Liver abscess as a rare complication of Crohn's disease: a case report.

Pyogenic liver abscess is a rarely seen extraintestinal complication of Crohn's disease. It has different features from other liver abscesses. Its clinical and laboratory findings are not specific and mimic the reactivation of Crohn's disease and diagnosis can be delayed. The radiological methods are very useful in diagnosis and treatment of liver abscess. In this paper, we present a patient with pyogenic liver abscess which developed in the course of Crohn's disease.     

Modulation of Gallbladder Contraction by Pirenzepine in Humans

Objectives : The mechanism (s) by which cholinergic innorvatiun modulates gallbladder contraction are not fully understood. To elucidate the role of muscarinic M, receptors in the mediation of gallbladder contraction, we investigated gallbladder volume reduction, plasma cholecystokinin (CCK). and pancreatic polypeptide (I'P) responses in humans during cephalic and intestinal phases of a meal under M, muscarinic receptor blockade with pirenzepine. Methods : In eight healthy subjects, intruduodenal meal- and in seven subjects, sham feeding-induced gallbladder volume reduction was measured by real-time ultrasonography during saline or piren/-epine administration. Plasma CCK and PP were measured by radioimmunoassay. Results : Pirenzepine partially inhibited gallbladder volume reduction in response to an intraduodenal fatty meal. The integrated gallbladder volume reduction over 120 min was 4462 ± 445%.min compared with 6879 ± 279%.min in the saline control group ( p < 0.01). Integrated plasma CCK and PP responses were unchanged in the presence of pirenzepine. Pirenzepine abolished sham feeding-induced gallbladder contraction and plasma PP response. Sham feeding with either isotonic saline or pirenzepine infusion did not modify fasting plasma CCK levels. Conclusion : M, muscarinic receptors play an important role in the intestinal and cephalic phases of gallbladder contraction. Plasma CCK response to intraduodenal meal is not influenced by M, muscarinic receptor blockade with pirenzepine.     

Idiopathic Jaccoud's arthropathy

We describe a patient who developed Jaccoud's type arthropathy without other prior rheumatic disease. Our patient's hand deformities were first noticed by chance at the age of 15 and gradually progressed over the next 4 years. We believe that after eliminating secondary causes, establishing a diagnosis of primary Jaccoud's arthropathy will prevent misdiagnoses and unnecessary treatment.     

Effect of fabrication techniques on the optical properties of zirconia-based systems

Statement of problemHow the optical properties of zirconia restorations are affected by their differing processing techniques is unclear.PurposeThe purpose of this in vitro study was to evaluate the effects of 5 different fabrication techniques on the optical properties of zirconia-based systems, including the color difference between the corresponding shades (ΔE1_ab, ΔE₀₀), translucency parameter, opalescence parameter, and fluorescence (ΔE1_ab-FL).Material and methodsSixty zirconia disks (IPS e.max ZirCAD) were prepared (0.5 ±0.01mm thick) and veneered by using different techniques (n=15): Group L – layering with fluorapatite ceramic; Group P – pressing with fluorapatite ceramic; Group CB – veneered with pressing followed by layering technique; Group CO – digitally veneered with lithium disilicate glass-ceramic; and Group FZ – prepared from monolithic zirconia (inCoris TZI) (n=15). All the specimens were set to 1.5 ±0.02 mm in thickness. Color measurements were made with a spectrophotometer. Data were statistically analyzed with 1-way ANOVA and the Tukey honestly significant difference, Kruskal-Wallis, Bonferroni (α=.05), Pearson, and Spearman correlation tests (α=.01).ResultsSignificant differences were found among the groups for all the optical parameters (P<.05). All the groups showed color differences higher than the perceptibility and acceptability thresholds for ΔE1_ab and ΔE₀₀, except the P and FZ groups that showed values lower than the acceptability threshold (ΔE1_ab<2.7). Translucency parameter, opalescence parameter, and ΔE1_ab-FL values ranged between 5.77 and 9.95, between 4.72 and 7.07, and between 1.93 and 3.14, respectively. Strong positive correlations were found between ΔE1_ab and ΔE₀₀, as well as between translucency parameter and opalescence parameter (P<.001).ConclusionsThe optical properties of the zirconia-based systems were significantly affected by the fabrication techniques even when the same nominal shade was used. Therefore, the color reproduction, translucence, opalescence, and fluorescence of the selected materials should be considered for acceptable color matching.     

Recurrent Hepatocellular Carcinoma in the Right Adrenal Gland 11 Years After Liver Transplantation for Hepatocellular Carcinoma: a Case Report and Literature Review

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver, and extrahepatic metastases are typically found during disease progression. The incidence of adrenal metastasis (AM) from HCC in autopsy series ranges from 4.6 to 12.5%, and it is the second most common site of metastasis after the lungs. To date, there have been few reports of patients who underwent adrenalectomy for isolated AM from HCC after liver transplantation (LT). A woman aged 55 years was referred to our clinic for the evaluation of a right adrenal mass that was detected by abdominal ultrasonography at another center. She had undergone liver transplantation secondary to HCC and acute liver failure due to cryptogenic liver cirrhosis 138 months previously. She had been followed up for 5 years following LT after which she declined to continue with further follow-up. After radiologic and biochemical evaluation, she underwent adrenalectomy and the histopathologic examination revealed a 10 × 8 × 7-cm adrenal mass, which was considered to be an isolated AM from HCC. To our knowledge, this is the first case of isolated AM from HCC in the literature that was diagnosed 138 months after liver transplantation. Isolated AM from HCC after LT is rare and might be detected a long time after LT. Curative surgical resection of isolated metachronous AM from HCC in the absence of disseminated disease might provide for an acceptable disease-free period after adrenalectomy.     

The Synthesis of Poly(ethylene glycol) (PEG) Containing Polymers via Step‐Growth Click Coupling Reaction for CO2 Separation

The synthesis of step‐growth polymers via a step‐growth click coupling reaction of diazides based on poly(ethylene glycol) (PEG) and dialkynes based on aromatics is reported. The polymers are characterized by proton nuclear magnetic resonance spectroscopy (¹H‐NMR), carbon‐13 nuclear magnetic resonance spectroscopy (¹³C‐NMR), Fourier transform infrared spectroscopy (FT‐IR), gel permeation chromatography (GPC), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA). Gas transport properties of one polymer are measured by the time lag (constant volume, variable pressure) method. Low gas permeabilities are a consequence of the rather high glass transition temperature. The rather high selectivities in separation of CO₂/N₂ and CO₂/CH₄ result from the CO₂‐philic groups such as PEG, triazole, and benzoxazine. According to the gas permeation measurements, the membrane is stable in the temperature range from 30 to 90 °C.

     

Comparison of efficacy of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort

Objectives:

To compare the effects of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort/pain in patients undergoing cystoscopy.

Methods:

This prospective study was conducted on 75 American Society of Anesthesiologists (ASA) I-II patients between 18-75 years of age and undergoing cystoscopy between November 2011 and June 2012 at Hacettepe University Hospital, Ankara, Turkey. Patients were randomly assigned to one of the 3 groups to receive 1 µ/kg dexmedetomidine, 250 µ/kg intravenous ketamine, or normal saline. All patients were questioned regarding probe-related discomfort, patient satisfaction, and pain at the end of the operation 0 (t₀) and 15 (t₁), 60 (t₂), 120 (t₃), and 360 (t₄) minutes postoperatively. Evaluations were performed in person at the post-anesthesia care unit, or in ambulatory surgery rooms, or by phone calls.

Results:

Pain incidence in the dexmedetomidine and ketamine groups (p=0.042) was significantly lower than that in the control group (p=0.044). The sedation scores recorded at t₀ in the dexmedetomidine and ketamine groups (p=0.004) were significantly higher than that of the control group (p=0.017). Patient groups were similar regarding the rate of hallucinations experienced at t₁, no patients experienced hallucinations at t₂, t₃, or t₄. Significantly more patients experienced hallucinations at t₀ in the ketamine group than in the dexmedetomidine group (p=0.034) and the control group (p=0.005).

Conclusion:

Dexmedetomidine and ketamine had similar analgesic effects in preventing catheter-related pain; however, dexmedetomidine had a more acceptable side effect profile. To identify the optimal doses of dexmedetomidine and ketamine, more large-scale interventional studies are needed.Postoperative pain and discomfort are frequent complaints in patients undergoing surgery requiring bladder catheterization. Catheter-related bladder discomfort (CRBD) is defined as an urge to urinate, and discomfort in the suprapubic region postoperatively in patients who undergo urinary catheterization during surgery.1,2 Discomfort caused by the probe is frequently a stressful situation resistant to conventional opioid treatment in patients hospitalized in the post-anesthesia care unit (PACU). A number of studies have been conducted to reduce the problems caused by bladder catheterization and identify agents that can be used for prophylactic postoperative treatment.3 Ketamine is a general anesthetic, which acts rapidly. An anesthetic state that characterized by deep analgesia, normal pharyngeal-laryngeal reflexes, and normal or increased skeletal muscle tone can be provided using ketamine.4 A series of intervention that ketamine used for postoperative shivering have shown that it also relieves catheter-related discomfort.5-7 Dexmedetomidine is a D-dimer form of the alpha-2 agonist agent medetomidine and a highly selective, specific, and strong agonist of the alpha-2 adrenoreceptor.8 Dexmedetomidine has anxiolytic, hypnotic, sedative, and analgesic effects and supporting features to anesthesia without significant depressive effects on the respiratory system.9 These features make dexmedetomidine a very useful adjuvant for general anesthesia procedures.10 There is strong evidence that alpha-2 receptor stimulation has an analgesic effect at the spinal cord level, and this “opioid supporting effect” of dexmedetomidine is still under investigation.2 In this study, our primary outcome was to evaluate the effects of prophylactic ketamine and dexmedetomidine on postoperative CRBD/pain in patients undergoing cystoscopy.     

Fatty acid composition and anticancer activity in colon carcinoma cell lines of Prunus dulcis seed oil

Context: Almond oil is used in traditional and complementary therapies for its numerous health benefits due to high unsaturated fatty acids content.

Objectives: This study investigated the composition and in vitro anticancer activity of almond oil from Northern Cyprus and compared with almond oil from Turkey.

Materials and methods: Almond oil from Northern Cyprus was obtained by supercritical CO₂ extraction and analyzed by GC-MS. Almond oil of Turkey was provided from Turkish pharmacies. Different concentrations of almond oils were incubated for 24 and 48?h with Colo-320 and Colo-741 cells. Cell growth and cytotoxicity were measured by MTT assays. Anticancer and antiprolifetarive activities of almond oils were investigated by immunocytochemistry using antibodies directed against to BMP-2, β-catenin, Ki-67, LGR-5 and Jagged 1.

Results: Oleic acid (77.8%; 75.3%), linoleic acid (13.5%; 15.8%), palmitic acid (7.4%; 6.3%), were determined as the major compounds of almond oil from Northern Cyprus and Turkey, respectively. In the MTT assay, both almond oils were found to be active against Colo-320 and Colo-741 cells with 1:1 dilution for both 24?h and 48?h. As a result of immunohistochemical staining, while both almond oils exhibited significant antiproliferative and anticancer activity, these activities were more similar in Colo-320 cells which were treated with Northern Cyprus almond oil.

Discussion and conclusion: Almond oil from Northern Cyprus and Turkey may have anticancer and antiproliferative effects on colon cancer cells through molecular signalling pathways and, thus, they could be potential novel therapeutic agents.