İsmail Aydın

Divertiküller, bağırsak lümeninden diğer katmanlara doğru gelişen kese şeklinde anatomik yapılardır. Çoğu kolonik divertikül, bağırsak duvarının yalnızca muko

Methotrexate (MTX) is still a broad-spectrum drug that has been used for almost a century for leukemia, rheumatoid arthritis, ectopic pregnancy. This study investigates the protective effects of coenzyme Q10 (CoQ10) on MTX induced gonadotoxicity. Twenty-four female wistar albino rats were divided into four groups. Control group; 1 ml corn oil was applied by oral gavage (p.o.). CoQ10 group; 100 mg/kg CoQ10 (in 1 ml corn oil) was applied by p.o. for seven days. MTX group; 20 mg/kg MTX intraperitoneal (i.p.) was used one time on the first day of the experiment. MTX + CoQ10 group; 20 mg/kg MTX i.p. one time and 100 mg/kg CoQ10 (in 1 ml corn oil) was applied p.o. for seven days. At the end of the experiment, all animals were euthanized under anesthesia, and blood samples were taken from intracardiac. The both sides ovaries were taken out and were put in to neutral formalin. Biochemical analysis for serum anti-mullerian hormone (AMH), flow cytometry for apoptosis (Annexin V), and histopathologic analysis with follicle counting were performed in ovarian tissues. According to results of follicle counting, apoptosis, morphometric and AMH analysis; there was no statistically significant difference in terms of follicle numbers and ovarium diameter between all groups. However, apoptosis significantly increased in the MTX group and decreased in the MTX + CoQ10 group. AMH level was decreased in the MTX group and interestingly significantly increased in the only CoQ10 treatment group and. As a result, CoQ10 has protective effects in terms of apoptosis and AMH against MTX induced gonadotoxicity.

In the present study, the effects of coenzyme Q10 (CoQ10), which is widely used in daily life, on the methotrexate (MTX)-induced hepatotoxicity, which is widely used today in malignancies and autoimmune diseases, were examined. Twenty-four female Wistar albino rats were divided into four groups. The group 1 (n = 6) was given 1 mL corn oil by oral gavage (p.o.) during seven days. Group 2 was given 20 mg/kg intraperitoneal (i.p.) MTX only on the first day of the experiment. Group 3 was given 20 mg/kg (i.p.) MTX on the first day of the experiment and 100 mg/kg CoQ10 dissolved in 1 mL corn oil were given by oral gavage during seven days, and group 4 was given 100 mg/kg CoQ10 dissolved in 1 mL corn oil by oral gavage during seven days. At the end of experiment, all animals were euthanized under anesthesia. In the liver tissue, histopathologic analysis on the hematoxylin and eosin (H&E), Masson trichrome, and periodic acid Schiff (PAS) stained sections, apoptotic analysis (% Annexin V positivity) by flow cytometry, and biochemical analysis for oxidative stress markers (GSH, CAT, and TBARS) was performed. According to histopathological analysis, apoptosis, concession, fibrosis, and inflammatory cell infiltration increased in the MTX group and those results significantly decreased in the MTX + CoQ10 groups. As an interesting result, fatty degeneration and TBARS elevation were observed in the MTX + CoQ10 group. As a result, although CoQ10 has protective effects on MTX-induced hepatotoxicity, fatty degeneration due to the combined usage of MTX and CoQ10 should be investigated with further studies.

OBJECTIVE: Breast cancer is a leading cause of death not only in the young population but also in the elderly. There are no consensus treatment guidelines for elderly breast cancer patients. We purposed to discuss surgical treatment options for breast cancer cases over 80 years concerning morbidity and mortality.METHODS: This retrospective study includes 58 patients over 80 years of age at the time of surgery for breast cancer between 2006 and 2017. A sum of 58 cases (54 females and 4 males), over 80 years of age, with an average age of 84.5 +/- 4.07 (80-94) years were included in the study. The modified radical mastectomy was the most common surgical modality in 30 (51.7%) cases, and the axillary intervention was performed on 41 (70.7%). Axillary dissection and sentinel lymph node biopsy were performed for 30 (51.7%) and 11 (18.9%) cases, respectively.RESULTS: Minor and major complications were observed in 8 (13.8%) cases. The average follow-up period of the patients was 37.5 (1-120) months. During the follow-up period, breast cancer-related mortality was observed in 9 (15.52%) cases. No statistical differences were detected in mortality with/without axillary intervention and chosen surgical modality.CONCLUSIONS: Comorbidity, the American Society of Anesthesiologists score, and life expectancy should be considered in the management and surgical planning of patients over 80 years of age with breast cancer. Minimally invasive approaches should be preferred for the elderly whenever feasible and applicable in the light of oncologic surgery principles in order to reduce complications and mortality rates.

Akademisyen Yayınevi yöneticileri, yaklaşık 30 yıllık yayın tecrübesini, kendi tüzel kişiliklerine aktararak uzun zamandan beri, ticarî faaliyetlerini sürdürmektedir. Anılan süre içinde, başta sağlık ve sosyal bilimler, kültürel ve sanatsal konular dahil 750 kitabı yayımlamanın gururu içindedir. Uluslararası yayınevi olmanın alt yapısını tamamlayan Akademisyen, Türkçe ve yabancı dillerde yayın yapmanın yanında, küresel bir marka yaratmanın peşindedir.

Primer meme sarkomları, tüm meme tümörlerinin %1’inden, tüm sarkomların ise %5’inden daha azını oluşturan nadir mezenkimal tümörlerdir. En sık 50-60 yaşlarında görülen bu tümörlerin çoğunluğu, radyoterapi uygulamalarına ikincil olarak gelişir. Risk faktörleri arasında dış ışın radyasyonu, kronik lenfödem ve kalıtsal sendromlar yer alır. Genellikle yüksek dereceli olup hızla büyüyen tek kitleler şeklinde ortaya çıkarlar. Tanıda fizik muayene, mamografi, sonografi ve MR kullanılmakla birlikte, kesin teşhis için histopatolojik ve immünohistokimyasal analiz kritik önem taşır; en sık anjiyosarkom alt tipi görülür. Bu tümörler yüksek nüks riskine sahip olup, hematojen yolla çoğunlukla akciğer, kemik iliği ve karaciğere metastaz yaparlar. Tedavide multidisipliner bir yaklaşım şarttır ve tek iyileştirici yöntem negatif cerrahi sınırlı rezeksiyondur; lenf nodu diseksiyonu ise düşük metastaz oranı nedeniyle önerilmez. Tümör boyutu ve cerrahi sınırın temizliği mortaliteyi belirleyen en önemli faktörlerdir. Genellikle kemoterapiye zayıf yanıt verirler ve adjuvan radyoterapinin faydaları konusunda literatürde henüz tam bir fikir birliği bulunmamaktadır. Primary breast sarcomas are rare mesenchymal tumors that account for less than 1% of all breast tumors and fewer than 5% of all sarcomas, predominantly peaking between the ages of 50 and 60, with most cases occurring secondarily to radiation therapy. Although risk factors include external beam radiation, chronic lymphedema, and genetic syndromes, these tumors present as rapidly growing solitary masses and differ from epithelial breast cancers as they mimic connective tissue. Diagnosis utilizes mammography, ultrasound, and MRI, but histopathological confirmation with immunohistochemical panels is essential, with angiosarcoma, malignant fibrous histiocytoma, and stromal sarcoma being the most common subtypes. Characterized by high recurrence rates and poor prognosis, they metastasize hematogenously to the lungs, bone marrow, and liver. Surgical resection with negative margins remains the only curative approach, whereas lymph node dissection is not recommended due to low nodal involvement. Ultimately, tumor size and clear surgical margins are the primary determinants of survival, while the roles of adjuvant chemotherapy and radiotherapy remain limited and lack consensus in current literature due to weak response rates.

Akademisyen Yayınevi yöneticileri, yaklaşık 30 yıllık yayın tecrübesini, kendi tüzel kişiliklerine aktararak uzun zamandan beri, ticarî faaliyetlerini sürdürmektedir. Anılan süre içinde, başta sağlık ve sosyal bilimler, kültürel ve sanatsal konular dahil 2000 kitabı yayımlamanın gururu içindedir. Uluslararası yayınevi olmanın alt yapısını tamamlayan Akademisyen, Türkçe ve yabancı dillerde yayın yapmanın yanında, küresel bir marka yaratmanın peşindedir.Bilimsel ve düşünsel çalışmaların kalıcı belgeleri sayılan kitaplar, bilgi kayıt ortamı olarak yüzlerce yılın tanıklarıdır. Matbaanın icadıyla varoluşunu sağlam temellere oturtan kitabın geleceği, her ne kadar yeni buluşların yörüngesine taşınmış olsa da, daha uzun süre hayatımızda yer edineceği muhakkaktır.

Objective: To compare levobupivacaine based caudal epidural anesthesia and spinal anesthesia in terms of Intraoperative hemodynamic changes and postoperative pain and patient comfort in subjects undergoing perianal surgery in outpatient setting. Material and methods: All consecutive patients who were scheduled for perianal surgery. The difference in intraoperative hemodynamic changes, sensory and motor block level, postoperative pain and patient comfort was the primary outcome measure of this study. Results: There were no significant differences between the groups in terms of mean arterial pressure and heart rate recorded. Subjects randomized to spinal anesthesia had a significantl extensive motor and sensory block compared to those randomized to caudal epidural anesthesia. Visual analogue scale scores for surgical pain at postoperative 12 hours was significantly higher in subjects receiving spinal anesthesia compared to those receiving caudal epidural anesthesia (p< 0.05). Time to first analgesic administration was significantly lower in subjects randomized to spinal anesthesia compared to those receiving caudal epidural anesthesia (p< 0.01). Conclusion: Spinal anesthesia is associated with more extensive sensory and motor block compared to caudal epidural anesthesia in patients undergoing perianal surgery. Both techniques lead to similar hemodynamic changes. Postoperative pain control is more favorable with caudal block than the spinal anesthesia.