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    The effect of fundus resection on weight loss and ghrelin levels in rats
    (Comenius Univ, 2016) Okus, A.; Sevinc, B.; Karahan, O.; Ay, S.; Civcik, S.
    BACKGROUND: Ghrelin is a 28-amino acid peptide that is isolated mainly from the oxyntic glands of the stomach, especially fundus. Ghrelin administration, either centrally or peripherally, increases food intake and body weight in both rodents and humans. This study evaluates the effects of fundus resection and sclerosing agent injection on ghrelin level and weight loss. MATERIAL AND METHODS: Thirty rats were divided into three groups. In group 1, NaCl was injected into the submucosal space at the gastric fundus while in Group 2, a sclerosing agent was injected into the latter site. In group 3, gastric fundus was resected. Ghrelin levels and weight were recorded. RESULTS: In group 1, rats continued gaining weight and ghrelin levels stayed stable. In group 2, rats' weight and ghrelin levels stayed stable and in group 3, while weight stayed stable, ghrelin levels decreased significantly. CONCLUSION: In rats, the resection of fundus stabilizes weight gain and decreases ghrelin levels. However, in sclerotherapy, although weight gain was stabilized, there was no decrease in ghrelin levels. In humans, the effect of fundus resection on weight gain can usher in a new era of investigation (Tab. 2, Ref. 16). Text in PDF www.elis.sk.
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    Three complications of pair (puncture, aspiration, injection, reaspiration) in one case: Recurrent hemobilia, cyst infection and pneumonia
    (Elsevier Sci Ltd, 2015) Sevinc, B.; Karahan, O.; Bakdik, S.; Aksoy, N.; Eryilmaz, M. A.
    INTRODUCTION: With the appropriate indications, puncture, aspiration, injection and reaspiration (PAIR) is the most effective minimal invasive method used in the treatment of hydatic cysts. Hemobilia is the hemorrhagia in bile ducts in consequence of any reason. In literature there is no case with hemobilia because of PAIR. This is the first case with recurrent hemobilia, infection in cyst cavity and pneumonia because of PAIR. CASE: A 66 years old female patient was admitted to hospital with complaints of abdominal pain, hematemesis and melaena. She gave the history of PAIR for two hydatic cysts. At physical examination, there were jaundice, tenderness at right subcostal area and melaena at rectal digital examination. Hemobilia was detected by abdominal ultrasonography and magnetic resonance cholangiopancreaticography (MRCP). An endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic sphincterotomy were performed. The patient was discharged after 6 days hospital stay. One day after the discharge the patient was admitted to hospital with the same complaints again. Performing ERCP and balloon extraction, the hematoma filling the common bile duct was removed. After the patient was hemodynamically stable for 3 days, she was discharged from the hospital. A week after that the patient was admitted to hospital with the clinical findings of infected hydatic cyst and pneumonia. The patient was treated medically with mechanical ventilation support for 8 days. CONCLUSION: It should not be underestimated that, there can be serious complications of PAIR like hemobilia. Therefore, PAIR should be performed only in centers having appropriate medical and surgical facilities. (C) 2015 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.