Malignant triton tumor of the gluteal region in a patient unaffected by neurofibromatosis: A case report

Malignant triton tumor (MTT) is a rare variant of malignant peripheral nerve sheath tumor (MPNST) made up of both malignant schwannoma cells and malignant rhabdomyoblasts.A 26-years-old male patient was admitted with an asymptomatic gluteal mass. Magnetic resonance imaging showed heterogeneous soft tissue mass and he underwent open biopsy. Malignant peripheral nerve sheath tumor was diagnosed. He was given adjuvant chemotherapy following the removal of the tumor with hip disarticulation. The tumor was diagnosed as “malignant triton tumor” based on pathological examination including immunohistochemical studies. There were no signs of metastasis but recurrence was observed at 9 months follow up.MTT is usually associated with Neurofibromatosis 1 and located in head, neck region. In this case sporadic involvement of gluteal region and aggressive behavior of the lesion despite radical surgery was demonstrated.     

Role of a combination dietary supplement containing mucopolysaccharides,vitamin C,and collagen on tendon healing in rats

Objective

The aim of this study was to investigate the effect of mucopolysaccharide, vitamin C, and collagen supplementation on the healing of Achilles tendon in rats.

Calcaneal Avulsion of an Ochronotic Achilles Tendon: A Case Report

Alkaptonuria is a hereditary disorder of phenylalanine and tyrosine, with an incidence of approximately 1/200,000 to 1/1,000,000. Ochronosis is the accumulation of homogentisic acid and its metabolites in connective tissues such as the tendons, cartilage, and skin. In the present case study, a 50-year-old male presented with a nontraumatic calcaneal avulsion without a previous diagnosis of ochronosis. To the best of our knowledge, little information has been reported of this pathology in the Achilles tendon and the surgical management.     

The superiority of the analgesic effect of intraurethral Bupivacaine during outpatient flexible cystoscopy in male patients

Objective

Flexible cystoscopy (FC) has become a frequently applied outpatient prosedure. Dysuria with an incidence of 30–54% is the main complaint of patients. As our hypothesis was, lower pain scores during and after cystoscopy would be achieved with bupivacaine application we aimed to compare the analgesic efficacy of intraurethral bupivacaine and lidocaine.

The Effects of Positive End-Expiratory Pressure at Different Levels on Postoperative Respiration Parameters in Patients Undergoing Laparoscopic Cholecystectomy

Purpose/Aim of the study: We investigated the effects of different positive end-expiratory pressure (PEEP) levels on postoperative respiration parameters in patients undergoing laparoscopic cholecystectomy. Materials and Methods: One hundred and five consecutive patients were randomly divided to three groups (n = 35, for each group). Group I did not receive PEEP whereas group II received PEEP as 5 cmH₂O and group III received PEEP as 8 cm H₂O. Measurements with spirometer were taken 1 hour before the operation (T₁) and, 1 (T₂), 6 (T₃), and 24 hours (T₄) after extubation by an anesthetist. Forced expiratory volume (FEV₁), forced vital capacity (FVC), and peak expiratory flow (PEF) were recorded. Results: Group I had higher FVC values measured at T₂ time point compared with other groups (p < 0.05, for both groups). There was a statistically significant difference between group I and group III in terms of the FVC values measured at T₃ and T₄ time points (p = 0.05 and p < 0.05, retrospectively). A statistical difference was found between group I and group II in terms of FEV₁ measured at T₂ time point (p < 0.05). Group I had higher FEV₁ values measured at T₃ and T₄ time points compared to group III (p = 0.05, P<0.05; respectively). Group III had lower PEF values measured at T₄ time point compared to group I and II (p < 0.05). Conclusions: We concluded that PEEP with 5 or 8 cmH₂O has negative effects on lung function tests measured with spirometer during postoperative 1^st, 6^th, and 24^th hours in patients underwent elective laparoscopic cholecystectomy.     

Laparoscopic Ileal Interposition with Diverted Sleeve Gastrectomy Versus Laparoscopic Transit Bipartition with Sleeve Gastrectomy for Better Glycemic Outcomes in T2DM Patients

Background

Metabolic procedures provide better outcomes for obese patients with type 2 diabetes mellitus. Our aim was to compare the glycemic regulation in patients that have undergone the laparoscopic ileal interposition with diverted sleeve gastrectomy (II-DSG), laparoscopic transit bipartition with sleeve gastrectomy (TB-SG), and laparoscopic sleeve gastrectomy (LSG) throughout a 12-month follow-up period retrospectively.

Methods

This study considered patients with T2DM who underwent metabolic procedures. The postoperative changes in the glucose, C-peptide, HbA1c, HOMA-IR, insulin, cholesterol, body mass index, and total weight loss (TWL) were compared retrospectively. The intended outcome was to reach a long lasting fasting blood glucose (FBG) <126 mg/dl. A multivariate regression analysis was applied to define the predictive markers in glucose regulation.

Results

Present study consisted of 83 patients with a mean age of 47.25 ± 6.58 years, mean preoperative BMI of 37.36 ± 2.71 kg/m², and mean outcomes in the HbA1C and FBG of 9.05 ± 1.33% and 237 ± 15 mg/dl, respectively. There were similar correlations in BMI and total weight loss (TWL). At 12-month follow up period, compared to LSG group, TB-SG and II-DSG groups have higher remission proportions (35.3, 67.9, 54.7, respectively, p < 0.05) with similar TWL% (22.35, 27.14, 23.16%) outcomes. The II-DSG and TB-SG results drew closer together toward the end of this study interval unlike the LSG group.

Conclusion

Our results showed that II-DSG and TB-SG ensured significant regression rates during the follow-up period. Since the TB-SG achieved these outcomes by finite anastomoses and intervening segments, it was considered to be a superior procedure compared to II-DSG and LSG procedures.

     

Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

Diseases and tumors of the appendix vermiformis are very rare, except for acute appendicitis. This study aimed to examine rare findings in the histopathologic examinations of specimens of patients undergoing appendectomy due to the diagnosis of acute appendicitis. The files of 1970 patients undergoing appendectomy due to the diagnosis of acute appendicitis between March 2012 and March 2016 were retrospectively investigated. Rare findings were found in 59 (3 %) patients, and these were evaluated in detail. Patients’ age, gender, pathology reports, and postoperation follow-ups were recorded. The rare histopathological findings of 59 patients were examined. Of these, 31 were female (52.5 %) and 28 were male (47.5 %). The average age was 33.1 ± 18.2 years. The unusual findings were as follows: 16 fibrous obliteration, 11 Enterobius vermicularis, 2 schistosomiasis, 3 appendiceal neuroma, 2 granulomatous appendicitis, 1 Crohn’s disease, 3 chronic appendicitis, 1 endometriosis, 2 hyperplastic polyps, 9 mucinous cystadenoma (+mucocele), 8 carcinoid tumors, and 1 lymphoma. All of the malignant tumors were localized in the distal end of the appendix, and all of the patients were treated with appendectomy. Patients with parasitic diseases also underwent anthelmintic treatment, while chemotherapy was administered to the patient with lymphoma. All of the patients diagnosed with malignancy were alive reported no problems at their follow-ups. Although all of the appendectomy samples were normal macroscopically, data from this study suggest that all specimens should be sent for routine investigation.