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Growth hormone is known to affect healing on the postoperative patient. The aim of the present experimental study was to evaluate the effect of systematic infusion of growth hormone on the healing of colonic anastomoses in rats.Fourty Albino-Wistar male rats were randomly divided into two groups, a control group (CONTROL) and a growth hormone (GH) group. In both groups, an end-to-end colonic anastomosis was performed after segmental resection. In the CONTROL group, 1 cc saline was administered subcutaneously in the experimental animals' necks in two equal doses daily until the sixth postoperative day. In the GH group, rats were administered a growth hormone solution (2 mg/kg b.w.) in an amount of 1 cc subcutaneously in their necks in two equal doses daily until the sixth postoperative day. Rats were sacrificed on the seventh postoperative day. Anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded and hydroxyproline was evaluated.No deaths or wound infections were observed until the sacrifice. Bodyweight was significantly increased in the GH group until the seventh postoperative day (p = 0.005). Bursting pressures (p = 0.0025), adhesion formation (p=0.0019), hydroxyproline concentrations (p = 0.007) were significantly higher in the GH group than in the control group. Also GH lead to decreased inflammation (p0.001), but increased neoangiogenesis (p0.001), fibroblast activity (p = 0.001) and collagen deposition (p0.001).Growth hormone, when applied systematically in rats with colonic anastomoses, promotes their healing in rats. Therefore, the application of growth hormone in colonic anastomoses leads to better outcomes.Adhesion, Bursting pressure, Collagen, Hydroxyproline, Inflammation, Neoangiogenesis.è noto che l’ormone della crescita influisce sulla guarigione del paziente postoperatorio. Lo scopo del presente studio sperimentale era di valutare l’effetto dell’infusione sistematica dell’ormone della crescita sulla guarigione delle anastomosi del colon nei ratti.Quaranta ratti maschi Albino-Wistar sono stati divisi casualmente in due gruppi, un gruppo di controllo (CONTROL) e un gruppo di ormone della crescita (GH). In entrambi i gruppi è stata eseguita un’anastomosi del colon end-to-end dopo resezione segmentale. Nel gruppo CONTROL, 1 cc di soluzione salina è stato somministrato per via sottocutanea nel collo degli animali da esperimento in due dosi uguali al giorno fino al sesto giorno postoperatorio. Nel gruppo GROWTH HORMONE (GH), ai ratti è stata somministrata una soluzione GH (2 mg / kg di peso corporeo) in una quantità di 1 cc sottocutanea nel collo in due dosi uguali al giorno fino al sesto giorno postoperatorio. I ratti sono stati sacrificati il settimo giorno postoperatorio. Le anastomosi sono state resecate ed esaminate macroscopicamente. Sono state calcolate le pressioni di scoppio, sono state classificate le caratteristiche istologiche ed è stata valutata l’idrossiprolina.Nessuna morte o infezione della ferita è stata osservata fino al sacrificio. Il peso corporeo è risultato aumentato significativamente nel gruppo GH fino al settimo giorno postoperatorio (p = 0,005). Le pressioni di scoppio (p = 0,0025), la formazione di aderenza (p = 0,0019), le concentrazioni di idrossiprolina (p = 0,007) sono risultate significativamente più elevate nel gruppo GH rispetto al gruppo di controllo. Il GH porta anche ad una riduzione dell’infiammazione (p0,001), ma a un aumento della neoangiogenesi (p0,001), dell’attività dei fibroblasti (p = 0,001) e alla deposizione di collagene (p0,001).L’ormone della crescita, quando applicato su anastomosi del colon, promuove la loro guarigione nei ratti. Pertanto, l’applicazione dell’ormone della crescita nelle anastomosi del colon porta a risultati migliori.

Σκοπός της παρούσας πειραματικής μελέτης ήταν η εκτίμηση της αποτελεσματικότητας της συγχορήγησης συμβιοτικών και Ω-3 λιπαρών οξέων στις μακροσκοπικές και ιστοπαθολογικές αλλοιώσεις σε πειραματική κολίτιδα με άλας του θειοδεξτρανικού νατρίου (DSS) σε επίμυες στελέχους Wistar. Υλικό και Μέθοδοι. 72 άρρενες επίμυες τυχαιοποιήθηκαν σε τέσσερις ομάδες των 18 πειραματόζωων. Σε κάθε ομάδα χορηγήθηκε 5% DSS μαζί με το πόσιμο νερό για 8 ημέρες. Μετά το πέρας των 8 ημερών διακόπηκε η χορήγηση του DSS και δύο πειραματόζωα από κάθε ομάδα θυσιάστηκαν για την ιστοπαθολογική επιβεβαίωση της κολίτιδας. Για τις υπόλοιπες 8 ημέρες στα πειραματόζωα της ομάδας Α χορηγήθηκε μόνο πόσιμο νερό, στα πειραματόζωα της ομάδας Β χορηγήθηκε σκεύασμα συμβιοτικών, στα πειραματόζωα της ομάδας Γ χορηγήθηκε δίαιτα πλούσια σε Ω-3 λιπαρά οξέα και στα πειραματόζωα της ομάδας Δ χορηγήθηκε σκεύασμα συμβιοτικών και δίαιτα πλούσια σε Ω-3 λιπαρά οξέα. Εν συνεχεία, εκτελέστηκαν δύο θυσίες την 4η και 8η μέρα μετά την θεραπευτική αγωγή σε όλες τις ομάδες και το παρασκεύασμα του κατιόντος κόλου εξετάζονταν μακροσκοπικά και ιστοπαθολογικά. Κατά την λαπαροτομία ελήφθησαν υπό άσηπτες συνθήκες παρασκευάσματα από το λοβό του ήπατος και από τους μεσεντέριους λεμφαδένες για την αξιολόγηση της βακτηριακής μετεγκατάστασης. Αποτελέσματα. Οκτώ ημέρες μετά τη χορήγηση 5% άλας του θειοδεξτρανικού νατρίου-DSS σε όλες τις ομάδες, ο εντερικός βλεννογόνος εμφανίστηκε οιδηματώδης με παρουσία αιμορραγικών αλλοιώσεων σε όλο το μήκος του κόλου. Μετά τη χορήγηση θεραπείας για 8 ημέρες το μέσο σωματικό βάρος στην ομάδα ελέγχου αυξήθηκε ελάχιστα. Ωστόσο, μετά το πέρας 8 ημερών θεραπείας της κολίτιδας το μέσο σωματικό βάρος αυξήθηκε στατιστικώς σημαντικά στην ομάδα Δ σε σχέση με τις άλλες ομάδες (P

The objective of the study was to estimate the effects of synbiotics on laboratory, macroscopic, and histopathologic features in dextran sulfate sodium (DSS) experimental colitis.A total of 40 Wistar rats received 5% of DSS in their drinking water for 8 days to induce ulcerative colitis (UC). Eight rats were sacrificed to confirm the presence of UC. The remaining rats were randomly assigned to two groups: the synbiotics group, which received synbiotics once per day and the control group, which received tap water for another 8 days.On the 8Administration of synbiotics in the experimental UC results in an attenuation of mucosal inflammatory neutrophil infiltration and an increase in HT.Estimar los efectos de los simbióticos en la colitis experimental causada por dextrano sulfato de sodio (DSS).Cuarenta ratas Wistar recibieron DSS al 5% en su agua de beber por 8 días para inducir colitis ulcerosa (CU). Ocho ratas fueron sacrificadas para confirmar la presencia de CU. Las ratas restantes fueron asignadas aleatoriamente a dos grupos: un grupo que recibió simbióticos una vez al día y un grupo control que recibió agua del grifo por 8 días.En el octavo día de la administración de DSS los animales desarrollaron CU con diarrea sanguinolenta. En la mayoría de las variables hematológicas estudiadas (hemoglobina, glóbulos rojos, plaquetas, volumen corpuscular medio, hemoglobina corpuscular media), en el peso corporal y en la clasificación histopatológica de la CU no hubo diferencias significativas entre los grupos. Sin embargo, el grupo con simbióticos, en comparación con el grupo control, presentó una longitud del colon más larga en el cuarto día, un hematocrito muy aumentado en el octavo día y un número de células mieloperoxidasa positivas significativamente reducido en el octavo día. Además, hubo una tendencia hacia un mejoramiento histopatológico y clínico.La administración de simbióticos en la CU experimental tiene como resultado una atenuación de la infiltración inflamatoria de neutrófilos de la mucosa y un aumento del hematocrito.

Objective The objective of the study was to estimate the effects of synbiotics on laboratory, macroscopic, and histopathologic features in dextran sulfate sodium (DSS) experimental colitis. Materials and methods A total of 40 Wistar rats received 5% of DSS in their drinking water for 8 days to induce ulcerative colitis (UC). Eight rats were sacrificed to confirm the presence of UC. The remaining rats were randomly assigned to two groups: the synbiotics group, which received synbiotics once per day and the control group, which received tap water for another 8 days. Results On the 8th day of DSS administration animals developed UC with bloody diarrhea. In the majority of the hematologic variables studied (hemoglobin [HB], red blood cells, platelets, mean corpuscular volume, and mean corpuscular HB), in bodyweight and histopathologic colitis score there was no significant difference between groups. However, the synbiotics group, compared to control, presented a significantly greater colon length on the 4th day, significantly increased hematocrit (HT) on the 8th day, and a significantly decreased number of myeloperoxidase positive cells on the 8th day. Furthermore, there was a trend toward histopathological and clinical improvement. Conclusions Administration of synbiotics in the experimental UC results in an attenuation of mucosal inflammatory neutrophil infiltration and an increase in HT.

A 74-year-old man had a resultant large oval scalp defect of 12×6 cm (72 cm2) following an excision of a stage IIIA melanoma. We decided to cover the defect with the pinwheel flap, with the aim to provide a good cosmetic result, preservation of hair follicles and minimal donor-site morbidity. This local flap has been traditionally used for much smaller defects. Four L-shaped flaps were designed at equal distances on the vertical and horizontal axes of the defect. The L-shaped flap had a length of 1.5 times the half diameter of the defect (4.5 cm). The incision was made through galea aponeurosis and subsequently undermined at least 3 cm to assist flap advancement. Z-plasties increased the rotation of the flap when it was required. This yielded an excellent reconstructive result at 1-year follow-up, demonstrating the usefulness of the pinwheel flap in large defects on the scalp region.

Aims: There is increased prevalence of inguinal hernia (ΙΗ) in patients with abdominal aortic aneurysm (AAA). As there is limited data on AAA in patients with ΙΗ our objective was to examine the prevalence of AAA in such patients. Methods: We prospectively examined 185 consecutive patients for AAA who presented to our department for surgical repair of an ΙΗ. All patients were referred for ultrasound of the abdominal aorta. An AAA was considered to be present when the distal diameter of the abdominal aorta was over 3 cm. Patients with no AAA were followed annually with an abdominal ultrasound for 5 years. Results: Out of the 185 patients (179 males, 6 females) aged from 35-81 (mean 58.6 years), AAA initially appeared in 28 patients with a mean age 61.2 years old. The range of the aortic distal diameter was between 3.4 and 8.1 cm with a mean diameter of 4.8 cm in patients with AAA. The prevalence of the ΑΑΑ was increased in smokers, with hypertension and with bilateral and direct hernia. At the end of the 5 years follow-up, 16 more patients had developed an AAA of mean diameter 3.2 cm (3-4.1 cm), increasing the prevalence of AAA to 27.7%. Conclusion: There is an increased prevalence of AAA in patients with ΙΗ, especially in smokers, with hypertension and with bilateral and/or direct hernia. Hence, periodic ultrasonound may play an important role in screening and early diagnosis of AAA in these patients.

Venous aneurysms are rare lesions and of little significance in every day clinical practice. While in many cases asymptomatic they can be the cause of great morbidity due to thrombosis and subsequent possibility of pulmonary embolism. Venous aneurysms are classified in deep and superficial according to affected vein. The diagnosis is based mainly on Doppler ultrasound, while computed tomography, magnetic resonance imaging and venography provide more details. Treatment of venous aneurysms should be surgical. We present a case of a double aneurysm of the lesser saphenous vein which according to our knowledge is the first case reported in literature.Superficial veins, Varices, Venous.Gli aneurismi venosi sono rari e di scarso impatto nella pratica clinica quotidiana. Mentre in molti casi sono asintomatici possono però essere la causa di grave patologia in caso di trombosi e causa successivamente di embolia polmonare. Gli aneurismi venosi sono classificati in profondi e superficilai a seconda della vena colpita. La diagnosi di basa essenzialmente sull’ecografia Doppler, mentre la tomografia computerizzata, l’imaging per risonanza magnetica e la flebografia forniscono maggiori dettagli. Il trattamento di questi aneurismi deve essere chirurgico. Presentiamo qui un caso di duplice aneurisma della vena piccola safena, che per quanto ci risulta è il primo caso affidato alla letteratura.

Background: Gallbladder cancer (GC) is a rare neoplasm associated with high mortality and poor prognosis. It is usually correlated with cholelithiasis and presents more commonly in elderly and female patients. Diagnosis is seldom made preoperatively because of the indolent progression of the tumor. Methods: The hospitalization and surgical records of our surgical department were examined from January 1992 to December 2001, searching for patients who had undergone cholecystectomy. Additionally, the histopathological diagnoses of the same period were studied by searching for patients with the diagnosis of gallbladder cancer established postoperatively and not intraoperatively by frozen section. Results: In the period of 1992 – 2001, a total of 1536 cholecystectomies took place and 14 cases of gallbladder cancer were diagnosed postoperatively. The ratio of men to women is 3/11 with a mean age of 69.4 years. The clinical symptoms were non-specific and mortality was 57%. Conclusion: In most cases gallbladder cancer is diagnosed after cholecystectomy and even in these cases it can be in an advanced stage and the prognosis of this rare neoplasm is poor.

Crohn’s disease and ulcerative colitis represent distinct phenotypic forms of inflammatory bowel disease and continue to be a common cause of morbidity. The corticosteroids and the immunomodulatory drugs, which are the basis of treatment for the inflammatory bowel diseases, do not assure always satisfactory outcomes. Nutrition has been used in order to modify the inflammatory response of various chronic inflammatory diseases, including Crohn’s disease and ulcerative colitis. In the pathogenesis of inflammatory bowel diseases, the intestinal microflora and the intestinal mucosal disorders play a crucial role. Also, the release of reactive oxygen species is a significant factor of initiation and preservation of the inflammatory reaction in these diseases. The advantages of the nutritional treatment derive from the sequestration of intraluminal agents which may promote the inflammatory bowel response or, alternatively, nutrition is able to modify the immune response, reducing the uncontrolled inflammatory reaction. Furthermore, nutrition can enhance the mucosal barrier function and consists a significant source of antioxidants. This review focuses on certain nutritional components that modulate the inflammatory response of the bowel and aims to present a rational thesis regarding the use of nutritional agents in the management of inflammatory bowel diseases.

Purpose omega 3 polyunsaturated fatty acids have anti-inflammatory properties and can be beneficial in the treatment of inflammatory diseases, such as ulcerative colitis. Dextran sodium sulphate (DSS) colitis in rats appears to mimic nearly all of the morphological characteristics and lesion distributions of ulcerative colitis. The purpose of the current study was to investigate the efficacy of omega 3 fatty acids in the treatment of experimental ulcerative colitis. Methods thirty-six Wistar rats were randomly assigned to group A or group B receiving 5% dextran sulfate sodium (DSS) in their drinking water for eight days. For the next eight days post-DSS, group A animals received tap-water, and group B animals were fed a nutritional solution containing high levels of omega 3 polyunsaturated fatty acids (ProSure®, Abbott Laboratories, Zwolle, Netherlands) once per day, administrated with a orogastric feeding tube. Results animals fed an omega 3 rich diet exhibited a statistically significant increase in hematocrit and hemoglobin levels, compared to animals drinking tap water, and a trend towards histopathological and clinical improvement, with the administration of omega 3 fatty acids ameliorating epithelial erosion by day 8 post-DSS, but no statistically significant difference was observed between group A and group B animals at 4 or 8 days post-DSS. Also, a statistically significant increase in neutrophil infiltration was observed, as depicted by myelohyperoxidase activity. Conclusion our findings support a positive role of omega 3 polyunsaturated fatty acids supplementation in an experimental model of ulcerative colitis despite the increased colonic neutrophil infiltration. Further studies are needed in order to investigate the role of increased neutrophils in colonic mucosa.

Background: Cutaneous plasmacytoma is a very rare manifestation of extramedullary plasmacytoma, with only 32 cases having been reported so far in the last 60 years. Extramedullary plasmacytoma is a plasma cell tumor that involves soft tissues, without any signs of systemic spread of multiple myeloma or bone marrow involvement. The cutaneous lesions usually range in diameter from 1 to 5 cm and can be treated with radiotherapy or surgical excision. Objective and Conclusion: We present a case of a giant cutaneous plasmacytoma of the sacrococcygeal region with a diameter of 12 cm that was treated with surgical excision.