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Investigation of various tumor-specific markers has a critical role in early diagnosis and treatment of breast cancer. The aim of the this study is to investigate the Human Leukocyte Antigen (HLA) alleles, the molecules that play an important role in immunity and tumor response of the body, and its relationship with breast cancer. In this prospective clinical study, after obtaining approval from the ethics committee of Istanbul University Experimental Medical Research Institute, 22 female patients who have been hospitalized in Istanbul University Cerrahpasa Faculty of Medicine the Department of General Surgery with a diagnosis of breast cancer were selected. In the control group, there were 22 healthy women who had no relationship and were donor candidates for renal transplantation. After collecting blood in 5 ml tubes with EDTA, HLA A, B and DR groups were measured with SSP method using the GenoVision Olerup SSP (Olerup SSP, Stockholm, Sweden) kit in Istanbul University Cerrahpasa Faculty of Medicine Blood Center Tissue Type Determination Laboratory. In patient and control group, totally 53 alleles; 17 alleles of HLA-A gene, 22 alleles of B gene, 14 alleles of DR gene were detected. A statistically significant relationship was determined between HLA-B55:01 and HLA-DRb1*18:01 alleles and the development of breast cancer (p<0.05). HLA-B13:01 antigen is determined only in the control group. It was concluded that HLA-B13:01 antigen, determined only in the control group, may be protective for breast cancer and HLA-B55:01 and HLA-DRb1*18:01 antigens, determined only in the patient group, may be a risk factor for breast cancer (Tab. 5, Ref. 22).

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The preventive effects of granulocyte colony-stimulating factor, cefephim, and sucralfate on bacterial translocation in experimentally induced acute pancreatitis were investigated. Forty male Wistar albino rats were used in this study. For each rat, the pancreatobiliary ductus was ligated and hence acute pancreatitis was induced. In the control group, no further procedure was performed. Meanwhile, cefephim as an antibiotic, filgrastim, which is a colony-stimulating factor, and sucralfate were given to the other groups at the specified doses. To inhibit bacterial translocation by preserving the bowel barrier, sucralfate, which is known to have a cytoprotective effect on the gastrointestinal system, was used in high doses. Cefephim 30 mg/kg per day (intramuscularly) in group II, filgrastim 10 mg/kg per day (subcutaneously) in group III, and sucralfate 50 mg/kg per day by 8-F feeding tube gavage into the stomach in group IV were given. The number of bacteria translocated into the mesenteric lymph nodes, pancreas, liver, and spleen in the control group significantly increased in comparison with the other groups (P < 0.05). The average number of leukocytes (per mm3) in the control group was significantly higher than that of other groups (P < 0.0001). Regarding the average serum amylase levels, the values of all groups clearly decreased in comparison with the control group (P < 0.0001). Although in the cefephim, filgrastim, and sucralfate groups, (+) pancreatitis was generally seen, in the control group (+++) pancreatitis was detected. Bacterial translocation to the mesenteric lymph nodes and pancreas was partially prevented by filgrastim and sucralfate, and was completely prevented by cefephim. We conclude that in the management of acute pancreatitis, the use of the prophylactic antibiotics, sucralfate and filgrastim, may be advantageous.

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OBJECTIVE: To find out whether pilonidal sinus is more common among obese people. DESIGN: Retrospective study from hospital records. SETTING: Two university hospitals, Turkey. SUBJECTS: 419 patients who were operated on for pilonidal sinus disease; and 213 age and sex matched patients with benign diseases other than pilonidal sinus disease and who were not morbidly obese acted as controls. MAIN OUTCOME MEASURES: Comparison of body mass index (BMI) in the two groups. RESULTS: Patients with BMI of 25-30 were classified as overweight (61/419, 15% compared with 28/213, 13%), and those with BMI of 30 or more as obese (7/419 compared with 4/213, 2% in each group). Mean (SD) BMI of patients with pilonidal sinus disease was 26.0 (3.9) compared with 25.6 (3.9) in the control group (p = 0.4). CONCLUSION: Obesity alone is not an important factor in the aetiology of pilonidal sinus disease.

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BACKGROUND: Conventional abdominal CT and Ultrasonography were not adequate for the immediate assessment of a closed perforation of the small intestine showing continuity. For definitive diagnosis of the main pathology, we advise enteroclysis. METHODS: All patients had non-traumatic small bowel perforation and had many diagnostic procedures including conventional abdominal CT and ultrasonography, but did not get a positive result from them. Following the enteroclysis, it was obvious that there existed a closed small bowel perforation with continuity. RESULTS: The first patient had fistula and interloop pouch filled with contrast in pelvis minor and perforations in small intestine and cecum. The second patient had closed perforation showing continuity in the level of ileum and the third patient had a pouch showing continuity in the ileum and a fistula in ileum. All patients had operation; the first one had a Crohn's disease and discharged postoperatively on 16th day, but the second one having ileal tumor was lost postoperatively due to pulmonary embolism and the third one having Non-Hodgkin Lymphoma was lost postoperatively due to sepsis. CONCLUSION: Conventional techniques were not sufficient to classify the main pathology in these cases, but enteroclysis revealed good results in diagnosis of the main event, and does not cause a delay in diagnosis.

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PURPOSE: The high mortality associated with ileosigmoid knotting prompted us to review the collected experiences of three university hospitals in order to establish a more rational approach to the problem. METHOD: The clinical records of 68 patients with ileosigmoid knotting from 1970 to 1990 were reviewed with respect to incidence, etiopathogenesis, clinical features, treatment, and clinical outcome. RESULTS: The most common type of ileosigmoid knotting was Type IA (48.5 percent), in which the active ileum encircled the passive sigmoid in a clockwise manner. Fifty (73.5 percent) patients developed a gangrenous bowel whereas 18 patients did not show any definite evidence of impairment of bowel viability. En bloc removal of gangrenous knot and reestablishment of intestinal continuity by enteroenteric or enterocolic anastomosis combined with the Hartmann procedure, which was employed in 20 (42.6 percent) cases, constituted the most frequently preferred operation. The mortality rate in this series was 30.9 percent (21/68) and toxic shock, which ultimately resulted in multiple organ failure, was the major cause of death. It was remarkable to note that there was an inverse correlation between the duration of symptoms and the mortality rate reflecting the dramatic rapidity and severity of symptoms due to tightness of the knot which led to early and extensive gangrene, thus inevitably urged the patients to seek medical help without delay. CONCLUSION: The performance of prompt, individualized surgical treatment in conjunction with the use of advanced measures of critical care to combat the disastrous consequences of multiple organ failure would contribute greatly to improve survival rate in victims of this dreadful entity.

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