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INTRODUCTION: Cholecystectomy for symptomatic cholecystitis is one of the common surgical procedures in the geriatric patients. Increased gallbladder wall thickness is expected due to acute cholecystitis and in some other clinical conditions. Routine histopathological evaluation of cholecystectomy materials are required to confirm the diagnosis and document other pathologies. The aim of this study was to evaluate age-related histopathological gallbladder morphometric measurements. METHODS: A retrospective chart review of 371 cholecystectomy materials was performed. Two groups were designed according to age (<65 and ≥65 years old, respectively). Age and gender analyses for histopathological gallbladder length, diameter and wall thickness were performed. In addition, pathologically confirmed acute inflammation rates were evaluated in this case-control study. RESULTS: Gallbladder morphometric measurements and pathologically confirmed acute inflammation rates were similar in males and females. Histopathological gallbladder diameter was higher with acute inflammatory changes, but no differences were observed in gallbladder length and wall thickness. Gallbladder wall thickness and pathologically confirmed acute inflammation rates were not comparable between the control and geriatric patients (2.8 ± 1.3 vs 2.6 ± 1.2 mm, and 30/281 (10.7 %) vs 10/74 (13.5 %), respectively, p > 0.05). However, higher gallbladder length and diameter were observed in geriatric group. CONCLUSION: Age is an independent factor on histopathological gallbladder length and diameter, but not for gallbladder wall thickness. In addition, pathologically confirmed acute inflammation rate is not higher in geriatric patients. Clinical significance of these findings merits further investigation.

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OBJECTIVES: Cryptogenic cirrhosis is a common indication for liver transplantation. Diagnosis is made after exclusion of other causes of cirrhosis. In this study, the aim was to evaluate patients with cryptogenic cirrhosis after histopathological examination of explanted liver. MATERIALS AND METHODS: A retrospective histopathological chart review of 117 patients with cryptogenic cirrhosis who had liver transplantation between November 2009 and June 2014 was performed. Age, sex, operative features, survival rates, and preoperative and postoperative diagnosis were evaluated. RESULTS: During the study period, 123 liver transplantations were performed for these 117 patients. Deceased donor liver transplantations were performed in 23 (18.7%) of the cases. Retransplantations were performed in 5 patients. Median age was 48 years, and female-to-male ratio was 41:76. Hepatosteatosis were observed in 29 patients. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis were observed in 20 (12%) and 9 (7.7%) of these patients, respectively. Autoimmune hepatitis was observed in 2 patients. The definitive cause of cirrhosis was unclear in 68 (58%) of the patients. Incidental malignant and premalignant lesions were observed in 15 patients. CONCLUSIONS: Histopathological examination of the explanted liver after liver transplantation in those patients with cryptogenic cirrhosis may significantly help to diagnose the cause of cirrhosis, such as nonalcoholic steatohepatitis or autoimmune hepatitis, with using the scoring system developed by the International Autoimmune Hepatitis Workgroup. In addition, incidental malignant or premalignant lesions may be observed.

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OBJECTIVE: The aim of this work was to evaluate the clinical outcomes of donor hepatic artery to recipient replaced right hepatic artery anastomosis in living-donor liver transplantation. METHODS: A retrospective analysis of 12 patients with donor hepatic artery to recipient replaced right hepatic artery anastomosis in living-donor liver transplantation from January 2012 to July 2014 was performed. Age, sex, clinical diagnosis of the liver disease, ABO mismatch, hepatic artery thrombosis, biliary strictures and leakage, graft loss, and mortality rates were evaluated. RESULTS: Female-to-male ratio was 4:8. Right lobe was transplanted in 11 (91.7%) of the patients. In 1 patient, left lobe was transplanted. In 9 patients, single duct-to-duct biliary anastomosis was performed with cystic duct catheterization. In 2 patients, double duct-to-duct biliary anastomosis was performed. In 1 patient, double biliary duct-to-duct anastomosis was performed after ductoplasty to achieve a single ductal orifice. No hepatic artery thrombosis was observed. Biliary complications were observed in 6 patients (50%: biliary leaks in 2 patients, biliary stricture in 3 patients, and both in 1 patient). ABO mismatch was not observed. No graft loss due to hepatic artery thrombosis was observed. Mortality was observed in 2 patients (16.6%). CONCLUSIONS: Donor hepatic artery to recipient replaced right hepatic artery anastomosis in living-donor liver transplantation is somewhat related to biliary complications, but not associated with increased rates of hepatic artery thrombosis.

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BACKGROUND: Living-donor liver transplantation with inferior vena cava resection and reconstruction is rarely indicated for Budd-Chiari syndrome. The aim of this case presentation was to present and discuss the inferior vena cava reconstruction with the use of cadaveric aortic allograft after resection of the suprahepatic inferior vena cava in a patient with Budd-Chiari syndrome who was treated with living-donor liver transplantation. CASE REPORT: A 29-year-old male patient with end-stage liver disease and suprahepatic inferior vena cava obstruction was referred to our center. He was scheduled for living-donor liver transplantation. The suprahepatic inferior vena cava was resected and reconstruction was achieved by means of interposition of the cadaveric aortic allograft between the right atrium and inferior vena cava. Postoperative course was uneventful. DISCUSSION: Liver transplantation and vena cava reconstruction is indicated in some patients with end-stage liver disease and Budd-Chiari syndrome. Limitations in cadaveric organ donation may be compensated for with the use of living-donor liver. In this condition, various aspects of inferior vena cava reconstruction may be discussed. CONCLUSIONS: Budd-Chiari syndrome due to suprahepatic inferior vena cava obstruction close to the right atrium may be treated with vascular reconstruction with the use of a cadaveric aortic allograft.

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Metabolic syndrome (METs) and periodontal diseases are emerging worldwide community health problem. These common health problems may result with significant complications and increase community health expenses. METs is defined with the presence of hypertension, increased triglyceride levels, decreased high-density lipoprotein cholesterol levels, abdominal obesity and elevated fasting glucose levels. The term "periodontal diseases" defines pathological inflammatory conditions of the gingiva and supporting tooth structures. In this review, basic clinical features and associations between metabolic syndrome and periodontal diseases have been underlined. In addition, basic research topics have been noted.

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We have previously reported our experience in inferior vena cava resection and reconstruction techniques during liver transplantation for Budd-Chiari syndrome. Herein, we present on a case that demonstrates the importance of experience in complex vascular reconstruction techniques for living donor liver transplantation. A 15-year-old boy was scheduled for living donor liver transplantation for Budd-Chiari syndrome. Venous occlusion was extended up to the right atrial orifice of the supra-hepatic vena cava. Retro- and supra-hepatic segments of the vena cava was resected. Inferior vena cava graft stored in deep-freeze was available. Venous reconstruction was performed with end-to-end atrio-caval anastomosis. Surgical treatment was completed with the implantation of the right liver lobe donated by the patient's mother. Post-surgical course was uneventful.

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OBJECTIVE: The aim of this study was to evaluate the effect of dexmedetomidine (100 µg/kg-ip) on liver ischemia and reperfusion (I/R) in rats. METHODS: Twenty-four Wistar Albino rats were separated into three groups as control (C), ischemia-reperfusion injury (I/R) and dexmedetomidine group (I/R-D). Ischemia was induced with portal clampage for 45 minutes and reperfusion period was 45 minutes after declampage. Group I/R-D was received dexmedetomidine 100 µg/kg i.p. 30 min before portal clampage. Thiobarbutiric Acid-Reactive Substances (TBARS), glutathioneS-transferase (GST), superoxide dismutase (SOD), Catalase (CAT), and Paraoxonase 1 (PON-1) were investigated in blood samples. Also HSP60 and p53-positive hepatocytes were counted under ImageJ image analysis program. RESULTS: All parameters, except GST levels, were significant between the groups (p < 0.05). Although HSP60 expression was significantly increased between I/R, I/R-D and C groups there were no significant differences between I/R-D and C (p = 0.443). On the other hand, p53 expression was also significantly increased between I/R, I/R-D and C groups At the same time, there were no significant differences between I/R-D and C groups (p = 0.354). CONCLUSION: All the results suggest that dexmedetomidine has beneficial effects on liver ischemia/reperfusion stress (Tab. 1, Fig. 2, Ref. 49).

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