Ethnic disparities in breast cancer between Central Europe Caucasian women of Slavic origin and Middle East Turkish subjects.

The biological, cultural, behavioral and sociodemographic differences across populations modulate breast cancer profile among races or ethnics. Following this, we aimed to identify differences in breast cancer epidemiology, histopathology, and clinical presentation from representatives of central Europe (Slovakia) and Middle-East countries (Turkey) to point on ethnic disparities in cancer biology. The population based cross-sectional study analyzing 414 cases of primary breast carcinomas where 214 represented Caucasian and 200 Turkish subjects. The differences were found for age at the time of diagnosis (<0.0001), education, menopausal status (<0.001), tumor localization (<0.01), size (<0.0001), grade (<0.05) and axillary lymph node status (<0.001) between groups. Although carcinomas in Slovak subjects were of higher grade, negative axillary nodal status was more frequent finding compared to Turkish patients (50.0 vs. 41.0%). The Slovak group showed carcinomas to be more often ER positive (72.4 vs. 54.0%; <0.001), ER/PgR positive (54.6 vs. 49.0%; <0.001), of better Nottingham prognostic index (<0.001), and less frequent Her-2 positive (21.2 vs. 28.5%). Slovak population expressed significantly higher risk of non-sentinel lymph node metastases with increased tumor size, grade, vascular invasion and Her-2 positivity compared to Turkey population. The tumor size >2 cm and high tumor grade (G3) bears a risk of OR=7.62 and OR=3.10 in Slovak compared to OR=3.94 and OR=1.79 in Turkish cases, respectively.There are wide demographic and biological disparities in breast cancer between observed ethnics providing unique information for clinicians working at the level of screening or therapy in these populations.

Splenic artery aneurysm rupture.

Splenic artery aneurysms are the most common visceral artery aneurysms and are known for their potential for rupture. Pregnancy and portal hypertension have been known as major risk factors. With improved methods of diagnosis and minimally invasive therapy, management and outcome of SAA may change significantly. SAA may rupture at any age. When rupture of the aneurysm occurs, the mortality rate remains low if immediate resuscitation is performed and an aggressive surgical approach is taken. Conservation of the spleen might have been preferred.

The effects of desferrioxamin and vitamin E as supplements to antibiotics in the treatment of peritonitis in rats.

AIM: The aim of the study was to determine the effects of vitamin E and the iron chelating agent desferrioxamin (Dfx), supplemented by clindamycin and gentamycin therapy, on peritonitis caused by caecal ligation of a puncture wound in an experimental model. MATERIALS AND METHODS: One hundred and twenty Spraque Dawley rats were divided into eight groups. Three groups were used as controls; intraperitoneal (i.p.), subcutaneous (s.c.) and i.p. and s.c., respectively. Group 4 was treated with Dfx, Group 5 with vitamin E and Group 6 with antibiotics. Group 7 was treated with vitamin E in combination with antibiotics, and Group 8 with a combination of antibiotics and Dfx. The rats were studied for 14 days following treatment, and survivors then humanely dispatched. Post-mortem examination was undertaken on all the rats studied. RESULTS: In the control groups, mortality at 14 days was 66%. Rats treated with antibiotics alone (Group 5) had a mortality rate of 40%. Those treated with a combination of antibiotics and vitamin E (Group 7), however, had a mortality rate of only 14%, and those treated with antibiotics and Dfx had a mortality rate of only 7%. CONCLUSION: This study suggests that treatment of peritonitis in rats with a combination of Dfx and antibiotics has a significant beneficial effect on survival, in comparison with treatment with antibiotics alone.

Endoscopic sphincterotomy in the management of postoperative biliary fistula A complication of hepatic hydatid disease.

BACKGROUND: Intrabiliary rupture is the most common complication of hepatic hydatid disease (HHD), and persistent biliary leakage is the most frequent complication after surgery for HHD. In this study, we evaluated the outcome of endoscopic sphincterotomy (ES) performed in the management of postoperative biliary fistula in 33 patients with HHD and investigated the effects of the daily output of the fistula and the timing of the ES on the duration of the fistula. METHODS: Between January 1994 and April 2000, 33 patients (20 female, 13 male; median age, 44 years; range, 17-72) underwent ES at our clinics. The daily output of the biliary fistula ranged from 100 ml to 1000 ml (mean, 430 ml; in 18 patients < or = 400 ml; in 15 patients, >400 ml). The interval between the occurrence of the fistula and the performance of the ES ranged from 7 days to 5 months (median, 20 days; in 12 patients, < or = 2 weeks; in 21 patients >2 weeks). RESULTS: In patients with fistula output 400 ml (n = 18) and >400 ml (n = 15), the average closure times for the fistula after ES were 10.7 +/- 4.5 and 10.4 +/- 4.9 days, respectively (t-test: p = 0.847, t = 0.195). In patients (n = 2) with a short interval between the occurrence of the fistula and ES (<2 weeks), the average closure time for the fistula was 11.6 +/- 5.6 days, whereas for the patients (n = 15) with longer intervals (>2 weeks) it was 9.4 +/- 3.9 days (t = test: p = 0.254, t = 1.180). The drainage from the fistula stopped after an average of 9.88 +/- 4.83 days in all patients who underwent ES, and there were no any complications. Pearson's correlation test (PC) showed no significant relationship between the time for the complete closure time of the fistula after ES and the fistula output (PC=-0.253, p=0.155) or for the duration of the fistula before endoscopic retrograde cholangio pancreatography (ERCP) (PC = -0.333, p = 0.058). CONCLUSIONS: Endoscopic sphincterotomy is safe and effective and should be considered the minimally invasive procedure of choice for the management of postoperative biliary fistula due to HHD because it obviates the need for reoperation. If the sphincterotomy is successful, neither the daily output not the duration of the fistula has any influence on the time required for complete closure of the fistula.

The effects of free oxygen radical scavenger and platelet-activating factor antagonist agents in experimental acute pancreatitis.

This study was done to evaluate the possible preventive effects of reactive oxygen species (ROS) scavenger agent desferrioxamine (DFX) and platelet-activating factor (PAF) antagonist agent ginkgo biloba (GB) in an experimental acute pancreatitis model. Seventy-eight CD-1 mice were divided into six groups consisting of 10-13 mice. Induction of pancreatitis was achieved by cerulein injection in groups 2-5. The first group was control, whereas DFX and GB were used alone or in combinations as preventive agents in groups 3-5. DFX or GB were injected to the mice in groups 6 and 7 to evaluate any toxic effect. The assessment of the pancreatic edema and inflammation, the measurement of the amylase and the pancreatic weight and the measurement of the pancreatic tissue oxidative capacity by chemiluminescence method were the parameters to evaluate pancreatitis. Although the results indicate DFX and GB alone or in combinations have significant preventive roles, this was not a complete prevention.

Preventive effect of hesperidin against inflammation in CD-1 mouse skin caused by tumor promoter.

Our earlier studies have shown that the flavonoid hesperidin inhibits tumor promotion in a two stage skin tumorigenesis protocol in CD-1 mice. In this study hesperidin's significant protection (p < 0.0001) against 12-0-tetradecanoylphorbol-13-acetate (TPA) induced edema in CD-1 mouse ear will be presented. Hesperidin also afforded significant protection against TPA induced hyperplasia in the dorsal skin through multiple application prior to TPA. Protection by hesperidin was 93% of the epidermal thickness and 100% of the vertical cell layers. The data also indicate the protective effect of hesperidin against TPA caused infiltration of neutrophils by 73%. These results suggest that hesperidin may possess potential as chemopreventive agent against tumor promoter induced inflammation and hyperplasia.

Chemoprevention of DMBA-induced mammary gland carcinogenesis--preventive effects of free oxygen radical scavengers.

This study was carried out to determine the effects of Mangan-Desferrioxamine (Mn-DFX) and Verapamil (VRP) in 7,12-dimethyl-benz-[a]anthracene (DMBA) induced mammary carcinoma. 70 Spraque Dawley rats were divided into four groups; as DMBA alone, DMBA + Mn-DFX, DMBA + VRP, and control. Incidence, multiplicity, and size of tumors were evaluated in addition to analyses of DNA ploidy status and proliferation index by flow cytometric technique. The results revealed that Mn-DFX and VRP caused significant decreases in tumor incidence (p < 0.02 and p < 0.05), multiplicity (p < 0.02 and p < 0.05), size (p < 0.05 and p < 0.02), and proliferation index (p < 0.05 and p < 0.02) without any toxic effect. The appearance of first tumors in Mn-DFX and VRP groups was also later than in the DMBA alone group (10th and 11th week versus 6th week). In conclusion, Mn-DFX and VRP have offered prevention in experimental mammary carcinogenesis. These agents caused slower tumor growth, though they could not achieve a complete prevention.

Inhibitory effect of Hesperidin on tumour initiation and promotion in mouse skin.

A flavonoid, Hesperidin was evaluated for its ability to inhibit tumour initiation by a polycyclic aromatic hydrocarbon and tumour promotion by a phorbol ester in the skin of CD-1 mice. Subcutaneous application of Hesperidin did not inhibit 7,12-dimethylbenz(a)anthracene-induced tumour initiation but did inhibit 12-O-tetradecanoyl-13-phorbol acetate-induced tumour promotion. Results provide evidence for a potential chemopreventive activity of Hesperidin.

Effect of mangan-desferrioxamin in the prevention of peritoneal adhesions.

An experimental study was carried out using mangan-desferrioxamin chelate, an effective iron-chelating and free oxygen radical scavenging agent, to prevent post-operative peritoneal adhesions in 40 Wistar albino rats. The density of adhesions was evaluated and group scores obtained. The means score (2.5 +/- 0.87) for the group of rats treated with mangan-desferrioxamin was significantly different (P < 0.001) (95% confidence interval 0.6 to 1.6) from that of the control group(mean score 3.9 +/- 0.3). This favourable effect of mangan-desferrioxamin in the prevention of post-operative adhesions should encourage further research to determine the mechanisms of action.

The effects of sterile or infected bile and dropped gallstones in abdominal adhesions and abscess formation.

BACKGROUND: The effects of gallstones and sterile or infected bile on postoperative adhesions and abscess formation were investigated in Sprague Dawley rats. METHODS: The first three groups were injected intraperitoneally with serum saline, sterile bile, or infected bile, respectively. Laparotomy was adjusted to the next seven groups. Serum saline, sterile bile, and infected bile were injected in the fourth through sixth groups intraperitoneally, respectively. Gallstones were placed intraabdominally to the seventh through ninth groups. The injections of sterile bile in group 7 and of infected bile in group 8 were added to laparotomies. Only laparotomy was carried out in group 10. RESULTS: Abscess formations were seen only in infected-bile-injected groups. Significant adhesion formations were seen in infected-bile groups. Sterile bile and/or gallstones had no significant effect in abscess or adhesion formation. CONCLUSIONS: Results suggest that noninfected gallstones and sterile bile, even in combination, do not increase postoperative intraabdominal complications in rats.

The prophylactic effects of superoxide dismutase, catalase, desferrioxamine, verapamil and disulfiram in experimental colitis.

In our study we have tried to compare the prophylactic effects of superoxide dismutase (SOD), SOD+catalase (CAT), desferrioxamine, verapamil and disulfiram, which are all free oxygen radical (FOR) scavengers, in an animal model of experimental acetic acid colitis. The control group had 58.3% colonic ulcers. The SOD group (48.6% ulcerated area) and the SOD+CAT group (47.2% ulcerated area) did not show a significant difference when compared with the control group. The values were significantly different in all other groups when compared with the control group (desferrioxamine (29.2% ulcerated area): P < 0.01; verapamil (10.4% ulcerated area) and disulfiram (7.6% ulcerated area): P < 0.001. In conclusion, desferrioxamine, verapamil and disulfiram have been found to be effective as prophylactics in experimental acetic acid colitis.

Effects of granulocyte colony-stimulating factor on bacterial translocation due to burn wound sepsis.

The presence of certain defects in both cellular and humoral immunity after thermal injury has been established. Likewise, the translocation of enteric bacteria to the mesenteric lymph nodes and to distant organs has also been observed following serious thermal injury. The effects of granulocyte colony-stimulating factor (G-CSF) on bacterial translocation, the small bowel mucosa, and cecal bacterial content were investigated in a rat model of burn wound sepsis in which albino Wistar rats were scalded over 30% of their bodies, after which the lesions were infected by 1 x 10(8) colony-forming units (cfu) Pseudomonas aeruginosa. The control group was treated with 5% dextrose solution subcutaneously starting 2 days preburn, while the treatment group received 100 microg/kg human G-CSF subcutaneously. On the 4th day post burn all animals were killed to examine the bowel and culture of the mesenteric lymph nodes (MLN), livers, and spleens. No significant differences were observed between the groups regarding the cecal bacterial content and small bowel; however, a difference was seen in the ratio of translocation in the MLN liver and spleen and quantitative MLN cultures. Based on these findings, G-CSF was thus found to be significantly effective in reducing bacterial translocation due to burn wound sepsis.

Protective effect of desferrioxamin against TPA caused inflammation in CD-1 mouse skin.

This study was planned to investigate the possible inhibitory effect of the oxygen radical scavenger agent desferrioxamin on 12-0-tetradecanoylphorbol-13-acetate (TPA) induced oedema and hyperplasia in the skin of 119 CD-1 mice. Topical application of different doses of desferrioxamin (20 ng, 200 ng, 2 microg, 20 microg and 200 microg per mouse) 10 min prior to 1 nmol TPA, inhibited oedema of mouse ears significantly (P < 0.02-0.001) except with the doses of 200 ng and 20 ng/mouse. The inhibitory effect of desferrioxamin (2 mg/mouse) in TPA induced mouse skin hyperplasia was also investigated in four groups of 20 CD-1 mice. Desferrioxamin produced an 83.7% reduction in epidermal thickness (P<0.0001) and an 85.8% reduction in the number of vertical cell layers (P <0.0001). Data also indicated the inhibitory effect of desferrioxamin against TPA caused infiltration of neutrophiles (P <0.02). These results suggest that the free oxygen radical scavenger agent desferrioxamin has a chemopreventive effect against TPA induced inflammation and hyperplasia.

Internal supravesical hernia: report of a case.

A patient with clinical signs of intestinal obstruction was found at celiotomy to have a loop of small intestine caught in the supravesical space between pubis and urinary bladder. This report aims to bring attention to vesical hernias, a very rare entity, as a possible cause of small bowel obstruction.

Effects of cholelithiasis and cholecystectomy on gastric emptying.

In this prospective, clinical study, four groups, each consisting of 12 patients were established to determine how gastric emptying is influenced in cholelithiasis with accompanied flatulent dyspepsia and the relationship of symptoms and gastric emptying after cholecystectomy: group 1--healthy people; group 2--patients with dyspeptic cholelithiasis; group 3--patients with no dyspepsia after cholecystectomy; group 4--patients with dyspepsia after cholecystectomy. Groups are compared according to solid phase gastric emptying scintigraphies performed with Tc 99m sulphur colloid bound with scrambled eggs. Gastric emptying delayed in groups 2 (P < 0.001) and 4 (P < 0.005) postprandially and did not differ in the group 3 (P > 0.005). These results demonstrate that dyspepsia, in cholelithiasis and persisting after cholecystectomy, has a close relation with delay in gastric emptying.

The effects of cholelithiasis and cholecystectomy on gastric emptying.

In this clinical study, four groups, each consisting of 12 patients are established to determine how gastric emptying is influenced in cholelithiasis with accompanied flatulent dyspepsia and the relationship of symptoms and gastric emptying after cholecystectomy. 1. group: healthy people, 2. group: patients with dyspeptic cholelithiasis, 3. group: patients who have no dyspepsia after cholecystectomy, 4. group: patients whose dyspepsia is continued after cholecystectomy. Groups are compared according to solid phase gastric emptying scintigraphies performed with Tc 99m sulfur colloid bound with scrambled eggs. Gastric emptying delayed in second (p < 0.001) and fourth (p < 0.005) groups postprandially and not differed in the third group (p > 0.005). These results demonstrate that dyspepsia, in cholelithiasis and persisting after cholecystectomy have a close relation with delay in gastric emptying.