The Effect of Sterilization Methods of Endoscopic Instruments on the Body: A Study on Rat Model

Purpose: Laparoscopy is widely used in many surgical areas for diagnosis and treatment. The need for sterilization of reusable instruments is an important issue. Ensuring patient safety, preventing infection, and protecting the functionality of the instruments are the most important points to be considered. We aimed to investigate two sterilization methods and their effects generated by their distribution into intra-abdominal tissues during insufflation. Materials and Methods: 21 rats were used in the study. The Control Group (Group 1) received anesthesia for 1 hour; Group 2 (Glutaraldehyde (GA)-Pneumoperitoneum Group) received anesthesia for 1 hour; Group 3 (Ethylene Oxide (EO)-Pneumoperitoneum Group) received anesthesia for 1 hour. After 24 hours, the animals were sacrificed, and the kidneys and omentum of the animals were analyzed in a histopathological manner. Blood samples were analyzed at preoperative 24th hour and at postoperative 24th hour. Results: There was a statistically significant difference in omentum, endothelium, and glomerular scores between the groups (p < 0.001 for all groups). Endothelial and glomerular scores were different at a statistically significant level in the EO and GA groups compared to the Control Group. The total score was higher at a statistically significant level in the EO and GA groups compared to the Control Group (p < 0.001 for both groups). Conclusion: It was determined in our study that sterilization methods such as EO and GA cause damage in intra-abdominal tissues. In the light of these results, we consider that the most ideal laparoscopic surgery set is the single-use laparoscopy set. However, this does not seem possible especially in developing countries in practice.     

Anatomic three-dimensional echocardiographic correlation of bicuspid aortic valve.

This study was undertaken to verify the echocardiographic characteristics of bicuspid aortic valve (AV) using 3-dimensional transesophageal echocardiography by comparing the findings with anatomic examination of autopsy specimens from carriers of this condition. Three-dimensional reconstructions of transesophageal echocardiograms were performed on 14 patients with bicuspid AV, and 20 autopsy specimens of bicuspid AVs were analyzed. Echocardiographic images and autopsy material were correlated. Two variants of bicuspid aorta were identified. In group I the AV had 2 leaflets. This group included 9 (9/14) 3-dimensional echocardiographic studies and 13 (13/20) necropsies. In group II 3 sigmoid leaflets had originally developed and 2 underwent dysplastic fusion, resulting in functionally bicuspid valves. Five (5/14) echocardiographic studies and 7 (7/20) anatomic specimens fell into this category. There was a clear correspondence between anatomic and echocardiographic findings, which leads to the conclusion that 3-dimensional echocardiography is a technique that reliably defines the morphological details of bicuspid AV with the precision of anatomopathologic examination.     

Tortuosity of coronary arteries: an indicator for impaired left ventricular relaxation?

Objective To investigate the relationship between coronary tortuosity and impaired left ventricular relaxation. Methods One hundred and four subjects who underwent coronary angiography were included in the study. Left anterior descending, left circumflex, and right coronary arteries were traced. Tortuosity was identified by the finding of ≥3 bends (defined as ≥45° change in vessel direction) along main trunk of at least one artery. Study population were divided into tortuosity (n = 54) and no tortuosity (n = 50) groups. Subjects were all submitted to pulsed-wave Doppler and two-dimensional echocardiographic examination to assess left ventricular functions. Results For subjects with tortuosity, early transmitral inflow (E) velocity was lower, late transmitral inflow (A) velocity was higher, E/A ratio was smaller compared with subjects without tortuosity (P < 0.001). Subjects with tortuosity had longer deceleration time of E velocity (DT) and isovolumic relaxation time (IVRT) than did subjects without tortuosity (P < 0.001). End-diastolic interventricular septal and left ventricular posterior wall thicknesses were greater in subjects with tortuosity than those without tortuosity (P = 0.01 and P = 0.005). There was an inverse correlation between total number of arteries with tortuosity and E/A ratio (r = −0.750, P < 0.001). Total number of arteries with tortuosity displayed correlations with DT (r = 0.723, P < 0.001) and IVRT (r = 0.703, P < 0.001). Conclusions This study depicts that coronary tortuosity is associated with impaired left ventricular relaxation.Thus, coronary tortuosity might be an indicator of impaired left ventricular relaxation.     

Insertion/deletion polymorphism of the angiotensin I-converting enzyme gene in patients with breast cancer and effects on prognostic factors.

The aims of the present study were to investigate the distribution of the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in breast cancer patients and the association between ACE genotypes and clinicopathologic features, as well as their effects on prognosis. We assessed the I/D polymophism of the ACE gene by using polymerase chain reaction from peripheral blood in breast cancer and healthy age-matched women. The clinicopathologic parameters of breast cancer patients were obtained from medical records. Of the 57 patients, 31 (54.4%) had DD, 24 (42.1%) had ID, and 2 (3.5%) had II genotypes. In control subjects, 33 (63.5%) had DD, 12 (23.1%) had ID, and 7 (13.4%) had II genotypes. The ID genotype was seen more commonly in breast cancer patients (p = .03). When the combination of ID and II genotypes was used as a reference group, the DD genotype was associated with negative hormone receptor status (p = .003), tumor size (p = .054), and lymph node involvement (p = .07) but not histologic high grade and c-erb B2 overexpression. These results suggest that the DD genotype may accompany poor prognostic factors and influence the tumor course.     

Susceptibility of Anaerobes to Cefoxitin and Other Cephalosporins

The in vitro susceptibility of 155 strains of anaerobic bacteria to five cephalosporin antibiotics was tested. Cefoxitin was the most active against 33 isolates of Bacteroides fragilis; 82% of the strains were sensitive at 16 mug/ml. At 64 mug/ml cefazolin and cephaloridine were also generally effective. Cephalothin and cephalexin were relatively inactive versus B. fragilis. Cefoxitin, cephaloridine, cefazolin, and cephalothin showed comparable activity against 122 strains of anaerobes other than B. fragilis. More than 90% of the strains were sensitive to each of these antimicrobials at 16 mug/ml. Cephalexin was the least effective cephalosporin against all species tested.