Aim: To compare the effects of endoscopic intragastric balloon (IGB) placement and intragastric botulinum toxin-A (BTX-A) injection in terms of weight loss among patients with non-morbid obesity. Methods: This retrospective single center study was conducted between 01.08.2020 and 01.01.2022. A total of 39 patients with a body mass index (BMI) of <40 without comorbidities were included in the study. Nineteen underwent intragastric BTX-A injection and 20 underwent IGB placement. Patients were evaluated 1 month and 6 months after the procedures. Results: Mean age was 39.4 ± 8.6 in the BTX-A group and 37.3 ± 10.4 in the IGB group (p = 0.496). 78.9% of the BTX-A group and 75.0% of the IGB group were female (p = 1.000). In both groups, the median weight 1 month after the procedure was significantly lower than before the procedure, and the median weight 6 months after the procedure was significantly lower than 1 month after the procedure (p<0.001 for both groups). The median weight loss in the IGB group at both the 1st and 6th months was significantly greater than the corresponding values of the BTX-A group (p < 0.001 for both). Conclusion: IGB insertion appears to be a more successful endoscopic bariatric procedure than intragastric BTX-A injection, as measured by weight loss at post-intervention 1 month and 6 months. IGB may be preferred in patients with a BMI below 40 without obesity-related comorbidity.

Aim: Especially in recent years, with the increase in the number of patients admitted to the emergency services the number of urological emergencies is increasing. Some of these require immediate attention. There are not enough studies on urological emergencies in our country. In this study, we aimed to investigate the demographic data of patients over the age of 18 who presented to the emergency department with non-traumatic urological emergency complaints. Materials and Methods: This study was designed based on a 6-month prospective, cross-sectional study. After obtaining the approval of the ethics committee, patients over the age of 18 with urological emergency complaints were examined between 06.11.2019 and 06.05.2020. Results: The ratio of urological emergencies to all patients was found to be 1.5%. 56.76% (n: 231) of the patients were male and 43.24% (n = 176) were female. In the study was found 44.7% of the patients to be urinary tract infection, 31.45% renal colic, 8.8% hematuria, 6.88% acute urinary retention. In our study, urology consultation was requested for 19% of urological emergency patients. Emergency intervention was applied to 21.13% of all urological emergency cases. Emergency operation was required for 1.47% of the patients. 10.81% of the patients required hospitalization. Conclusion: As a result, urological emergencies are common. Among these cases, there may be diseases that require urgent intervention or surgery. It is very important for the patients the emergency physicians who evaluate the patient first to make a careful and meticulous evaluation and to make a urology consultation if necessary.

Aim: To evaluate the possible effects of red-ginseng on colon anastomosis healing in an experimental rat model. Methods: In Group 1 (sham), laparotomy and colonic mobilization were performed. Colonic transection and anastomosis were performed to Groups 2 and 3. In Group 2 (control), 2 ml of saline was administered rectally to all rats for 10 days. Group 3 (drug group) rats were given 2.5 gr/kg ml red ginseng extract rectally for 10 days. Results: The rats in the sham group had the highest bursting pressure and the rats in the red ginseng group had higher bursting pressure than in the control group (p

Objectives: We aimed to describe our technique and donor selection for donor hepatectomy, review our case series and report our complication rates and outcomes. Materials and Methods: We retrospectively reviewed 41 consecutive donor hepatectomy cases between October 2019 and November 2020 at Yeditepe University, Istanbul, Turkey. Complications were graded according to Clavien-Dindo classification. All cases were performed via laparotomy. Results: Out of 41 donor cases, 38 (92,6%) were right lobe, 2 (4,8%) were left lobe and 1 (2,4%) was left lateral segment donor hepatectomy. Follow up was 9 ±2,2 months (4-16 months). There were 8 (19,5%) complications and all were minor (grade 1 or 2). There were no grade 3 or higher complications. Three (7,3%) of our donors are heterozygous for factor 5 leiden mutation and 4 (9,7%) of our donors had heterozygous prothrombin mutation. Length of stay was average 6.4±1,4 days (range=5-12). Ten donors lost weight with a supervised diet and exercise program. There was one wound complication in this subset of patients. Conclusions: We present our single center donor hepatectomy series with excellent results. We also describe successful weight loss for donors with Body Mass Index (BMI) >30. Donor safety is the most important component of living donor liver transplantation. As donor results continue to improve, living donor liver transplant (LDLT) will continue expand worldwide.

AİM: Hip fracture causes high mortality rates in elderly patients. Here we investigate the relationship between serum laboratory parameters, bone densitometers, malnutrition, depression and pre-fracture survival activity scores of patients who died within 24 months after surgery for hip fracture. METHODS: 121 patients who underwent surgery for hip fracture between 2013 and 2016 and who met the study criteria were evaluated retrospectively. The patients who died within the first 24 months after surgery were evaluated as Group 1, and the patients who died after 24 months or who were still alive were evaluated as Group 2. Serum parameters before surgery, hip and vertebra bone densitometry were examined. The Barthel and Lawton life scale was completed, Mini nutritional assesment (MNA), geriatric depression scala short form (GDS-SF) and preoperative length of stay and BMI were evaluated. RESULTS: Comparing the parameters between groups, we detected no significant difference between age, BMI, vertebral BMD preoperative length of stay. Albumin, total protein, hip BMD, barthel score, and the lawton scoring system, GDS-FM, MNA showed significant differences between the two groups (P<0.05). According to the regression analysis, Albumin, total protein, MNA, GDS-SF, Barthel Score and Lawton scoring systems showed a significantly correlation in patients with mortality in the first 24 months (P<0.05). CONCLUSION: Geriatric hip fractures have many factors that determine the risk of mortality within the first 24 months. According to our study, low albumin, total protein , malnutrition, high depression as well as low pretreatment activity scores, indicate high mortality risk in the 24 months.

Hemoglobin is not an guiltless bystander of the pathophysiology in a number of atherosclerotic diseases. Heme, which is released from hemoglobin or other heme proteins, triggers various pathophysiological consequence, including heme stress as well as intracellular stress. Although heme serves key functions and is tightly controlled, high levels of free heme, which may occur in various pathophysiological conditions, are may hazardous via pro-oxidant, pro-inflammatory, and cytotoxic effects. Heme oxygenases are heat shock protein enzymes that use heme as a substrate and function as an essential antioxidant adaptive response by all human cells. A major function of heme oxygenases is clearance of heme that accumulate in tissues due to erythrocyte turnover. The potentially toxic free heme is converted by heme oxygenases into carbon monoxide, iron, and biliverdin, the latter of which is reduced to bilirubin. In literature the heme degradation pathway has been demonstrated to play a protective role against the development of atherosclerosis. Because growing evidence suggests that oxidative stress is involved in atherosclerosis. This review documents the roles of bilurubin in atherosclerosis and focuses on the clinical significance as a potential therapeutic target in atherosclerotic diseases, such as coronary artery disease.

Giriş ve Amaç: Gastrik kanser (GK) ve kolorektal kanser (KRK) gibi gastrointestinal ilişkili kanserler, önemli bir halk sağlığı problemi haline gelmiştir ve preoperatif değerlendirme, ilk tedavi stratejilerinin belirlenmesinde oldukça önemlidir. Bu çalışma, GK ve KRK hastalarında preoperatif nötrofil-lenfosit oranı (NLO) ve trombosit-lenfosit oranı (TLO)'nın olası prognostik değerini değerlendirmek için yapıldı. Gereç ve Yöntem: Bu retrospektif çalışmaya 50 GK, 50 ardışık KRK hastasını ve yaşları eşleştirilmiş 60 ardışık sağlıklı kişi (kontrol grubu) alındı. Preoperatif tam kan sayımı sonuçları (nötrofiller, trombositler ve lenfositler) hastanın tıbbi kayıtlarından alındı. Bulgular: NLO ve TLO değerleri hem GK hem de KRK hastalarında kontrol grubuna göre anlamlı olarak yüksek bulundu (her ikisi de p <0.001). KRK hastalarında TLO değerleri GK hastalarına göre anlamlı derecede yüksek bulundu (p <0.01). NLO ve TLO değerleri hem GK hem de KRK hastalarında kontrol grubuna göre anlamlı olarak yüksek bulundu (her ikisi de p <0.001). NLO ve TLO değerleri hem gastrik hem de kolorektal kanserin evre 4 hastalarında evre 3 hastalara göre anlamlı derecede yüksek bulundu (her ikisi de p <0.001). Hem GK hem de KRK hastalarında NLO, lenfosit sayısıyla negatif olarak ilişkiliyken, nötrofil sayısı, trombosit ve TLO ile pozitif olarak ilişkiliydi. Sonuç: GC ve CRC'de, NLO ve TLO, önemli bir öngörücü biyobelirteç olabilir. NLO ve TLO değerlerinin, GK ve KRK hastalarında prognozu tahmin etmek için basit, uygulanabilir, ucuz ve kullanışlı parametreler olarak kullanılabileceği sonucuna varıldı. Sonuçlar klinik uygulamada daha geniş çaplı çalışmalarda doğrulanmalıdır.

Aim: Helicobacter pylori (HP) infection causes inflammation and oxidative stress at a cellular level. In the present study, we aimed to evaluate the possible relationship between HP and thiol-disulfide homeostasis (TDH), a novel indicator of oxidative stress.Methods: Medical data of a total of 53 patients admitted with persistent dyspepsia and undergoing gastroscopy were evaluated prospectively. The patients were divided into two groups, based on the result of gastric biopsy, as HP-positive (+) and HP-negative (-). Demographic data, ferric-reducing ability of plasma (FRAP), ischemia-modified albumin (IMA), native thiol, total thiol, disulfide, and malondialdehyde (MDA) levels of the patients were recorded and compared between the two groups.Results: The native thiol (451.03 mmol/L vs. 407.03mmol/L, p=0.005) and total thiol (493.20 mmol/L vs. 456.40 mmol/L, p=0.027) levels were significantly higher in the HP (+) group than in the HP (-) group. The disulfide levels and disulfide/native thiol, disulfide/total thiol and native thiol/total thiol ratios were similar between the HP (+) and HP (-) groups. Although the FRAP was lower in the HP (+) group than in the HP (-) group, this difference was not statistically significant (0.94 mmol/L vs. 1.10 mmol/L). No statistically significant difference was found between the groups in the IMA and MDA levels. Conclusion: In this study, oxidative status of HP patients was evaluated in several different methods. Among them, only elevated native thiol and total thiol levels were found in HP-induced gastritis. There is a need for further studies involving a larger number of patients and a subgroup analysis to examine whether elevated serum thiol-disulfide levels in HP infection suggest an antioxidant or pro-oxidant status.

Recurrence of lower rectal carcinoma on perineal pseudo-continent colostomy is rarely reported in the literature. It presents a real challenge for the physician. The aim of this case report was to document an exceptional recurrence and how to manage it. A 56-year-old man presented with stage II adenocarcinoma of the lower rectum. He received concomitant chemoradiation followed by abdominoperineal resection with perineal pseudo-continent colostomy. Three years later, he developed a local recurrence of his prior adenocarcinoma, on the perineal pseudo-continent colostomy. He underwent wide excision, followed by reconstruction with a rectus abdominis myocutaneous flap with an inferior pedicle and an oblique skin paddle. He underwent adjuvant chemotherapy. The patient is free of disease with three years follow up. Extended resection should be considered as an initial treatment for locally recurrent rectal cancer.

Aim: This study was conducted to evaluate the relationship between disease severity, mean platelet volume and platelet distribution width in stable chronic obstructive pulmonary disease. Methods: The study included 120 consecutive patients with stable chronic obstructive pulmonary disease and 30 consecutive age-matched healthy subjects (control group). Patients were classified as A (mild), B (mild to moderate), C (moderate to severe) and D (severe) defined by the GOLD committee and grouped as A/B (n= 60) and C/D (n=60).Results: Platelet levels were not different among the groups. Mean platelet volume was lower in all patients than control group (p=0.001). Level of platelet distribution width was higher in all patients than control group (p=0.018). Mean platelet volume in C/D groups were significantly lower than A/B group (p=0.011) and control group (p=0.001). Mean platelet volume in A/B group were also significantly lower than control group (p=0.001). Erythrocyte sedimentation rates were higher in A/B and C/D groups than control group (p=0.007 and p=0.001, respectively). C-reactive protein levels in control group were significantly lower than C/D group (p=0.001). No statistically significant correlations were observed between mean platelet volume and forced expiratory volume in one second and forced expiratory volume in one second/forced vital capacity or between mean platelet volume and other inflammatory parameters in A/B or C/D groups. Significant positive correlations were found between erythrocyte sedimentation rate and C-reactive protein (r=0.375; p=0.003), and between mean platelet volume and platelet large cell ratio (r=0.749; p=0.001) in C and D groups. Conclusion: It was concluded that mean platelet volume could be used as a negative acute‑phase reactant in evaluation of disease severity of chronic obstructive pulmonary disease as C-reactive protein.