Injury of the rectum with intact anal sphincter is an extremely rare but very serious complication of vaginal delivery. It is also called a "buttonhole" tear.
We present two cases of "buttonhole" ...tear/injury.
In one case, the injury was recognized at the time of delivery and adequately treated. In the other case the injury was not diagnosed on time and the patient was treated for complications on the 6th postpartal day.
The consequences for the wellbeing of young mothers with perineal injury can be serious and affect social and sexual aspects of their lives. Adequate surgical treatment and postoperative care assure optimal results and prevent long term complications such as fistulas or fecal incontinence.
Traditionally, probiotics are linked to the good health of the intestine and most clinical studies focus on that field. Evidence of oral probiotic use for ear and oral cavity disease prevention with ...impact on human health is limited. This work reviews existing studies and literature on
Streptococcus salivarius
K12 as an oral probiotic and effects of
S
.
salivarius
K12 on human ear and oral cavity human health. The studies were accessed via database searches: MEDLINE, PubMed, and Elsevier. The search included/focused on/encompassed publications from 2003 to 2016 with keywords related to K12
Streptococcus salivarius
, bacteriocin-like inhibitory substances (BLIS) K12, probiotic K12
salivarius
, and K12 probiotic health effects. Only a small amount of studies was identified: the total of 68 studies was identified, 35 of which were relevant after screening, and 9 were included in the final analysis. Very little literature is available about the association/correlation between/connection/interrelation of
S
.
salivarius
K12 with/and human ear and oral cavity health.
S
.
salivarius
K12 may have a role in reducing the occurrence and/or severity of secretory otitis media (SOM) and also in prevention of streptococcal and viral pharyngotonsillitis in children. Research highlights that
S
.
salivarius
K12 has shown promising results in treatment of halitosis, but data are still deficient. Further studies need to be initiated to improve understanding of the association of oral probiotic
S
.
salivarius
K12 with human ear and oral cavity health.
Background: Injury of the rectum with intact anal sphincter is an extremely rare but very serious complication of vaginal delivery. It is also called a "buttonhole" tear. Case: We present two cases ...of "buttonhole" tear/injury. Results: In one case, the injury was recognized at the time of delivery and adequately treated. In the other case the injury was not diagnosed on time and the patient was treated for complications on the 6th postpartal day. Conclusion: The consequences for the wellbeing of young mothers with perineal injury can be serious and affect social and sexual aspects of their lives. Adequate surgical treatment and postoperative care assure optimal results and prevent long term complications such as fistulas or fecal incontinence. Key words: fourth degree perineal laceration; "buttonhole" tear; perineal injury. Pozadina: Ozljeda rektuma s intaktnim analnim sfinkterom je izrazito rijetka no vrlo ozbiljna komplikacija vaginalnog poroda. To se takoder naziva ,,buttonhole" razdor. Slucaj: Predstavljamo dva slucaja ,,buttonhole" razdora. Rezultati: U jednom je slucaju ozljeda primijecena pri porodu te prikladno zbrinuta. U drugom slucaju ozljeda nije diagnosticirana na vrijeme, pa je pacijent lijecen zbog komplikacija 6. dan nakon poroda. Zakljucak: Posljedice za zdravlje u mladih majki s perianalnom ozljedom mogu biti ozbiljne i utjecati na drustvene i seksualne aspekte njihovih zivota. Primjereno kirursko lijecenje i postoperativna njega osiguravaju optimalne rezultate i sprjecavaju dugorocne komplikacije kao sto su fistule ili fekalna inkontinencija. Kljucne rijeci: ozljeda medice cetvrtog stupnja, "buttonhole" ozljeda rektuma, ozljeda medice
Objectives: Cytokeratin 20 (CK20) is one of the most investigated markers for the detection of circulating colorectal cancer (CRC) cells by reverse transcription polymerase chain reaction (RT-PCR). ...The aim of this study was to evaluate prognostic value of RT-PCR detection of circulating CRC cells using CK20 as a marker, and to compare the value of preoperative and postoperative blood sample analysis for that purpose.
Methods: Ribonucleic acid (RNA) was isolated from mononuclear cell fraction of blood samples taken from 95 CRC patients before and after tumor resection and from 23 healthy volunteers and assayed by real-time RT-PCR for CK20 expression.
Results: In patients positive for CK20 postoperatively both progression-free survival (PFS) and overall survival were significantly shorter than in patients negative for CK20 postoperatively, while the difference between patients positive and negative for CK20 preoperatively was not statistically significant in terms of neither PFS nor overall survival.
Conclusion: Our results have shown prognostic value of circulating cancer cells detected in postoperative blood samples from CRC patients using CK20 as marker for RT-PCR, which has potential implications for treatment of these patients. In clinical practice, CK20 expression profile could be a factor in weighting treatment options in CRC patients. In cases where multiple treatment options are possible, patients with positive postoperative CK20 expression could be candidates to receive more aggressive treatment.
Twenty common genetic variants have been associated with risk of developing colorectal cancer (CRC) in genome wide association studies to date. Since large differences between populations exist, ...generalisability of findings to any specific population needs to be confirmed.
The aim of this study was to perform an association study between risk variants: rs10795668, rs16892766, rs3802842 and rs4939827 and CRC risk in Croatian population.
An association study was performed on 320 colorectal cancer cases and 594 controls recruited in Croatia. We genotyped four variants previously associated with CRC: rs10795668, rs16892766, rs3802842 and rs4939827.
SMAD7 variant rs4939827 (18q21.1) was significantly associated with CRC risk in Croatian population. C allele was associated with a decreased risk, odds ratio (OR): 0.70 (95% CI: 0.57-0.85, P=3.5E-04). Compared to TT homozygotes, risk was reduced by 34% in heterozygotes (OR=0.66, 95% CI: 0.47-0.92) and by 52% in CC homozygotes (OR=0.48, 95% CI: 0.33-0.72).
Our results show association of rs4939827 with colorectal cancer risk in Croatian population. The higher strength of the association in comparison to other studies suggests population-specific environmental or genetic factors may be modifying the association. More studies are needed to further describe role of rs4939827 in CRC. Likely reason for failure of replication for other 3 loci is inadequate study power.
The aim of this study was to analyze microphthalmia-associated transcription factor (MITF) as a marker for the detection of circulating melanoma cells, determine its prognostic value in melanoma ...patients, and compare it with tyrosinase. Blood samples from 201 melanoma patients in all stages of the disease and 40 healthy volunteers were analyzed. RNA was isolated from mononuclear cell fraction of the blood and assayed by reverse transcription-PCR for the expression of MITF and tyrosinase. All samples from healthy volunteers were negative for both MITF and tyrosinase. Out of 201 blood samples from melanoma patients 32 were positive for MITF, 20 for tyrosinase, and four for both MITF and tyrosinase. Analysis of MITF as an additional marker to tyrosinase allowed for detection of circulating melanoma cells in a larger number of melanoma patients in comparison to tyrosinase analysis alone (48 vs. 20 positive). A positive value of MITF was associated with shorter progression-free (P=0.005) and overall survival (P=0.042). A positive value of tyrosinase was associated with shorter overall survival (P=0.012), whereas there was no significant association between the value of tyrosinase and progression-free survival. The value of MITF was selected with multivariate analysis as the independent prognostic factor for progression-free survival, whereas the only independent prognostic factor for overall survival was the stage of disease. This study has shown that MITF is a specific marker for detection of circulating melanoma cells that has a prognostic value in melanoma patients. Determination of MITF in addition to tyrosinase improved the detection of circulating melanoma cells in melanoma patients.
To estimate the incidence and mortality trends of gastric and colorectal cancers in Croatia between 1988 and 2008.
Incidence data for the period 1988-2008 were obtained from the Croatian National ...Cancer Registry. The number of deaths from gastric and colorectal cancers were obtained from the World Health Organization mortality database. Joinpoint regression analysis was used to describe changes in trends by sex.
Gastric cancer incidence rates declined steadily during the study period, with estimated annual percent change (EAPC) of -3.2% for men and -2.8% for women. Mortality rates in men decreased, with EAPC of -5.0% from 1988-1995 and -2.5% from 1995-2008. Mortality rates in women decreased, with EAPC of -3.2% throughout the study period. For colorectal cancer in men, joinpoint analysis revealed increasing trends of both incidence (EAPC 2.9%) and mortality (EAPC 2.1%). In women, the increase in incidence was not significant, but mortality rates in the last 15 years showed a significant increase (EAPC 1.1%).
The incidence and mortality trends of gastric cancer in Croatia are similar to other European countries, while the still increasing colorectal cancer mortality calls for more efficient prevention and treatment.
Detection of circulating cancer cells by reverse transcription polymerase chain reaction (RT-PCR) has been studied as a prognostic marker in patients with colorectal cancer (CRC) but so far with ...conflicting results regarding specificity and prognostic value. In this study cytokeratin-20 (CK20) was evaluated by real-time RT-PCR as a marker for circulating CRC cell detection and the influence of surgical tumor resection on the presence of circulating CRC cells was analyzed.
RNA was isolated from the mononuclear cell fraction of blood samples taken from 95 CRC patients before and after tumor resection and from 23 healthy volunteers and assayed by real-time RT-PCR for CK20 expression.
Among 23 healthy volunteers one was positive for CK20. Among 95 CRC patients, 25 were positive for CK20 before and 23 after surgery. Sixteen patients positive before surgery became negative after surgery, while 14 patients negative before surgery became positive after surgery. An increase in the proportion of CK20-positive samples with increasing stage of disease was observed for preoperative but not postoperative blood samples.
Its association with clinical stage indicates that CK20 might have prognostic value as a marker for detection of circulating CRC cells. Surgical tumor resection can both reduce and induce the presence of circulating CRC cells.
Overexpression of p53 protein in malignancies induces an immune response in some cancer patients. We investigated whether production of serum antibodies against p53 (p53-Ab) is associated with ...pathohistological parameters of colorectal carcinoma and whether p53-Ab can serve as a tumor marker during cancer treatment.
Serum samples from 220 colorectal cancer patients during surgery and adjuvant chemotherapy and 42 healthy controls were tested for the presence of p53-Ab by ELISA. Expression of p53 protein in tumors was determined using mouse anti-human p53-Ab.
Serum p53-Ab were detected in 18% of patients while all controls were negative. A strong correlation between p53-Ab production and p53 protein expression was observed: 70% of p53-Ab positive cases had tumors positive for p53 vs. 52% of p53-Ab negative cases. There was also a significant predominance of p53-Ab positive cases in Dukes' stages B and C over stage A. Although surgery alone reduced p53-Ab levels, decreases in p53-Ab titer became significant midterm through chemotherapy compared to both pre- and postoperative values and remained decreased until the completion of treatment.
The presence of p53-Ab in sera of patients with colorectal cancer indicates tumors in more advanced histopathologic stages (Dukes' B, C). Due to low sensitivity (18%) p53-Ab are not recommendable as a preoperative marker for colorectal cancer. However, due to high specificity (100%), their monitoring after surgery and adjuvant chemotherapy has potential for early diagnosis of tumor relapse in p53-Ab positive cases.
Gallstone ileus with impaction of gallstone in distal duodenum is an extremely rare complication of cholecystolithiasis. Gallstone ileus in itself accounts for less than 1% of these complications ...with 800 cases described so far. However, there are less than 15 cases described with the impaction of gallstone in distal duodenum. We report a case of an 84-year-old male patient in whom gallstone impacted in distal duodenum was found by ultrasonography and confirmed by computed tomography. Cholecystitis and a remaining large gallstone in the gallbladder were found intraoperatively, which made us opt for one-step procedure, i.e. lithotomy and fistula repair with cholecystectomy. Due to the rare position of impacted gallstone, we believe that cases like this should be reported in detail in order to generate enough data for establishing optimal treatment options.