To evaluate association between duodenogastric reflux and early gastric mucosal changes before and after the cholecystectomy procedure. Patients were evaluated with preoperative and postoperative endoscopy and endoscopic biopsy. Demographic and clinical characteristics, histological parameters, presence of duodenogastric reflux, and Updated Sydney scores were noted. A total of fifty patients who obeyed the follow-up were enrolled into the study. Median age of the patients was 43 years (range 25–84). Male–female ratio was 0.51 (17/33). Duodenogastric reflux % and Updated Sydney scores before and after cholecystectomy were 24 (48%) versus 39 (78%) and 2.38 ± 2.21 versus 3.46 ± 3.05, respectively (p = 0.001, p < 0.000). Mucosal inflammation degree showed significant increase in 15 (30%) patients, decrease in 7 (14%) patients and equality in 28 (56%) patients (p = 0.037). Neutrophil activation degree was significantly higher in 21 (42%) patients, lower in 5 (10%) patients after the surgery (p = 0.005). Postoperative glandular atrophy degree was also higher in 13 (26%) patients and equal in 37 (74%) patients (p = 0.001). Pre- and postoperative degree of intestinal metaplasia and H. pylori density did not any show significant difference (p = 0.157, p = 0.248, respectively).There were significant positive correlation between postoperative H. pylori infection and mucosal activity, inflammation, atrophy and intestinal metaplasia. Cholecystectomy is a potent inducer of pathologic duodenogastric reflux. Early onset of duodenogastric reflux and underlying H. pylori gastritis cause early gastric mucosal injury following cholecystectomy procedure by interacting collectively.

In the present study we aimed to figure out the effect of metformin on the expression of AMPK-alpha, cyclin D1 and Tp53, and apoptosis in primary breast cancer cells (PBCCs). PBCCs were treated with two doses of metformin (0 mM, 25 mM). Proliferation was determined by BrdU assay. Real-time PCR was used to assess AMPK-alpha, cyclin D1, and Tp53 gene expressions; apoptotic indexes of PBCCs were analyzed using flow cytometry. 24 hour-incubation with 25 mM metformin reduced the proliferation of PBCCs. AMPK-alpha gene expression in PBCCs was not affected by 25 mM metformin treatment compared with the control group. PBCCs treated with 25 mM metformin had lower cyclin D1 expression compared with non-treated cells, however, the difference was not statistically significant. 25mM dose of metformin increased p53 expression significantly compared with the non-treated group. The high concentration of metformin elevated the number of Annexin V positive apoptotic cells, and the increase in the apoptotic index was statistically significant. Metformin can modulate cyclin D1 and p53 expression through AMPK-alpha independent mechanism in breast cancer cells, leading to cell proliferation inhibition and apoptosis induction.

Metastasis of renal cell carcinoma is seen in approximately 25% of all cases. Rarely, they can appear in unusual sites. Herein, we present a 40-year-old female patient with an itching scalp mass. The mass appeared one year after the nephrectomy performed for a right renal cell carcinoma. Computed tomography scans have not identified any metastasis during the postoperative evolution of the disease. We excised the mass with a large surgical margin under local anesthesia. Pathological examination of the lesion diagnosed metastasis of clear cell carcinoma. Our case is not just the rare metastatic site but also the fact that the tumor appeared despite its low grade (T2N0MO). Unfortunately, the prognosis of metastatic renal cell carcinoma (RCC) with skin metastasis is in most cases unfavorable. We believe that our case could add more information to the following measures, complete the frame of rare oncologic cases and consolidate the data published on the topic so far. Although skin metastases are a poor sign of progression, disease-free follow-up is possible after appropriate surgical excision.

Idiopathic granulomatous mastitis (IGM) is an immune-mediated inflammatory breast disease presenting significant treatment challenges due to its varied symptoms and lack of standardized guidelines. This study aims to evaluate the efficacy and safety of immunosuppressive modalities, including corticosteroids (CS) and immunosuppressive agents such as methotrexate (MTX) and azathioprine (AZA), in managing IGM, with a focus on recurrence rates and treatment outcomes. We conducted a retrospective analysis of 505 female patients diagnosed with IGM at the Bursa Uludag University Breast Surgery Clinic between January 2011 and December 2022. Patients received various treatments, including observation, CS therapy, MTX, AZA, and surgical interventions when necessary. Recurrence rates among different therapy groups were compared using chi-square tests, with Bonferroni correction applied for multiple comparisons. Of the total patients, 29.7% received first-line conservative therapy, while 70.3% required second or third-line immunosuppressive treatments. Among those who received immunosuppressive therapy (n = 355), CS therapy alone had the highest recurrence rate at 28.8%. The addition of MTX reduced the recurrence rate to 19.8%, but this reduction was not statistically significant (p = 0.143). AZA therapy significantly lowered recurrence rates, both when used alone (4.7%) and in combination with CS (9.1%) (p < 0.005). Patients treated with a combination of MTX and AZA had a recurrence rate of 4.8%. Overall, there were significant differences in recurrence rates among the therapy groups (χ² (4, N = 352) = 25.58, p < 0.001). AZA, whether used alone or in conjunction with other immunosuppressive agents, effectively reduces recurrence rates in IGM patients. These results support its use as an alternative to CS therapy in tailored treatment plans.