Local recurrence of renal cell carcinoma that simulated multiple renal arteriovenous fistulas after laparoscopic partial nephrectomy: Report of a rare case

Herein we report a patient who was initially thought to have renal arteriovenous fistulas 3 months after laparoscopic partial nephrectomy for a small renal mass. After timely intervention using selective renal artery embolization, computed tomography 9 months post‐surgery showed persistent renal arteriovenous fistulas and nodular lesions in the perirenal fat. The patient then underwent radical nephrectomy, and histopathological examination showed underlying recurrent clear cell renal cell carcinoma invading the intraparenchymal arteries and veins, which was simulating multiple high‐flow renal arteriovenous fistulas.     

Vitamin D insufficiency in a boy with obsessive–compulsive disorder

Vitamin D deficiency not only causes low bone mass but also may lead to neuropsychiatric disorders. In the present case, vitamin D supplementation reduced obsessive–compulsive disorder (OCD) symptoms associated with streptococcal infection in a 7‐year‐old boy. Sudden onset of symptoms, including excessive hand washing and fear of touching anything, had occurred 1 month before presentation. Although there are few studies on a possible causal relationship between vitamin D and neuropsychiatric disorders, the present report; together with previous data, suggest an etiological role of vitamin D‐related immune processes.     

Effects of paracetamol and etodolac on plasma adrenaline levels of rats

Adrenaline, which is released from the adrenal medulla, is an important compound in the reaction of sympathetic nerve system. This hormone can increase the body’s normal metabolic rate up to 100 %, and thus improves the effectiveness of the whole body. It has been considered to be involved in the control of inflammation. Therefore, we investigated whether there are effects of paracetamol and etodolac on adrenaline levels of rats after oral administration. The rats were divided into three subgroups while analysing the effects of adrenaline on paracetamol and etodolac. The first group was the control, second group was composed of rats given paracetamol, and third group was composed of rats given etodolac. In order to measure adrenaline plasma concentration, we have used the high-performance liquid chromatography coupled with fluorescence detection. According to the result of the analysis, there are statistically important differences at adrenaline levels between control group and rats-applied drugs. Obtained results showed that although adrenaline level in the paracetamol-applied group decreased, adrenaline level in the etodolac-applied group increased. It is concluded that different effects of etodolac and paracetamol on circulating adrenaline levels can be related to their different effects on inflammation, COX enzymes, prostaglandins, etc. Also we can suggest usage of paracetamol instead of etodolac in patients with cardiovascular system diseases.     

An extremely rare manifestation of Behcet’s disease: urethrovaginal fistula

Behcet’s disease (BD) is a rare chronic, relapsing, multisystemic disorder characterized by mucocutaneous, ocular, vascular and central nervous system manifestations. However, the etiopathogenesis of the disease remains unknown, and diagnosis is basically dependent on clinical manifestations. Sometimes BD may be diagnosed with rare clinical entities. Herein, we presented an extremely rare case of urethrovaginal fistula which has been diagnosed as manifestation of BD. After surgical treatment of fistula, there was no complication in 6 months following surgical repair and the follow-up period has been going on.     

Laparoscopic Anterior Resection: New Anastomosis Technique in a Pig Model

Background and Objectives:

Bowel anastomosis after anterior resection is one of the most difficult tasks to perform during laparoscopic colorectal surgery. This study aims to evaluate a new feasible and safe intracorporeal anastomosis technique after laparoscopic left-sided colon or rectum resection in a pig model.

Methods:

The technique was evaluated in 5 pigs. The OrVil device (Covidien, Mansfield, Massachusetts) was inserted into the anus and advanced proximally to the rectum. A 0.5-cm incision was made in the sigmoid colon, and the 2 sutures attached to its delivery tube were cut. After the delivery tube was evacuated through the anus, the tip of the anvil was removed through the perforation. The sigmoid colon was transected just distal to the perforation with an endoscopic linear stapler. The rectosigmoid segment to be resected was removed through the anus with a grasper, and distal transection was performed. A 25-mm circular stapler was inserted and combined with the anvil, and end-to-side intracorporeal anastomosis was then performed.

Results:

We performed the technique in 5 pigs. Anastomosis required an average of 12 minutes. We observed that the proximal and distal donuts were completely removed in all pigs. No anastomotic air leakage was observed in any of the animals.

Conclusion:

This study shows the efficacy and safety of intracorporeal anastomosis with the OrVil device after laparoscopic anterior resection.     

Quality of life assessments with SF 36 in different musculoskeletal diseases

The aim of this study is to evaluate comparatively the life quality of patients with knee osteoarthritis (KO), shoulder impingement syndrome(SIS), fibromialgia(FM), or osteoporosis(OP) using SF 36 and establish the impact of these diseases on quality of life (QoL). A total of 193 patients with one of the above-mentioned different diagnoses completed SF 36 scale. The diseases were compared to each other with SF 36 subgroups scores. There were significant differences among patients with KO and SIS,SIS and FM with respect to all SF 36 subgroups scores. According to these assessments, QoL of KO and FM patients was worst than that of SIS. The QoL scores of KO patients were worse than those of FM patients considering the physical function, while QoL scores of FM patients were lower than those of KO patients with respect to their general well-being. Scores of physical function and pain in KO patients were lower than those of OP patients. In domains of social functioning, emotional role, energy, pain, and general health condition QoL of FM patients was worse than that of OP patients. Quality of life of SIS patients was less affected than the patients of the other disease groups. In spite of their young age, FM patients appear to be the group with the worst quality of life scores.     

Increased levels of soluble adhesion molecules E-selectin and P-selectin in patients with cardiac syndrome X

The role of endothelial dysfunction and platelet activation in patients with cardiac syndrome X is controversial. The aim of this study was to investigate the plasma levels of circulating E- and P-selectin molecules in patients with syndrome X. The study included 21 patients with cardiac syndrome X (11 men and 10 women, mean age = 56 +/- 5 years) and 20 patients with significant coronary artery disease who had stable angina pectoris (11 men and 9 women, mean age = 60 +/- 8 years). Twenty-two age- and sex-matched subjects (12 men and 10 women, mean age = 58 +/- 8 years) undergoing diagnosis of atypical chest pain in whom coronary arteries were found normal and exercise test had no signs of ischemia served as the control group. Syndrome X was defined as presence of typical chest pain on exertion or at rest with positive exercise test and angiographically normal epicardial coronary arteries with no evidence of coronary spasm after intracoronary infusion of ergonovine maleate. The mean plasma concentrations of P-selectin were significantly elevated both in patients with coronary artery disease and syndrome X as compared with control subjects (49.15 +/-7.47 and 42.80 +/- 8.93 vs 22.63 +/-6.47 ng/mL, p < 0.001). Similarly, both patients with coronary artery disease and syndrome X had higher plasma concentrations of E-selectin than the control group (78.85 +/- 16.69 and 68.38 +/- 15.30 vs 36.43 +/- 4.72 ng/mL, p < 0.001). In conclusion, patients with syndrome X had increased plasma concentrations of soluble adhesion molecules, E-selectin and P-selectin, reflecting an ongoing chronic inflammation involved with endothelial dysfunction and enhanced platelet activation/damage in this setting.     

Location of Golgi membranes with reference to dividing nuclei in syncytial Drosophila embryos.

The role of cytoskeletal elements in thecellularization of syncytial Drosophila embryos is becoming evident; however,the distribution and role of organelles such as the Golgi complex, essential formembrane biogenesis, remain unknown. We have cloned a Golgi-membrane-associatedpolypeptide, beta-COP, from Drosophila. Immunocytochemical studies of syncytialDrosophila embryos with anti-Drosophila beta-COP antibody reveal that Golgimembranes are spatially segregated from the rapidly dividing nuclei. In earlyembryos, the Golgi membranes are located in the embryonic cortex and nuclei areconfined to the core. This distribution of Golgi membranes may serve inpreparation of the embryonic cortex for the accommodation of nuclei upon theireventual migration to the cortex and in biogenesis of the excessive plasmamembrane needed for cellularization of syncytial embryos.