No abstract

Purpose. To evaluate the predictive effect of IMA in incarcerated hernias. Methods. Three groups (n = 7) of rats were operated. Group I aimed to mimic incarceration, group II aimed the strangulation, and group III was the sham group. IMA and LDH measurements were made. Results. IMA levels were significantly higher in strangulation mimicking group and IMA levels were normal at postoperative 6th hour in incarceration mimicking group. LDH levels were significantly higher in both incarceration and strangulation mimicking groups. Conclusion. IMA seems to be an effective marker in incarcerated hernias to predict necrosis. But we need further studies to generalise this hypothesis.

Choledochoduodenal fistula (CDF) is an abnormal passage between the choledochus and duodenum. The most common causes of CDF are cholelithiasis, duodenal ulcer, and tumors. There are mainly two types of fistulas depending on the location. Type 1 is usually present on the longitudinal fold just close to the papilla. Type 2 is present at the duodenal mucosa adjacent to the longitudinal fold and probably caused by larger stones, duodenal ulcer penetration, impacted cystic duct stones, and as a complication of laparoscopic cholecystectomy. In this study, we investigate the characteristics of our patients those were diagnosed with CDF. This is a descriptive study. We retrospectively obtained the data of 21 patients with spontaneous CDF out of 2430 endoscopic retrograde cholangiopancreaticography (ERCP) patients between 2000 and 2014. We analyzed the laboratory results, demographic and etiological features, major clinical presentations, diagnostic methods, and treatment modalities of the patients. The mean age of the 21 patients was 66.6 ± 2.2 years and a female to male ratio was 12:9. In ten patients, interventional procedures were performed via fistulotomy, not through the papilla. The eventual diagnosis was tumor in five patients and stone or sludge in bile ducts in 14 patients. In the remaining two patients, no reason was found as a cause of CDF. Whipple operation was performed in one patient and stents were placed in three patients for malignacy. Among the 14 patients with sludge or stone in bile ducts, ERCP has been therapeutic in ten. One of the remaining patients has been operated for proximal fistula and underwent choledochus exploration and repair of fistula over a T-tube. In the second patient, stone extraction and T-tube drainage were performed. In patients who had bile duct obstruction and got over of jaundice afterwards, one of the most important reasons of this recovery is the development of spontaneous choledochoduodenal fistula. Even if it is very rare, malignancy can be observed in this area. Therefore, it is extremely important to evaluate the papillary area with ERCP and to conduct biopsy; this will make early diagnosis possible in many patients. In these patients, ERCP can both be diagnostic and therapeutic.

Objective: To investigate the roles of cytokines in the etiopathogenesis of idiopathic granulomatous mastitis (IGM). Design: Case-control study.

OBJECTIVE: Our aim was to investigate the hemogram index parameters and their clinical significance in the evaluation of the inflammatory response of patients with male breast cancer, who are rarely observed in the literature. METHODS:In total, 22 (n=22) healthy male and 28 (n=28) male breast cancer patients without synchronous/metachronous tumors were included in this study. They were grouped as the healthy male control group (Group 1) and the male breast cancer patient group (Group 2). The male breast cancer was divided into two subgroups, namely, early stage [(stage: 0/I/II) (Group 2A)] and late stage [(stage: III/IV) (Group 2B)], and their hemogram index parameters were compared.RESULTS: A significant (p>0.05) increase was observed in neutrophil/lymphocyte ratio (NLR) and•platelet/lymphocyte ratio (PLR) values in the late stage (Group 2B: stage III/IV) compared to the early stage (Group 2A: stage 0/I/II) and healthy control (Group 1) groups. CONCLUSIONS:In male breast cancer patients, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were significantly higher as the stage of cancer increased. These readily available simple tests can be used to evaluate the host's inflammatory response in male breast cancer.