Alpaslan Terzi

Protective Effects of Nigella sativa against Ischemia-Reperfusion Injury of Kidneys

Background. Ischemia-reperfusion, commonly seen in the fields of trauma surgery and renal transplantation, is a major cause of acute kidney injury and is associated with significant morbidity and mortality. The protective effects of Nigella sativa against ischemia-perfusion damage to various organs have been previously documented. However, its protective effects on kidney tissue against ischemia-reperfusion injury are unclear. In this study, we aimed to examine the effect of Nigella sativa in modulating inflammation and apoptosis after renal I/R injury. Materials and methods. Thirty male Wistar-albino rats were divided into three groups: sham-operated, ischemia-reperfusion, and ischemia-reperfusion + Nigella sativa. Rats in the third group were given Nigella sativa 6 h prior to ischemia-reperfusion and at the beginning of reperfusion. All rats except those in the sham-operated group underwent 45 min of bilateral renal ischemia followed by 45 min of reperfusion. Blood samples and liver tissues were harvested from the rats, and then rats were sacrificed. Serum urea and creatinine levels were determined. Total antioxidant capacity (TAC), catalase (CAT), total oxidant status (TOS), oxidative stress index (OSI), and myeloperoxidase (MPO) in kidney tissue and blood were measured. Kidney tissue histopathology was also evaluated. Results. Nigella sativa was effective in reducing serum urea and creatinine levels as well as decreasing the tubular necrosis score. Nigella sativa treatment significantly reduced OSI and TOS levels and increased TAC levels in both kidney tissue and blood. Conclusion. The observed differences seem to demonstrate the protective effect of Nigella sativa against renal I/R injury in rat kidneys.

Protective Effects of Nigella Sativa on Intestinal Ischemia-Reperfusion Injury in Rats

ABSTRACT Background: In previous studies, it has been demonstrated that Nigella Sativa (NS) has protective effects against ischemia reperfusion injury on various organs. However, its protective effects on intestinal tissue against ischemia reperfusion injury are unclear. We aimed to determine whether NS prevents intestinal ischemia- reperfusion injury in rats. Materials and Methods: Thirty rats were divided into three groups as sham (group 1), control (group 2), and NS-treatment group (group 3). All rats underwent intestinal ischemia for 60 min followed by a 60-min period of reperfusion. Rats were intraperitoneally infused only 0.9%% saline solutions in group 2. Rats in the group 3 received NS (0,2 mL/kg) intraperitoneally, before ischemia and before reperfusion. Total antioxidant capacity (TAC), catalase (CAT), total oxidative status (TOS), oxidative stress index (OSI), and myeloperoxidase (MPO) in ileum tissue were measured. Also, ileum tissue histopathology was evaluated by a light microscope. Results: The levels of liver enzymes in group 3 were significantly lower than those in group 2 (p <.01). TAC and CAT activity levels in ileum tissue were significantly higher in group 3 than in group 2. TOS, OSI, and MPO in ileum tissue were significantly lower in group 3 than group 2 (p <.05 for TOS and MPO; p < .01 for OSI). Histological tissue damage was milder in the NS treatment group than in the control group. Conclusion: Our results suggest that NS treatment protected the rats intestinal tissue against intestinal ischemia- reperfusion injury.

The efficacy of laparoscopic surgery in patients with peritonitis.

Background Laparoscopy is an essential part of our armamentarium in certain conditions and has been recently begun to be used on acute abdominal peritonitis effectively and frequently by surgeons. But, there is still a debate on laparoscopic management of surgical emergencies. The aim of the current study is to evaluate the safety and efficiency of laparoscopy and its role in patients with acute abdominal emergencies retrospectively. Materials and Methods From May 2002 to May 2006, 147 patients with provisional diagnosis of acute abdomen were operated laparoscopically (68 suspected lower quadrant peritonitis, 17 gastroduodenal perforated ulcers, and 62 cholecystitis). Results A definitive diagnosis was accomplished in 93.1% (137 patients) of the cases and 85.7% (126) of the patients were successfully treated by emergent laparoscopy. An unnecessary laparotomy was avoided in 17.0% (24 women and 1 man) of the patients. The conversion rate was 14.2%. The morbidity rate was 4.0% with a postoperative mortality rate of 0.68%. After a mean period of 16.2 months, postoperative evolutions of patients were satisfactory. Conclusions Laparoscopic surgery, with high diagnostic accuracy and therapeutic capabilities, can be safely and effectively applied to the patients with acute abdominal emergencies in experienced hands. We believe that laparoscopy is a valuable way to prevent unnecessary laparotomies when routine investigations fail to identify the cause. This technique can be widely used in abdominal emergencies with increasing experience, but further studies are required to definitively establish its role in acute abdominal disorders.

Natal cleft deeper in patients with pilonidal sinus: implications for choice of surgical procedure.

PURPOSE: The study was planned to evaluate the depth of natal cleft in patients with pilonidal sinus disease and in healthy persons. METHODS: The study included 50 patients with pilonidal sinus disease and 51 volunteers. Data including body mass index and natal cleft depth were recorded. Natal cleft depth was measured in millimeters by using a caliper instrument. Data were evaluated with the use of the statistical package program (SPSS) with a chi-squared test analysis. P < 0.01 was evaluated as significant. RESULTS: There was no discernable difference in age, occupation, and sex between the groups. The mean natal cleft depth was 27.06 mm in the pilonidal sinus group and 21.07 in the nonpilonidal sinus group. The differences between the two groups were statistically significant (P < 0.01) for natal cleft depth. The mean body mass index was 25.71 in the pilonidal sinus group and 25.28 in the nonpilonidal sinus group. The difference between groups was statistically insignificant for body mass index. CONCLUSIONS: The natal cleft of patients with pilonidal sinus disease is deeper than the natal cleft of members of the volunteer group.

The effect of caffeic acid phenethyl ester (CAPE) against cholestatic liver injury in rats.

OBJECTIVES Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. METHODS Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 micromol/kg) intraperitoneally daily throughout 14 d. RESULTS Data showed a decrease in gamma glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin-1alpha (IL-1alpha) and interleukin-6 (IL-6) were significantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation. CONCLUSION These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necro-inflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury.

Protective effects of resveratrol on small intestines against intestinal ischemia–reperfusion injury in rats

Background and Aim:  The aim of this study was to determine whether resveratrol could prevent intestinal tissue injury induced by ischemia–reperfusion (I/R).

Surgical treatment of complicated pilonidal disease: limited separate elliptical excision with primary closure.

Objective  We aimed at treating complicated pilonidal sinus (PS) patients by a simple and effective surgical procedure.

A case series of 46 appendectomies during pregnancy

ZusammenfassungZIEL DER ARBEIT: Von den Patienten mit Appendizitis sind nur wenige schwanger. Bei Schwangeren ist die Diagnose und das Management einer akuten Appendizitis oft schwierig. Wir haben versucht, an Hand unserer Serie von schwangeren Patientinnen mit akuter Appendizitis diese Schwierigkeiten zu durchleuchten. STUDIEN DESIGN: Die vorliegende Studie umfasst 46 schwangere Patientinnen, die von 2006 – 2009 nach Diagnosestellung einer akuten Appendizitis in unserer Klinik operiert wurden. Folgende Daten wurden retrospektiv aus den Krankengeschichten erhoben: Alter, Zeit bis zur Diagnose, Leukozytenzahl, Schwangerschaftsalter, Schwangerschaftsanamnese, Morbidität, Mortalität und Ergebnisse der Pathologie. ERGEBNISSE: Das mittlere Alter der Patieninnen lag bei 26 Jahren, das Schwangerschaftsalter bei 21 und die Zahl früherer Schwangerschaften im Mittel bei 2,6. Die Dauer vom Auftreten der ersten Symptome bis zur Aufnahme ins Spital lag bei ungefähr 40 Stunden (6–120 Stunden). Die mittlere Dauer von der Aufnahme bis zur Operation lag im Mittel bei 5.89 (range 1–32) Stunden. Die Perforationsrate lag bei unseren Fällen bei 21%, die Rate negativer Appendektomien bei 13%. Die Perforationsrate war signifikant mit einem fortgeschrittenen Schwangerschaftsalter (p ≤ 0.001) und einer verzögerten Spitalsaufnahme korreliert (p = 0.027). SCHLUSSFOLGERUNGEN: Die Diagnose einer Appendizitis ist während der Schwangerschaft schwierig – die Perforationsrate ist hoch. Wir empfehlen daher die Durchführung einer Appendektomie unmittelbar im Anschluss an den Kaiserschnitt.SummaryOBJECTIVE: Among appendicitis patients pregnant ones occupy only a small proportion. Still there are difficulties in the diagnosis and management of the acute appendicitis in pregnant population. We tried to find answers to these difficulties with our acute appendicitis cases in pregnant patients. STUDY DESIGN: This study involved 46 pregnant patients who received an operation following diagnosis of acute appendicitis in our clinic from 2006 to 2009. Data were collected retrospectively from medical records. Age, time delay to diagnosis, leukocyte count (WBC), gestational age, gestational history, morbidity-mortality and pathology results were evaluated. RESULTS: The mean age of patients, gestational age and number of prior pregnancies were 26, 21 and 2.6, respectively. The amount of time spent in the hospital, from presentation of first symptom to admission, was approximately 40 hours (range 6–120). The mean time from admission to operation was 5.89 (range 1–32) hours. The perforation rate among our cases was 21%. The negative appendectomy rate was 13%. The perforation rate was associated with advanced gestational age and delayed admission to the hospital (p ≤ 0.001 and p = 0.027, respectively). CONCLUSION: The diagnosis of appendicitis in pregnancy is difficult, and the perforation rate is high. Particularly in term pregnancies, we recommend performing appendectomy immediately after cesarean section.

A rare cause of difficulty with sexual intercourse: large retroperitoneal leiomyoma.

INTRODUCTION The prevalence of sexual dysfunction is high among women; however, sexual dysfunction secondary to anatomical deformity in women is rare. In addition, primary retroperitoneal leiomyomas are very rare clinical conditions. AIM To present a case with sexual dysfunction secondary to anatomical deformity. METHODS In this article, we report the case of a large retroperitoneal leiomyoma causing sexual dysfunction. RESULTS After the surgical removal of the large retroperitoneal mass, previous intercourse difficulties had been resolved. CONCLUSIONS Retroperitoneal tumors may obstruct the vagina by congesting the pelvic area and may be considered as a possible cause of female sexual dysfunction.

Protective Effect of Micronized Purified Flavonoid Fraction on Ischemia/Reperfusion Injury of Rat Liver

BACKGROUND Flavonoids have been subjected to considerable investigation because of its antioxidant and anti-inflammatory properties. However, there is no previously reported study about its effect on hepatic ischemia/reperfusion (I/R). We investigated the effects of micronized purified flavonoid fraction (MPFF) on hepatic I/R injury in rats. METHODS Thirty rats were recruited in the study as follows: group A, sham operation (n = 10); group B, I/R (n = 10); and group C, I/R+MPFF (n = 10). In group C, rats received (80 mg/kg/day) MPFF by gavage for 3 days before surgery, 30 minutes before ischemia and just before the reperfusion. Blood samples were taken, and serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels were measured to assess liver functions. Liver tissues were taken for histological evaluation and to determine the total antioxidant capacity (TAC), catalase (CAT), total oxidant status (TOS), oxidative stress index (OSI), and myeloperoxidase (MPO). RESULTS The present data showed a decrease in AST, ALT, and LDH levels in the MPFF-treated rats when compared with I/R group rats (P < .001 for all). In the MPFF-treated rats, tissue levels of TOS, OSI, and MPO were significantly lower than those in the I/R group (P < .01, P < .001, and P < .05, respectively). Increases in TAC and CAT levels were statistically significant in the MPFF-treated rats compared with the I/R group (P = .01 for both). On the other hand, MPFF attenuated histological alterations that were induced by I/R. CONCLUSIONS The present study demonstrates that MPFF ameliorates I/R-induced liver damage, probably through antioxidant and anti-inflammatory properties.