Significance of Gastric Wall Thickening Detected in Abdominal CT Scan to Predict Gastric Malignancy.

BACKGROUND: Early diagnosis of gastric cancer is one of the most important parameters affecting the survival of the disease. In this study, we aimed to stress the importance of antrum wall thickness in CT examination. METHOD: The study included 111 patients between ages of 18 and 95 who had antral wall thickening in computed tomography and also had endoscopic evaluation performed in the same clinic. The patients were divided into two groups as benign and malignant according to the pathology results. The thickness of the antrum wall in computed tomography, hemoglobin and albumin levels, and age was compared among these two groups. Parameters with significant differences were further analyzed by multivariate analysis using logistic regression analysis. RESULTS: Of the 111 patients included in the study, 57 were male and 54 were female. Mean age was 65 years. Fifty-one patients were classified as benign and 60 patients as malignant. Mean age of the malignant patients was 70, while that of benign patients was 59 (p < 0.05). Antrum wall thickness was 13.68 ± 3.27 mm in malignant patients and 9.22 ± 2.17 mm in benign patients (p < 0.05). Similarly, hemoglobin level was significantly different in malignant and benign patients (10.78 ± 1.57 g/dl and 12.64 ± 1.43 g/dl, respectively; p < 0.05). Albumin levels were 3.36 ± 0.57 mg/dl in malignant patients and 3.97 ± 0.57 mg/dl in benign patients (p < 0.05). CONCLUSION: Evaluation of antrum wall thickness, age, hemoglobin, and albumin values together may contribute to distinguishing the benign and malignant pathologies involving this region in patients with suspected stomach wall thickening in abdominal CT scan.

Colonic Wall Thickening Reported in Abdominal CT: Does It Always Imply Malignancy?

AIM/BACKGROUND: Early diagnosis of patients with colon cancer is one of the most important parameters affecting the survival of patients. In this study, we aimed to examine the effect of the age, hemoglobin (Hb), albumin, neutrophil lymphocyte ratio (NLR), thrombocyte lymphocyte ratio (PLR), and mean platelet values (MPV) on the separation of benign and malignant diseases in patients with suspected colon wall thickness (CWT) observed in abdominal computed tomography (CT) examination. METHOD: The study included 116 patients between the ages of 18 and 95 who had CT examination where the colon wall could be evaluated and who also had colonoscopy. Patients suspected for CWT in CT with difficulties in differential diagnosis were divided into two groups according to colonoscopic-histopathological evaluations. Normal or benign pathological causes were included in the first group, while malignant causes constituted the second group. Whether the two groups differed in terms of CWT, Hb, age, albumin, NLR, PLR, and MPV values was investigated with descriptive statistics. RESULTS: One hundred and sixteen patients (74 males, 42 females) with CT examinations and colonoscopic sampling were included in the study. After colonoscopic and histopathological evaluations, there were 64 cases in the first group and 52 in the second group. According to the results of the univariate analysis and multivariate logistic regression, CWT, Hb, NLR, and MPV were identified to be independent variables for determining colon cancer. CONCLUSION: A combined evaluation of Hb, NLR, and MPV values in patients with CWT in abdominal CT examination may contribute to the separation of benign and malignant pathologies.

Increase in Body Mass Index After Renal Transplantation.

The aim of this study was to determine the changes in body mass index (BMI) of patients after renal transplantation regarding causes like steroid use, lower necessity for dietary restrictions, and changes in eating habits. Ninety-seven patients were enrolled in this retrospective study; they had undergone cadaver or living donor renal transplantation between 2011 and 2013. Demographic features of patients, height, weight, and BMI were evaluated before and 6 and 12 months after surgery. The patients were grouped as malnutritioned, normal, overweight, and obese. Statistical analyses were performed using the SPSS 11.0 statistics program. Mean age of patients was 39.1 ± 10.7 years. Twenty-six (26.8%) were female and 71 (73.1%) were male. Mean BMI before surgery was 22.52 ± 3.97 kg/m(2). Six months post-transplantation the mean BMI was 24.40 ± 4.1 kg/m(2) and after 12 months it was 25.56 ± 4.14 kg/m(2) (P < .05). Also, 68% of patients showed improvement 12 months after surgery; they were in the preoperative malnutrition group. There is a significant increase in the BMI of patients in the first year who undergo renal transplantation, and the reason is multifactorial. BMI is relevant to diabetes, hypertension, and allograft nephropathy. BMI should be carefully considered in the follow-up of patients who have undergone renal transplantation, and early nutritional changes with dietary and exercise programs should be performed in overweight cases.

Insights to the clarification of sugar cane juice expressed from sugar cane stalk and trash.

Processing of juice expressed from green sugar cane containing all the trash (i.e., tops and leaves, the nonstalk component) of the sugar cane plant during sugar manufacture has been reported to lead to poor clarified juice (CJ) quality. Studies of different liming techniques have been conducted to identify which liming technique gives the best clarification performance from juice expressed from green cane containing half of all trash extracted (GE). Results have shown that lime saccharate addition to juice at 76 °C either continuous or batchwise gives satisfactory settling rates of calcium phosphate flocs (50-70 cm/min) and CJ with low turbidity and minimal amounts of mineral constituents. Surprisingly, the addition of phosphoric acid (≤ 300 mg/kg as P2O5), prior to liming to reduce juice turbidity (≤ 80%), increased the Mg (≤ 101%) and Si (≤ 148%) contents particularly for clarified GE juices. The increase was not proportional with increasing phosphoric acid dose. The nature of the flocs formed, including the zeta potential of the particles by the different liming techniques, has been used to account for the differences in clarification performance. Differences between the qualities of the CJ obtained with GE juice and that of burnt cane juices with all trash extracted (BE) have been discussed to provide further insights into GE processing.

Evaluation of different surgical techniques in the management of subluxated cataractous lens.

OBJECTIVE: To compare and evaluate the outcome of different surgical techniques in the management of subluxated cataractous lens. MATERIAL AND METHODS: This retrospective study included 18 eyes of 18 patients with subluxated cataracts of varying etiology. Their preoperative examination maintain included: best corrected visual acuity (BCVA), thorough anterior segment examination, by slit -lamp especially for the degree and extent of subluxation and cataract, cornea, iris and the pupil for other abnormalities or other traumatic signs, presence or absence of vitreous in the anterior chamber, IOP and finally fundus examination. The patients were then divided into 3 groups each comprising 6 patients. The first group underwent ECCE with sulcus implantation PMMA IOL , the second and third groups underwent phacoemulsification with bag implanted Acrylic IOL but the third group underwent special techniques and precautions during surgery. Postoperatively, all patients were examined for BCVA, IOP, IOL positioning, pupil, fundus examination. RESULTS: Thirteen patients were males and five were females. The etiology of subluxation was traumatic in ten males and two female. The ages of the patients were between 11 and 62 years old the post operative follow up period ranged between 7 and 16 months. No major intraoperative complications were noted. In the 1st group 2 patients underwent AC automated vitrectomy, 3 in the 2nd group, 1 in the 3rd group. Three patients needed scleral fixation suture . Thirteen patients had well centered IOL and 4 had slight decentration not necessitating further intervention and one in the 2nd group had clinically significant decentration where IOL explanation, widening of the wound and re implantation of a wide 6.5mm optic PMMA IOL was done in the second post operative daily. CONCLUSION: Subluxated cataracts need special precautions in the chosen surgical technique to maintain a reasonable safety level intraoperatively and an acceptable surgical.

Transient appearance of hepatic natural killer cells with high cytotoxicity and unique phenotype in very young mice.

There were few natural killer (NK) cells in the liver in very young mice at the age of 1-2 weeks. This was because the cell yield from the liver of young mice was low. The percentage of NK cells in the liver of young mice, however, was almost comparable with that in the liver of adult mice. Lymphocytes were isolated from the liver and spleen of C57BL/6 (B6) mice, and NK cytotoxicity and phenotype were herein examined in this study. NK cytotoxicity was extremely high in the liver of very young mice. This phenomenon was seen in the liver of various normal mouse strains. In contrast, the appearance of high cytotoxicity was not seen in NK cells of the spleen, irrespective of mouse strains. The quality of NK cells in the liver of young mice was different from that in adult mice. NK cells in the liver of young mice were mainly CD69(+)Mac-1(-) Fas ligand(+), whereas those in the liver of adult mice were CD69(-)Mac-1(+) Fas ligand(-). These results revealed that the quality of hepatic NK cells changes in the process of ageing. Namely, liver NK cells in very young mice temporarily show the highest NK cytotoxicity and a unique activated phenotype. Physiological meaning of the present phenomenon was discussed.

Intraocular foreign bodies associated with traumatic cataract.

OBJECTIVE: To determine prognostic factors and visual outcomes in patients with intraocular foreign bodies (IOFBs) associated with traumatic cataract. PARTICIPANTS: 19 patients undergoing surgical removal of IOFB and cataract extraction with a minimum of 6-months follow-up. OUTCOME MEASURES: Final best corrected visual acuity was the main outcome where ocular findings at presentation were compared with final visual acuity to determine prognostic factors for visual outcome. RESULTS: Final best corrected visual acuity of > 6/30 was obtained in 12 patients (63.2%) and functional vision (> 1.5/60) was achieved in five patients (26.3%). CONCLUSION: Final visual outcomes were found in 63.2% of patients. Initial visual acuity was the strongest predictor of final visual outcome in this study. Additional predictive factors included the mechanism of injury and the presence of vitreous hemorrhage.

Sustainable wastewater management for small communities in the Middle East and North Africa.

Accelerated expansion of wastewater services to small communities in the Middle East and North Africa (MENA) is essential in order to address serious concerns over water scarcity and pollution in addition to meeting the demand for convenience and protecting public health. Centralized and conventional wastewater systems are currently the preferred choice of planners and decision-makers in MENA. Water and funding are not available to provide these centralized conventional services to small communities. This paper presents an integrated approach to sustainable wastewater management for small communities in MENA under the severe water resources crisis. The approach calls for a paradigm shift from centralized conventional wastewater systems to decentralized wastewater systems. Management of wastewater in MENA should start at home. Wastewater generation should be reduced through a combination of domestic water conservation measures. On-site systems must be improved and monitored to control pollution and to recover water for non-potable water uses. Should the circumstances not allow the use of on-site systems, wastewater should be transported and managed through a community system applying the principles of decentralized wastewater management and using the settled sewers for wastewater transportation where appropriate. This approach will facilitate the accelerated and sustainable extension of environmentally responsible wastewater services to MENA's small communities. It offers great potential for cost reduction, accommodates the necessary domestic water conservation efforts, reduces freshwater inputs in wastewater transportation thus eliminating unnecessary demand on freshwater, reduces associated environmental risks and increases wastewater reuse opportunities.

A synthetic form of tracheal antimicrobial peptide has both bactericidal and antifungal activities.

We have chemically synthesized tracheal antimicrobial peptide (TAP) with 38 amino acids and examined efficacy of the peptide on various organisms. The synthetic peptide showed potent bactericidal effect on both gram positive and negative bacteria. The action of bactericidal effect was relatively quick and 99.9% of E. coli cells were killed within 90 minutes at a concentration of 2.5 micrograms/ml of TAP. The peptide also showed antifungal activity against both mycelia (Aspergillus fumigatus) and yeast (Candida albicans) forms of fungi. Our domain analysis with a series of synthetic peptides of various lengths indicates that 17 amino acid residues of the C-terminal end is the minimum functional domain of the bactericidal activity.

Effects of synthetic form of tracheal antimicrobial peptide on respiratory pathogens.

We have synthesized a C-terminal portion of tracheal antimicrobial peptide (TAP) with 38 amino acids and tested it for efficacy on various clinical isolates of Pseudomonas aeruginosa strains from patients with cystic fibrosis and also on Aspergillus fumigatus. Our results indicate that the synthetic TAP has both potent bactericidal and fungicidal activities and that a combination of TAP and amphotericin B showed strong additive effects of growth inhibition on A fumigatus. These results suggest that TAP is potentially an effective therapy for Aspergillus and multi-drug-resistant Pseudomonas, pathogens that are often a serious threat to patients with cystic fibrosis.

The effects of lithotripsy on adrenocortical hormones.

In order to evaluate the effects of lithotripsy (ESWL) on adrenocortical hormone levels, we prospectively compared blood ACTH, cortisol, aldosterone and DHEA-S levels of patients treated by lithotripsy and with elective operative cholecystectomy for biliary stone disease. After surgery, blood cortisol and ACTH levels were increased significantly at 16 hours (p < 0.05) and returned to normal at 40 hours while in the ESWL group the aforementioned enzyme levels were elevated significantly at 16 and 40 hours after ESWL (p < 0.05). The comparison of two groups at 16 hours showed no difference (p > 0.05). DHEA-S levels were elevated significantly at 16 hours after lithotripsy (p < 0.05) but the elevations after surgery were not significant (p > 0.05). Aldosterone levels were elevated significantly in both groups (p < 0.05) but the comparison of the two groups showed no difference (p > 0.05). In conclusion, ESWL induces trauma to the neuroendocrine system and the duration of the response is longer when compared with surgical trauma.

Which technique for treatment of pilonidal sinus--open or closed?

PURPOSE: After excision of the pilonidal sinus, some surgeons leave the wound open, and others close the wound primarily. The aim of this study is to compare length of hospital stay, length of time to return to work, wound infection rate, and recurrence rate in chronic pilonidal sinus patients, after modification of both closed and open techniques. METHODS: One hundred ten patients who had chronic-stage pilonidal sinus were randomly assigned to receive one of two excisional surgical procedures. One-half were treated by surgical excision and primary closure (closed technique, Group A). The other one-half were treated with Obeid's surgical excision (open technique, Group B). RESULTS: Ninety-one (46 in Group A and 45 in Group B) of 110 patients were followed for a period four months to three years. Although patients with primary closure had significantly longer hospital stays (P < 0.05) than patients in the open group, they returned to work significantly earlier (P < 0.05). In Group A and Group B, infection rates were 3.6 percent and 1.8 percent (P > 0.01), and recurrence rates were 4.4 percent and 0 percent (P > 0.01), respectively. CONCLUSION: Because both techniques have very low complication rates, treatment of chronic pilonidal sinus should be based on patient preference and characteristics, especially employment status.