Can we use endocan level to determine severity of pancreatitis?

Background and study aims: Endothelial cell specific molecule-1 (ESM-1), also known as endocan, is a soluble proteoglycan secreted by human vascular endothelial cells. In some studies, it has been found that endocan have important effects on cell adhesion, inflammation and angiogenesis. In this study, we aimed to evaluate the endocan level in patients with pancreatitis and the availability of endocan level in determining the severity of the disease. Patients and methods: A total of 42 patients with pancreatitis and 33 healthy individuals were included in the study. The serum endocan levels in patients were evaluated 1st and 3 th days after the symptom's onset. Current scoring systems and the relationship between the severity of the disease and endocan levels were evaluated. Results: The endocan levels of the patients on day 1 are significantly correlated only with the APACHE II score (p=0.039 r=0.319), while the endocan values on day 3 are significantly correlated with the BISAP (bedside index of severity in acute pancreatitis) (p=0.013 r=0.380), APACHE II (Acute Physiology and Chronic Health Evaluation)(p<0.001; r=0.53) and Ranson (p=0.037 r=0.32) scores. The cutoff level of endocan (day 3) was calculated 92.2 pg/ml (83% sensitivity and 50% specificity; p=0.039 area under the curve 0.706) for severe pancreatitis when considering the patients with a score of 8 or higher in the APACHE II scoring system. Conclusion: Serum endocan level can be used as a marker of prognosis in patients with pancreatitis. However, studies involving large populations are needed on this matter.

Intra-operative magnetic resonance imaging in neurosurgery.

Intra-operative MRI (iMRI) has been incorporated into modern neurosurgical operating rooms as a guide for neurosurgical interventions for almost ten years. This technology has been shown to be a useful modality in brain tumour surgery and biopsy; its use in spine, vascular and epilepsy surgery has been evolving. It is particularly useful in low-grade gliomas, pituitary adenomas and pediatric tumors. We evaluate currently available iMRI systems and their applications in neurosurgery. Future possibilities related to iMRI systems are mentioned in the light of current advances.

Use of beta blockers for increasing survival of free fat grafts.

Fat tissue is abundant in the body and preferred in soft tissue augmentation. Since resorption is its greatest disadvantage, many agents have been tried in an attempt to increase fat graft survival in various studies. Yet selective beta1 blocker had not been used before. The effect of selective beta1 blockers on resorption following auto-transplantation of free fat graft was examined in rats. The effect of selective beta1 blockers was compared with those of insulin and saline solution as a control. For this comparison, the weight of fat grafts was measured both during and nine months after operation using the "liquid overflow method" in which obtained material was put into 5 cc syringe filled with saline solution and the increase in liquid level was recorded as graft volume. Histological examination of grafts and statistical analyses of the results were also made. Our in vivo study demonstrated that selective beta1 blocker significantly increased free fat graft survival. It is our conclusion that selective beta1 blocker is a promising agent for decreasing fat graft resorption.