not differ significantly from those of concentrically located impellers, impellers which have complex dynamics such as DF-PBT require further studies to understand scale-up effects.

Iloprost reduces colitis induced oxidative stress: An experimental study in rats

BACKGROUND/AIMS

Reactive oxygen species have a known potent role in the pathogenesis of ulcerative colitis. Iloprost, a pharmaceutical, is a chemically stable derivative of a naturally- occurring human prostacyclin. Several studies have demonstrated protective effects of iloprost via its antioxidant and its anti-inflammatory activity. The aim of this study is to evaluate the effects of iloprost on oxidant/antioxidant status, as well as the large bowel histopathology in experimental colitis.

MATERIALS AND METHOD

Forty adult male Wistar-albino rats were randomly divided in to four equal weight-matched groups: sham group (n=10), iloprost administered sham group (n=10), colitis group (n=10), iloprost administered colitis group (n=10). Acetic acid (1 ml of 4% solution) was used to induce colonic inflammation in the rats.

RESULTS

Colonic tissue and plasma malondialdehyde levels were significantly lower in the iloprost administered colitis group than the colitis group (p<0.01). Tissue glutathione levels of the iloprost administered colitis group were significantly higher than the colitis group (p<0.001).

CONCLUSION

We have demonstrated in this study iloprost to be an antioxidant, as well as iloprost demonstrating protective activity against colitis induced oxidative stress.

Passage of "colonic cast" after colorectal surgery: report of four cases and review of the literature

Anal passage of a full-thickness infarcted colonic segment (so-called "cast") not accompanied by any features of acute peritonitis is a very rare occurrence and may be the main advertising manifestation of acute colonic ischemia. Most of the reported cases of acute colonic ischemia are secondary to abdominal aortic aneurysms and ensuing inferior mesenteric artery thrombosis or to the repair of these aneurysms. The preceding events causing ischemia in other cases are Hartmann reversal, rectal resection and colonic J-pouch construction, and acute pancreatitis. In this article we present our experience on four cases of colonic cast passage, all of which developed subsequent to colorectal resection. Three of these casts are supposed to be mucosal and one is transmural. Generally, surgery is the rule and consists of the resection of the concerned ischemic segment. Every clinician should be aware of this form of presentation of bowel ischemia, not only following aneurysm surgery but also in the postoperative course of colorectal surgery.

Laparoscopic repair of Morgagni hernia

BACKGROUND

Morgagni hernia is a rare type of diaphragmatic hernia which represents less than 5% of all congenital diaphragmatic hernias. Patients are generally asymptomatic and are diagnosed incidentally. When symptomatic, it generates symptoms due to the compression of thoracic organs or compression of herniated intraabdominal organs. Once diagnosed, the condition requires prompt surgical correction. The defect is repaired either by primary suture or by the use of a prosthetic mesh. In adults, prosthetic mesh repair is preferred. Recently, laparoscopic repair of Morgagni hernia has been introduced and gained wide acceptance.

MATERIALS AND METHODS

Between 2002 and 2004, 5 patients with Morgagni hernia were treated laparoscopically at our department. Female/male ratio was 3/2. Mean age was 56 years (range 41 to 69 y). Diagnosis were made by chest x-ray and CT scan. Herniation was on the left in 2 patients, and on the right in 3. The content of hernial sac was transverse colon and stomach. There were 2 separate defects in a patient with left-sided hernia. All cases were laparoscopically treated using prosthetic material.

RESULTS

All operations were completed laparoscopically. The postoperative hospital stay was 3 to 5 days with a mean of 4 days. None of the patients developed any complication in the early postoperative period. The mean follow-up period is 7 months (range 3 to 24 mo). All patients are actually in good health and without recurrence.

CONCLUSION

Laparoscopic repair of Morgagni hernia is a safe, simple, and reliable procedure which presents all the advantages of the minimally invasive surgery.

Laparoscopic repair of ventral and incisional hernias: our experience in 150 patients

BACKGROUND

Incisional hernias develop in 2 to 20% of laparotomy incisions. Approximately 100,000 ventral hernias are operated on each year in the United States. The reported recurrence rates for open repair are 25-52% for primary and 12.5-19% for mesh repair. Compared to the open technique, laparoscopic repair has low rates of complications and recurrence, greater patient acceptance, and shorter hospital stay.

MATERIALS AND METHODS

Between April 1999 and April 2004, we treated 150 patients (111 female, 39 male) with ventral and incisional hernias laparoscopically. Data concerning the age and sex of patients, the location, number, and size of fascial defects, the type of hernias and their contents, the size and type of meshes used in repair, operative time, length of hospital stay, and postoperative complications were collected.

RESULTS

Of the 150 patients, 92 had incisional hernias and 58 had umbilical hernias. Polypropylene was used in 85 cases, dual mesh in 40 cases, and composite mesh in 25 cases. The mean age of the patients was 56.0 years (range, 33-81 years). Mean operative time was 63 minutes (range, 30-125 minutes). Mean postoperative hospital stay was 2.5 days (range, 1-15 days). The postoperative complication rate was 8.6% (seroma, paralytic ileus, small bowel injury, and suture-site neuralgia). The mean follow-up period was 32 months (range, 4-60 months). There was a 3% recurrence rate. Three subileus cases were detected during follow-up.

CONCLUSION

The laparoscopic approach to ventral and incisional hernias is safe, feasible, and a good alternative to the open approach. Our results are comparable with those of other reports in the literature.

Laparoscopic transperitoneal adrenalectomy using the LigaSure vessel sealing system

BACKGROUND

Laparoscopic adrenalectomy is being performed with increasing frequency in the surgical treatment of adrenal tumors. Among laparoscopic approaches to the adrenal glands, the transperitoneal access is preferred. Along with advances in technology, different energy systems have been utilized. Laparoscopic adrenalectomy has become easier with the use of the LigaSure vessel sealing system (Valleylab, Boulder, Colorado).

MATERIALS AND METHODS

Between January 2002 and August 2004, 23 laparoscopic transperitoneal adrenalectomies were performed in 22 patients using the LigaSure vessel sealing system: 16 of the patients were female, 6 were male and the mean age was 44 years (range, 17-70 years). Indications for surgery were non-functioning adenoma (n = 10), pheochromocytoma (n = 4), Cushing's syndrome (n = 5), Conn's syndrome (n = 2), and lymphoma (n = 1). The mean diameter of lesions was 4 cm (range, 1-7 cm). The distribution was 12 left, 9 right, and 1 bilateral adrenalectomies.

RESULTS

The mean operative time for unilateral adrenalectomies was 57 minutes (range, 30-75 minutes). The operative time for the patient with Cushing's disease in whom a bilateral adrenalectomy was performed was 180 minutes. All operations were completed laparoscopically. A nonsteroidal anti-inflammatory drug (Lornoxicam) was sufficient for postoperative analgesia. Oral feeding was started 6 hours postoperatively. When used, drains were removed on postoperative day 1. The mean postoperative hospital stay was 1.5 days (range, 1-3 days). Wound infections developed in two patients with Cushing's syndrome. There was no mortality. Histopathologic examination of specimens revealed a cortex adenoma in 16 cases (10 of which was nonfunctional), a pheochromocytoma in 4 cases, a bilateral cortical hyperplasia in 1 case, and a lymphoma in 1 case.

CONCLUSION

Laparoscopic adrenalectomy is an established method in the treatment of adrenal masses. Laparoscopic adrenalectomy as well as other laparoscopic procedures has become easier with the introduction of new energy systems. Vascular control and dissection of the gland by Liga- Sure is feasible. It makes the procedure easier and eventually shortens the operation time.

Enteroliths developed in a chronically obstructed afferent loop coexisting with gastric remnant carcinoma: Case report and review of the literature

A case of gastric remnant carcinoma coexisting with a chronic afferent loop syndrome harboring multiple enteroliths in a grossly dilated and elongated afferent loop is presented herein. The patient had undergone a Polya type antecolic Billroth II reconstruction for a stenosing duodenal ulcer 40 years previously. A concise review of the relevant literature is also presented.

Serum free prostate-specific antigen and zinc levels in experimental acute pancreatitis

Serum free prostate-specific antigen (fPSA) is the most useful tumor marker for prostatic cancer screening. However, recently, fPSA has also been detected in sera from patients with pancreatic diseases. In addition, it has been shown that zinc (Zn) concentration might change in both serum and tissues in pancreatic disease. In the present study, we measured serum concentrations of fPSA and Zn as possible markers and prognostic factors in an experimental acute-pancreatitis model. Twenty-five female Wistar albino rats were divided into two groups: the control group (n=10) and the experimental group (n=15). Acute pancreatitis was induced by injection of ethyl alcohol into the common biliary duct. The animals were sacrificed 24 h later to detect the concentrations of serum fPSA and Zn. fPSA values were detected to be significantly higher in the experimental group (p < 0.001). There was also a significant decrease in the serum Zn level of the acute-pancreatitis group (p < 0.001). In conclusion, these findings suggested that a combination of these parameters might represent a significant improvement on the diagnostic value of each of them separately and provide a powerful tool for differential diagnosis and prognosis in pancreatic diseases.

Plasma leptin levels in rats with pancreatitis

Diagnosis of pancreatitis is based on the determination of serum amylase and lipase levels. However, recent identification of specific leptin receptors in the pancreas suggests that this peptide may also play some roles in the modulation of pancreatic function. The objective of the present study was to investigate the relationship between serum leptin levels and pancreatitis. Thirty male Wistar rats were divided into 3 groups: the control group, acute pancreatitis group and chronic pancreatitis group. Pancreatitis was induced by injection of ethyl alcohol into the common biliary duct. A sham laparotomy was performed in the control group. Control and acute pancreatitis groups were sacrificed 24 hours later, and chronic pancreatitis group was sacrificed on postoperative day 7. Blood was taken by cardiac puncture for the determination of plasma leptin levels, and the pancreatic tissue was excised for histopathologic confirmation of pancreatitis. Plasma leptin rose significantly from the median of 0.78 +/- 0.12 ng/ml in the control group to 1.92 +/- 0.10 ng/ml and 1.86 +/- 0.13 ng/ml in acute and chronic pancreatitis groups, respectively (p < 0.001, for both). There was no significant difference in the plasma leptin levels between the acute pancreatitis group and the chronic pancreatitis group (p > 0.05). These findings confirm that leptin has a role in pancreas inflammation, and the inflamed tissue can be the source of local production of leptin.

Single staged, z-plasty supported, wedge excision modification for treatment of auricular lesions under local anesthesia: a technical note

Following wedge-excision of auricular lesions, a triangular-cartilage only-excision is planned at the tip of the wedge. The dimensions and the angles of this cartilage can be modified as much as the required helical rotation. After approximating the cartilage edges a notching deformity may be observed which can be improved using single or multiple z-plasties.

Effect of Intra-abdominal Pressure Level on Gastric Intramucosal pH During Pneumoperitoneum

The present study was designed to examine the effect of intra-abdominal pressure level on gastric intramucosal pH using gastric tonometry during pneumoperitoneum. One hundred patients were prospectively randomized into 5 equal groups (N = 20 each). Intra-abdominal pressure levels were 8, 10, 12, 14, and 16 mm Hg in groups I, II, III, IV, and V, respectively. Intramucosal pH measurement was done 2 times: 30 minutes following insufflation and 1 hour after the ending of the surgery. In the first and second measurements, intramucosal pH values were found as 7.39 +/- 0.02 and 7.36 +/- 0.03 in group I; 7.41 +/- 0.03 and 7.38 +/- 0.03 in group II; 7.37 +/- 0.03 and 7.37 +/- 0.03 in group III; 7.36 +/- 0.03 and 7.37 +/- 0.03 in group IV; and 7.39 +/- 0.03, 7.36 +/- 0.03 in group V, respectively. Statistical significance was not found in the comparison of these values within the groups and between the groups (P > 0.005, for each). In conclusion, intra-abdominal pressure between 8 and 16 mm Hg did not cause significant difference in gastric intramucosal pH.

Thoracoscopic enucleation of a giant submucosal tumor of the esophagus

Since the introduction of thoracoscopy in the surgical field, many thoracic interventions have been considered feasible via thoracoscopic route. The authors reported a case of thoracoscopic enucleation of a giant esophageal submucosal tumor (8.5 cm in diameter) situated along the left side of the midesophagus. Histopathologic evaluation revealed a gastrointestinal stromal tumor (GIST). Postoperative period was uneventful and the patient was discharged on the eighth postoperative day. Given the well-known advantages of minimally invasive surgery, we assume that the removal of esophageal submucosal tumors can first be attempted by thoracoscopic approach, even if the tumor is of a big size. In cases of histopathologically unknown tumors preoperatively, definitive examination of the complete specimen provides the basis for further therapeutic decisions.

Major retroperitoneal vascular injuries during laparoscopic cholecystectomy and appendectomy

BACKGROUND

Serious complications may occur during laparoscopic surgery, as in any surgical procedure. Injuries of major retroperitoneal vascular structures are uncommon but important complications of laparoscopy.

METHODS

We report on 9 major vascular injuries in 8 patients in the course of 8 laparoscopic procedures between 1994 and 2002.

RESULTS

The primary operations were cholecystectomy in 7 patients and appendectomy in one patient. Six vascular injuries occurred during placement of the first umbilical trocar, two in the course of the insertion of a Veress needle, and one during the insertion of the second trocar. A laparotomy was performed immediately in all cases. Left common iliac arteries were injured in two patients, aorta in three patients, right common iliac vein in one patient, both right common iliac artery and vein in one patient, and inferior vena cava in one patient. Polytetrafluoroethylene (PTFE) graft interposition was employed in two common iliac arteries and a tubular PTFE graft in one aortic injury, and Dacron patchplasty in one common iliac artery injury. Two aortic, two common iliac vein, and an inferior vena cava injury were repaired primarily. There were also four visceral organ injuries, which were repaired primarily. The major retroperitoneal vascular complication rate was 0.07%. An average of 3.5 units of whole blood were transfused in each case and the average stay in hospital was 6.8 days. There was no mortality.

CONCLUSIONS

The surgeon's experience and knowledge are the essential factors for prevention of major vascular injuries during laparoscopic procedures. In case of an injury, immediate laparotomy must be performed to achieve hemostasis and a surgeon who is familiar with vascular surgery should employ the definitive treatment.

Totally Laparoscopic Pericystectomy in Hepatic Hydatid Disease

Hepatic hydatid disease is still a commonly seen problem in endemic areas as well as in our country. There is a wide spectrum of therapeutic modalities ranging from simple medical treatment to radical liver resection. Progress in laparoscopic procedures made it possible to consider laparoscopic approaches in selected patients with hepatic hydatid disease. The current laparoscopic approach seems to be limited to cystotomy and drainage. There are fewer reports on hepatic resections or pericystectomy in the literature. In this article we present a case of laparoscopic pericystectomy performed in a selected patient.

Laparoscopic repair of an internal supravesical hernia: a rare hernia causing small bowel obstruction

The application of diagnostic laparoscopy in emergency surgery has facilitated a wide range of endoscopic operative procedures. We report an extremely rare case of a patient who had a bowel obstruction caused by an internal supravesical hernia that was repaired via a minimally invasive technique. Abdominal computed tomography (CT) showed signs of small bowel obstruction: the cause was thought to be an invagination due to a small bowel tumor. Laparoscopic exploration of the dilated small bowel segments allowed the diagnosis of supravesical hernia. Reduction was performed with slight traction, and the hernial orifice was closed with intracorporeal sutures. To our knowledge, this is the first repair of an internal supravesical hernia ever to receive herniorraphy based on laparoscopic techniques. The mean starting time for bowel-function and mean hospital stay following the laparoscopic release of the intestinal obstruction were significantly shorter than is typically seen with standard techniques.

Laparoscopically treated liver hydatid cysts

HYPOTHESIS

Laparoscopy is effective and reliable in treating hepatic hydatid disease.

DESIGN

Case series of patients with hepatic hydatid disease who underwent laparoscopic treatment within 7 years.

SETTING

Department of General Surgery, Cerrahpasa Medical School, University of Istanbul, Istanbul, Turkey.

PATIENTS

Forty-eight patients with hydatid disease who met our criteria for laparoscopic surgery and were aged 17 years or older.

INTERVENTIONS

Cystotomy and partial cystectomy with drainage were performed in 33 patients. Omentoplasty was simultaneously performed in 15 patients to obliterate the cystic cavity.

MAIN OUTCOME MEASURES

Clinicopathologic features, morbidity, mortality, operative time, length of hospital stay, conversion to laparotomy, and recurrences were reviewed retrospectively.

RESULTS

The mean operative time was 82 minutes (range, 45-170 minutes). The conversion rate to open surgery was 4%. The mean postoperative length of hospital stay was 4.2 days. Morbidity was 6% (3 patients). There was no mortality. The mean follow-up was 34.2 months. No recurrences were observed during this period.

CONCLUSIONS

Laparoscopic hepatic hydatid surgery is a safe and effective method in selected patients. Further studies should be encouraged in this field because there is no universally accepted standard technique.

Correlates for end-stage renal disease patients

In this study 112 end-stage renal disease patients on hemodialysis were analyzed for their state of well-being, cognition, ambulatory capacity, and dexterity. The Nottingham Health Profile, the locomotion and dexterity sections of the Office of Population Censuses and Surveys disability scale, the modified Mini Mental State examination and a weighted index of comorbidity were used for assessment. The study revealed that good cognition, good mood, young age, and milder comorbid conditions were positively linked with good functional levels of locomotion and dexterity. The test instruments used in the investigation were considered simple to use and were effective in revealing relationships between the above-mentioned parameters.

Subcutaneous hydatidosis due to iatrogenic spreading of cystic fluid during surgery

Subcutaneous involvement is a rare manifestation of echinococcosis. We report a rare case of a 28-year-old woman with widespread hydatidosis of the lung, liver, and subcutaneous adipose tissue. The patient underwent surgical excision of multiple hepatic and pulmonary cysts with a thoraco-abdominal incision two years earlier. The subcutaneous cyst was located over the incision, and it is likely that resulted from accidental rupture of the primary cyst and spreading of scolices during surgery.

Isokinetic measurement of trunk muscle strength in women with chronic low-back pain

OBJECTIVES

To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined.

DESIGN

A controlled, prospective study of trunk muscle strengths of patients with chronic low-back pain and the short-term impact of exercise on strength. The study group consisted of 25 female patients who had been experiencing low-back pain for at least 3 mo, and the control group included 20 age-matched women without known low-back trouble. The Davenport Index was used to calculate the body mass indexes of all subjects. The Oswestry Disability Questionnaire was used to assess pain in the study group. Full flexion and extension ranges of motion were measured, then isokinetic measurements of trunk muscles were performed at 60-, 120-, and 180-degrees/sec velocities. Isometric measurements were also recorded for both flexors and extensors at a 60-degree angle.

RESULTS

Increased body mass index and decreased trunk muscle strength were found to be directly associated with chronic low-back pain (P < 0.05). After a 15-day standard trunk strengthening exercise program in the patient group, trunk muscle strength was found to be increased (P < 0.05).

CONCLUSIONS

Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.

Impact of initial surgical treatment on survival of patients with differentiated thyroid cancer: experience of an endocrine surgery center in an iodine-deficient region

This retrospective clinical study was designed to analyze the impact of the initial surgical procedure on the survival of 1000 patients with differentiated thyroid cancer of follicular cell origin who had a thyroid operation and were followed for the 30 years between 1968 and 1998 (median 14 years) in an iodine-deficient region where goiter is endemic. There were 753 women and 247 men with a mean age of 42.8 +/- 6.7 years (range 17-86 years). Patients were divided into three groups. All patients had undergone thyroxine treatment and thyroid-stimulating hormone (TSH) suppression, and most had had iodine-131 treatment postoperatively. Group A consisted of 336 patients with differentiated thyroid cancer (DTC) who were treated with bilateral subtotal thyroidectomy in our institution or elsewhere. Group B consisted of 158 patients with DTC who were treated initially with unilateral total lobectomy and contralateral subtotal lobectomy in our institution or elsewhere and underwent reoperation in our department. Group C consisted of 506 patients with DTC who were treated initially with total or near-total thyroidectomy in our department. Kaplan-Meyer survival analysis was used. Recurrence was seen in 23% and death in 8% of the patients. The 20-year survival rates were 76%, 85%, and 92% for groups A, B, and C, respectively. The survival difference among the patients of group A and groups B and C was found to be statistically different (p < 0.001). Long-term survival of patients with differentiated thyroid cancer living in endemic areas for goiter can be influenced by the initial surgical treatment. Patients treated initially with total or near-total thyroidectomy appear to have a better prognosis.

Functional outcome in stroke patients with atrial fibrillation

OBJECTIVES

To identify the prevalence of atrial fibrillation (AF) in a sample of stroke patients and to evaluate the impact of AF on patient clinical characteristics and functional outcome.

DESIGN

A retrospective case-comparison study.

SETTING

University-affiliated rehabilitation centers.

PARTICIPANTS

One hundred ninety-six of 231 consecutive stroke patients admitted to inpatient rehabilitation units were evaluated during the rehabilitation period.

MAIN OUTCOME MEASURES

Characteristics of cerebral lesions, patient demographic features, disease duration, length of hospital stay (LOS), risk factors for stroke, and functional status at admission and at discharge were assessed and compared in patients with and without AF. Functional Independence Measure (FIM) and Adapted Patient Evaluation Conference System (APECS) were used to evaluate functional status.

RESULTS

AF was diagnosed in 41 (20.1%) patients. Patients who had AF were more likely to have ischemic cerebral lesions. There were no significant differences between the AF and non-AF groups with regard to mean age, LOS, and disease duration. Ischemic and valvular heart disease were more common in patients with AF. Based on FIM and APECS scores, both initial and discharge disability were more severe in patients with AF. In a multivariate model, AF was a negative prognostic factor for functional outcome in stroke patients.

CONCLUSION

AF is not only associated with increased risk of stroke, but also with markedly greater disability in stroke patients. Factors such as size and type of cerebral lesions, stroke severity, comorbid conditions, and impact of AF on systemic and cerebral circulation can influence stroke recovery.

The effect of oral sodium taurocholate on endotoxemia and intestinal anastomotic wound healing in rats with obstructive jaundice

The effect of sodium taurocholate (ST) on endotoxemia and intestinal anastomotic wound healing in obstructive jaundice was evaluated in a rat model. A total of 108 Wistar rats were divided into three main groups. Thus, 36 animals were given ileal anastomosis (IA) alone (IA group), 36 were given IA with bile duct ligation (BDL) (IA + BDL group), and 36 were given IA with BDL and oral sodium taurocholate (ST) (IA + BDL + ST group). These three main groups were then divided into three equal subgroups, A, B, and C, which were killed on postoperative days (POD) 3, 5, and 9, respectively. In the IA + BDL + ST group, ST was administrated perioperatively and ceased from POD 5 onwards. The anastomotic hydroxyproline level and bursting pressure were significantly lower in the IA + BDL animals compared with the others on POD 3, 5, and 9 (P < 0.008). Endotoxemia was prominent in the IA + BDL group from POD 3 (P = 0.011). After ST was stopped, 42% of the AI + BDL + ST animals developed endotoxemia by POD 9 (P = 0.008). Anastomotic wound healing was better in the IA + BDL + ST group (P < 0.01). These findings suggest that endotoxemia and its adverse effects on wound healing in obstructive jaundice can be prevented by the oral administration of ST.

A comparison of two functional tests in quadriplegia: the quadriplegia index of function and the functional independence measure

Individuals with spinal cord injury are evaluated according to a set of guidelines based on motor, sensory, and functional tests. The resulting scores are used to quantify the extent of neurological injury and functional loss. The purpose of the present study was to compare certain scoring systems using the same group of patients. Twenty-nine subjects with cervical spine cord injury were evaluated by the same examiner using three scales: (1) The American Spinal Cord Injury Association (ASIA) (2) The Quadriplegia Index of Function (QIF) (3) The Functional Independence Measure (FIM) Assessments were made both at admission to, and discharge from, the rehabilitation center. Positive change in motor score is widely used as an indicator of recovery after spinal cord injury. We assessed the relationship of the two functional tests, the FIM and the QIF, to ASIA scores and found strong correlations in both cases. The feeding and dressing categories of QIF showed an even stronger correlation to ASIA motor scores, though the statistical significance was the same for corresponding categories of FIM and QIF. The percent of recovery on ASIA motor scores was significantly correlated only to gain in QIF scores, not FIM. FIM lacks the category of bed activities. Some additions to the FIM may be useful, especially in the feeding and dressing categories, and a category of bed activities could be included as well, in order to improve sensitivity.

Prevention of adhesions by Seprafilm, an absorbable adhesion barrier: an incisional hernia model in rats

Adhesion formation, which is almost inevitable following incisional hernia repair with prosthetic mesh, may lead to intestinal obstruction and enterocutaneous fistulae. Physical barriers, namely carboxymethylcellulose and hyaluronic acid, have been reported to lessen the intra-abdominal adhesions. To evaluate the effects of Seprafilm (Genzyme Corp., Cambridge, MA), a bioresorbable, translucent membrane composed of carboxymethylcellulose and hyaluronic acid, in the presence of a foreign body such as polypropylene mesh, an incisional hernia model in rats was used. Twenty-four male rats were divided into two groups: control (12) and Seprafilm (12). A defect, measuring 1.5 x 2.5 cm, was created in each animal. Control animals had the polypropylene mesh sutured to the defect, whereas in the other group, two membranes of Seprafilm were laid over the abdominal viscera before repair with polypropylene mesh. Half of the animals from each group were killed at postoperative day 7 and remaining half at day 30 for adhesion scoring and histological evaluation of wound healing. Seprafilm animals had fewer adhesions compared with control animals (P = 0.0008). Seprafilm had no adverse effect on wound healing. This membrane seems to have the potential to lessen the adhesion-related morbidity following incisional hernia repair.

Peritoneal cytology in the determination of free tumour cells within the abdomen in colon cancer

The presence of free tumour cells at the mesothelial surface in patients with intraperitoneal colon cancer is an important prognostic factor and may alter the decision regarding adjuvant chemotherapy. In this prospective study of 72 patients we aimed to show the existence of malignant cells in the peritoneal cavity by scraping the serosa and by peritoneal lavage. Intraoperative peritoneal cytology was performed in 72 colon cancer patients who underwent curative surgery in our department between 1992 and 1995. Specimens were obtained by peritoneal lavage and by scraping the serosa overlying the major tumour mass and an area of normal serosa at least 10 cm from the primary site. Slides were stained with haemotoxylen-eosine stain. Statistical analysis was performed with chi-squared and Fisher's exact tests. In conclusion, peritoneal washing and serosal cytological study appeared to be a simple and reliable method to detect serosal involvement and the existence of malignant cells in the peritoneal cavity.

[Measurement of the sigmoid colon and its relationship with volvulus]

Sigmoid volulus occurs more frequently in Turkish people than the European. The anatomy of the sigmoid colon plays an important role in the etiology. In our study various measurements of the sigmoid colon of 25 preserved cadavers were taken and the results were interpreted according to the frequency of sigmoid volvulus in this country.