Intestinal obstruction due to bezoars: a retrospective clinical study

PURPOSE

The purpose of this study was to compare the results of surgical procedures applied to rare intestinal obstruction cases due to bezoars and to identify effective factors for determining the type of surgical procedure to be applied.

METHODS

The records of 62 patients who had received gastrointestinal surgical treatment due to bezoars were assessed retrospectively. The preoperative characteristics, perioperative findings and postoperative results of cases that had and had not undergone an enterotomy were compared

RESULTS

The average patient age was 57.7 years (range, 26-84 years), and all patients had phytobezoars, except one. The most common location for bezoars was the jejunum (28 cases, 45.1 %). Sixteen cases (25.8 %) had multiple bezoars located in different parts of the gastrointestinal tract. While milking was applied to 26 cases (41.9 %) with small intestinal bezoars, an enterotomy was used to remove bezoars in 23 cases (37 %). More complications tended to be identified in patients who underwent an enterotomy; however, the difference was not significant (p = 0.553).

CONCLUSIONS

The frequency of previous abdominal surgery in patients suffering from an intestinal obstruction due to bezoars causes diagnostic conflict. The location of bezoars in the small intestine should also be considered when deciding the surgical procedure, as well as the physical properties of the bezoars. Our opinion is that conducting the milking procedure should not be insisted on, and that an enterotomy should be conducted when necessary.

A morphological and stereological study on calculating volume values of thoracic segments of geese

BACKGROUND

In this study, the total volume of the thoracic segments of the spinal cord and volume densities of grey matter and white matter were examined by using stereological methods in adult geese having a weight of 3-4 kg.

MATERIALS AND METHODS

Ten geese were used as material without sex discrimi- nation. All animals were perfused with 10% formaldehyde. In addition, after perfusion, the geese were kept in 10% formaldehyde for 1 week. Afterwards, thoracic spine was removed and thoracic part of spinal cord was excised. 5 μm thick sections were taken from these tissue samples by microtome. The cross- sectional series were obtained by sampling from each segment at 250th section. Twelve sections were taken from tissue specimens of every segment. The sections were stained by using haematoxylin-eosin and photographed on a microscope.

RESULTS

By using the Cavalieri's Principle, the volume densities (volume fractions) of thoracic segments of spinal cord, volume of white matter, and volume of grey matter in segments were calculated.

CONCLUSIONS

In the study, total volume of the thoracic segment, volume of white matter, and the volume of grey matter, and the ratio of these volume values to each other were calculated. The SHTEREOM 1.0 software was used for calculating the volume of section specimens.

AutoCOR: Autonomous condylar offset ratio calculator for post-operative total knee arthroplasty radiographs

BACKGROUND

This study aims to automate the measurement process of posterior condylar offset ratio (PCOR) and anterior condylar offset ratio (ACOR) to improve the Total Knee Arthroplasty (TKA) evaluation. Accurate calculation of PCOR and ACOR, performed manually by orthopedic surgeons, is crucial for assessing postoperative range of motion and implant positioning. Manual measurements, however, are time-consuming, prone to human error, and subject to variability. Automating this process could improve precision in clinical practice.

METHODS

We developed AutoCOR, a software system that autonomously calculates PCOR and ACOR by utilizing built-in function, employing k-means clustering, from the OpenCV library for image segmentation. The software detects key anatomical landmarks on true postoperative lateral radiographs. The definitions of PCOR and ACOR are PCO (posterior condylar offset) divided by femoral diameter, and ACOR is defined as ACO (anterior condylar offset) divided by femoral diameter, respectively. We tested the algorithm on 50 postoperative lateral radiographs of 32 patients from the Istanbul Kosuyolu Medipol Hospital, which included data from. The assessment process included calculating the mean, standard deviation and plotting the Bland-Altman plots, comparing AutoCOR's results against ground truth values.

RESULTS

The mean PCOR was 0.984 (SD 0.235) for AutoCOR and 0.972 (SD 0.164) for ground truth values, showing a strong correlation (Pearson r = 0.845, p < 0.0001). The mean ACOR was 0.107 (SD 0.092) for AutoCOR and 0.107 (SD 0.070) for ground truth values, with moderate correlation (Spearman's rs = 0.519, p = 0.0001).

CONCLUSION

AutoCOR provides accurate measurements and shows potential to reduce variability in TKA evaluation, improving precision in clinical practice.

A stereological study of the renal and adrenal glandular structure of red-legged partridge (Alectoris chukar)

BACKGROUND

Partridge is a major bird species that has recently gained an increasing importance as an alternative food source and a game animal in hunting tourism. Herein, we aimed to examine the histological structure and stereological properties of the renal and adrenal glands of red-legged partridge.

MATERIALS AND METHODS

Seven healthy adult red-legged partridges (Alectoris chukar) of both genders were used in this study. The Alectoris chukars were perfused with the intracardiac method and were kept in 10% formaldehyde for 72 h for optimal fixation. The tissues were embedded in paraffin after routine light microscopic processes. Then, 5-μm thick sections were taken, which were stained with haematoxylin and eosin, photographed, and examined in light microscope. Modified Cavalieri principle was used for volume calculation as stereological analysis. Total tissue volume ratios were calculated with the help of a point grid provided by the Shtereom 1.5 packaged programme. Mann Whitney-U test was used for inter-group comparisons. The significance level was set at 5% SPSS (ver: 13) statistical software was used for all statistical analyses.

RESULTS

Renal histological structure was found to resemble those of other bird species and contained a mixed type (mammalian, reptilian) glomerular structure. It was also found that the adrenal histology was not in the form of separate layers but composed of cell groups with different properties. Stereological renal volume assessment revealed statistically similar right and left renal size (p > 0.05). In adrenal gland volume assessment, the right and left adrenal volumes were also statistically similar (p > 0.05).

CONCLUSIONS

The obtained data in the present study is thought to contribute to the understanding of the stereological, morphological and histological structure of the red-legged partridge (Alectoris chukar) kidney and adrenal gland.

Micronuclei frequencies in exfoliated nasal mucosa cells from pathology and anatomy laboratory workers exposed to formaldehyde

Formaldehyde (FA) is a widely used industrial chemical. Sufficient evidence exists to consider FA as an animal carcinogen. A possible causal role for FA may be considered likely for cancer of the nasopharynx and the nasal cavities in humans. The frequency of micronuclei (MN) in cells of the nasal mucosa was evaluated for 23 individuals in pathology and anatomy laboratories exposed to FA. Twenty-five healthy subjects were selected from the university and hospital staff as a control group. The measured air concentrations of FA in the breathing zone of the laboratory workers were between 2 and 4 ppm. The mean +/- SD values of nasal mucosa MN (per 1000) frequency from exposed and controls were 1.01 +/- 0.62 and 0.61 +/- 0.27, respectively (p < 0.01). Effect of smoking, age, sex and duration of exposure on the genotoxicity parameters analyzed were also evaluated. Our data suggest that low level exposure to FA is associated with cytogenetic changes in epithelial cells of the nasal region and that nasal mucosa cells exposed through respiration is an important target of FA-induced genotoxic effects.